Interactions between Docetaxel and Vincasar PFS

DOCEtaxel has a moderate potential interaction with Alcoholism.

The alcohol content in a dose of docetaxel injection may affect the central nervous system. Cases of intoxication have been reported with some formulations of docetaxel due to the alcohol content. Close monitoring is recommended in alcoholic patients. Consideration should be given to the alcohol content in docetaxel injection on the ability to drive or use machines immediately after the infusion.

DOCEtaxel has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

The use of docetaxel is contraindicated in patients with a neutrophil count < 1500/mm3. Docetaxel induces dose-related myelosuppression resulting in neutropenia, thrombocytopenia, and anemia. Neutropenia occurs in all patients administered 60-100 mg/m2 of docetaxel. Grade 4 neutropenia (< 500/mm3) occurs in nearly all patients administered 100 mg/m2 of docetaxel. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, or local infection. Therapy should be administered cautiously to patients with compromised bone marrow reserve and should be withheld until neutrophil levels is > 1500/mm3 and/or platelet counts is > 100,000/mm3. A 25% reduction in dosage is recommended during subsequent cycles following severe neutropenia (< 500/mm3). It is recommended to performed frequent blood cell counts on all patients receiving docetaxel.

The vinCRIStine in Vincasar PFS has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.

Vincristine induces dose-related myelosuppression. Leukopenia, thrombocytopenia, and anemia have been reported, however vincristine does not appear to have a consistent or significant effect on platelets or red blood cells. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Therapy with vincristine should be administered cautiously in patients with compromised bone marrow reserve. Monitor complete blood counts prior to each dose. If Grade 3 or 4 neutropenia, thrombocytopenia, or anemia develops, consider a dose modification or reduction as well as supportive care measures.

The vinCRIStine in Vincasar PFS has a moderate potential interaction with Constipation.

Vincristine can cause constipation. Ileus, bowel obstruction, and colonic pseudo-obstruction have occurred. When using this agent in people at risk of constipation, appropriate measures should be instituted to prevent such complications. A routine prophylactic regimen against constipation is recommended for all patients receiving vincristine.

DOCEtaxel has a major potential interaction with Fever.

The use of docetaxel is contraindicated in patients with a neutrophil count < 1500/mm3. Docetaxel induces dose-related myelosuppression resulting in neutropenia, thrombocytopenia, and anemia. Neutropenia occurs in all patients administered 60-100 mg/m2 of docetaxel. Grade 4 neutropenia (< 500/mm3) occurs in nearly all patients administered 100 mg/m2 of docetaxel. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, or local infection. Therapy should be administered cautiously to patients with compromised bone marrow reserve and should be withheld until neutrophil levels is > 1500/mm3 and/or platelet counts is > 100,000/mm3. A 25% reduction in dosage is recommended during subsequent cycles following severe neutropenia (< 500/mm3). It is recommended to performed frequent blood cell counts on all patients receiving docetaxel.

The vinCRIStine in Vincasar PFS has a moderate potential interaction with Fever.

Vincristine induces dose-related myelosuppression. Leukopenia, thrombocytopenia, and anemia have been reported, however vincristine does not appear to have a consistent or significant effect on platelets or red blood cells. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Therapy with vincristine should be administered cautiously in patients with compromised bone marrow reserve. Monitor complete blood counts prior to each dose. If Grade 3 or 4 neutropenia, thrombocytopenia, or anemia develops, consider a dose modification or reduction as well as supportive care measures.

DOCEtaxel has a major potential interaction with Fluid Retention.

Severe fluid retention characterized by peripheral edema, generalized edema, pleural effusion, dyspnea at rest, cardiac tamponade, or abdominal distention due to ascites has been reported during docetaxel therapy. Therapy with docetaxel should be administered cautiously to patients adversely affected by fluid retention. Prophylaxis with a five day dexamethasone premedication regimen is recommended, however, fluid retention has occurred despite this pretreatment.

The vinCRIStine in Vincasar PFS has a moderate potential interaction with Gastrointestinal Obstruction.

Vincristine can cause constipation. Ileus, bowel obstruction, and colonic pseudo-obstruction have occurred. When using this agent in people at risk of constipation, appropriate measures should be instituted to prevent such complications. A routine prophylactic regimen against constipation is recommended for all patients receiving vincristine.

DOCEtaxel has a major potential interaction with Infection.

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

The vinCRIStine in Vincasar PFS has a moderate potential interaction with Infection.

Vincristine induces mild, dose-related myelosuppression. The use of vincristine may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during therapy with vincristine. Clinical monitoring of hematopoetic function is recommended.

DOCEtaxel has a major potential interaction with Liver Disease.

Docetaxel is extensively metabolized by the liver. Total body clearance of docetaxel has been reported to be reduced as much as 27% in patients with mild to moderate hepatic impairment resulting in a 38% increase of docetaxel serum concentration. Patients with elevated transaminase levels (>1.5 times the upper limits of normal) and alkaline phosphatase (>2.5 times the upper limits of normal) should not be administered docetaxel. The incidence of docetaxel related deaths is increased in patients with impaired hepatic function. Bilirubin, transaminase, and alkaline phosphatase levels should be obtained prior to each cycle of docetaxel therapy. Patients with combined abnormalities of transaminases and alkaline phosphatase should not be treated with this agent.

The vinCRIStine in Vincasar PFS has a moderate potential interaction with Liver Disease.

Vincristine is primarily metabolized by the liver. The influence of severe hepatic impairment on the safety and efficacy of vincristine has not been evaluated. Additionally, fatal liver toxicity and elevated levels of aspartate aminotransferase have occurred in clinical trials. Vincristine should be reduced or interrupted if there is evidence of hepatic toxicity. Therapy with vincristine should be administered cautiously and dosages reduced in patients with compromised hepatic function. Close clinical monitoring of hepatic function is recommended.

DOCEtaxel has a major potential interaction with Macular Edema.

Cystoid macular edema has been reported with the use of docetaxel. Patients with impaired vision should undergo a prompt and comprehensive ophthalmologic examination prior to therapy with this agent. If cystoid macular edema is diagnosed, treatment should be discontinued and appropriate treatment initiated. Alternative non-taxane cancer treatment should be considered.

The vinCRIStine in Vincasar PFS has a major potential interaction with Neurological Disorders.

The use of vincristine is contraindicated in patients with demyelinating conditions including Charcot-Marie-Tooth syndrome. Neurotoxicity associated with vincristine therapy is dose-related and frequently sequential. Sensorimotor (paresthesia, decreased deep- tendon reflex, ataxia, paralysis), autonomic (constipation and adynamic ileus), and CNS (mental status changes, seizures, coma) neurotoxicity have been reported. Patients with existing neuromuscular or neurologic diseases may be at increased risk for toxicity with vincristine therapy. Therapy with vincristine should be administered cautiously and dosage reduction considered in patients with neurologic dysfunction.

The vinCRIStine in Vincasar PFS has a major potential interaction with Peripheral Neuropathy.

The use of vincristine is contraindicated in patients with demyelinating conditions including Charcot-Marie-Tooth syndrome. Neurotoxicity associated with vincristine therapy is dose-related and frequently sequential. Sensorimotor (paresthesia, decreased deep- tendon reflex, ataxia, paralysis), autonomic (constipation and adynamic ileus), and CNS (mental status changes, seizures, coma) neurotoxicity have been reported. Patients with existing neuromuscular or neurologic diseases may be at increased risk for toxicity with vincristine therapy. Therapy with vincristine should be administered cautiously and dosage reduction considered in patients with neurologic dysfunction.

DOCEtaxel has a moderate potential interaction with Peripheral Neuropathy.

Severe neurosensory symptoms such as paresthesia, dysesthesia, and pain have been reported during docetaxel therapy. Therapy with docetaxel should be administered cautiously to patients with or predisposition to neurosensory symptoms. Although reversible with discontinuation of docetaxel therapy, the dosage must be adjusted if neurosensory symptoms occur and therapy discontinued if symptoms persist.

The vinCRIStine in Vincasar PFS has a major potential interaction with Pulmonary Impairment.

Acute shortness of breath and bronchospasm, some severe and life-threatening, have been reported with the use of vinca alkaloids. These reactions were observed most often during combination therapy with mitomycin C, occurring within minutes to several hours after administration of the vinca alkaloid or up to 2 weeks following the mitomycin dose. Therapy with vinca alkaloids should be administered cautiously in patients with preexisting pulmonary dysfunction. Aggressive treatment may be necessary, including use of supplemental oxygen, bronchodilators, and/or corticosteroids. In patients who develop progressive dyspnea requiring chronic therapy, vinca alkaloid should not be readministered.

The vinCRIStine in Vincasar PFS has a moderate potential interaction with Renal Dysfunction.

The influence of renal impairment on the safety, efficacy, and pharmacokinetics of vincristine has not been evaluated. Caution and monitoring of renal function is advised in patients with renal impairment.

The vinCRIStine in Vincasar PFS has a moderate potential interaction with SIADH.

A syndrome of sudden inappropriate antidiuretic hormone (SIADH) secretion has been reported rarely in association with the use of vincristine. Therapy with vincristine should be administered cautiously in patients with or predisposed to abnormal antidiuretic hormone release and/or suppression.