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Drug Interactions between dostarlimab and thalidomide

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

thalidomide dostarlimab

Applies to: thalidomide and dostarlimab

GENERALLY AVOID: Coadministration of thalidomide or its analogs with a programmed death receptor-1 (PD-1) or programmed death ligand-1 (PD-L1) blocking antibody may increase the risk of mortality in patients with multiple myeloma. The mechanism has not been established. In two randomized clinical trials of patients with multiple myeloma, the addition of pembrolizumab to a regimen of thalidomide analog plus dexamethasone resulted in increased mortality and toxicity. In the first trial (n=249), investigators reported a greater than 50% increase in relative risk of death in patients with relapsed and refractory multiple myeloma receiving pomalidomide and low-dose dexamethasone with pembrolizumab compared to controls receiving the treatment without pembrolizumab. There was also an 18% increase of severe, grade 3 to 5 toxicity and 17% increase of serious adverse events relative to the control arm. In the second trial (n=301), the relative risk of death was more than doubled in newly diagnosed patients with multiple myeloma receiving lenalidomide and low-dose dexamethasone with pembrolizumab compared to controls. The incidence of severe, grade 3 to 5 toxicity was increased by 22% and serious adverse events increased by 15% relative to controls.

MANAGEMENT: Concomitant use of a PD-1 or PD-L1 blocking antibody with thalidomide or a thalidomide analog plus dexamethasone in the treatment of multiple myeloma is not recommended outside of controlled clinical trials.

References

  1. (2001) "Product Information. Thalomid (thalidomide)." Celgene Corporation
  2. (2006) "Product Information. Revlimid (lenalidomide)." Celgene Corporation
  3. (2013) "Product Information. Pomalyst (pomalidomide)." QLT Phototherapeutics Inc
  4. (2014) "Product Information. Keytruda (pembrolizumab)." Merck & Co., Inc
  5. U.S. Food & Drug Administration (FDA) (2018) FDA alerts healthcare professionals and oncology clinical investigators about two clinical trials on hold evaluating KEYTRUDA (pembrolizumab) in patients with multiple myeloma. https://www.fda.gov/Drugs/DrugSafety/ucm574305.htm?source=govdelivery&utm_med
View all 5 references

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Drug and food interactions

Moderate

thalidomide food

Applies to: thalidomide

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
View all 4 references

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.