Can you take Eculizumab with Rituximab?

riTUXimab has a major potential interaction with Arrhythmia.

Cardiotoxicity has been reported in a few patients receiving rituximab infusion during clinical studies. Patients with a history of angina or arrhythmias have experienced recurrences of these conditions during administration of rituximab. Therapy with rituximab should be administered cautiously in patients with preexisting arrhythmias or coronary artery or ischemic heart disease. Clinical monitoring of cardiac function throughout infusion and immediately post-infusion is recommended.

riTUXimab has a major potential interaction with Autoimmune Disorders.

JC virus infection resulting in Progressive Multifocal Leukoencephalopathy (PML) and death can occur in rituximab-treated patients with hematologic malignancies or with autoimmune diseases. Consider the diagnosis of PML in any patient presenting with new-onset neurologic manifestations. Discontinue rituximab and consider discontinuation or reduction of any concomitant chemotherapy or immunosuppressive therapy in patients who develop PML.

riTUXimab has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.

Myelosuppression has been reported during administration of rituximab. Leukopenia and thrombocytopenia occur more frequently than anemia. Severe myelosuppression has been reported rarely. Therapy with rituximab should be administered cautiously in patients with severe bone marrow suppression. Clinical monitoring of hematopoietic function is recommended.

Eculizumab has a moderate potential interaction with History, Thrombotic/Thromboembolic Disorder.

Thrombotic microangiopathy (TMA) complications have occurred after treatment discontinuation or after a missed dose of eculizumab. It is recommended to monitor patients with atypical hemolytic uremic syndrome for signs and symptoms of thrombotic microangiopathy (TMA) complications for at least 12 weeks. If TMA complications occur after eculizumab discontinuation, consider reinstitution of treatment, plasma therapy or appropriate organ-specific supportive measures.

Eculizumab has a major potential interaction with Immunodeficiency.

Immunosuppressive agents may increase the risk of progressive multifocal leukoencephalopathy (PML). Certain agents are contraindicated in patients who have or have had PML. Patients receiving chronic immunosuppressant or immunomodulatory therapy or who have systemic medical conditions resulting in significantly compromised immune system function should not be treated with these agents. Health care professionals should monitor patients for any new sign or symptom suggestive of PML. Therapy dosing should be withheld immediately and an appropriate diagnostic evaluation should be performed at the first sign or symptom suggestive of PML.

Eculizumab has a moderate potential interaction with Immunodeficiency.

Eculizumab blocks terminal complement activation; therefore, patients may have increased susceptibility to infections, especially with encapsulated bacteria. Caution is advised when using this agent in immunocompromised and neutropenic patients as Aspergillus infections may occur. It is recommended to administer vaccinations for the prevention of Streptococcus pneumoniae and Haemophilus influenza type b (Hib) infections according to the Advisory Committee on Immunization Practices (ACIP) guidelines and to use caution when administering to patients with any systemic infection.

Eculizumab has a major potential interaction with Infection.

Serious and sometimes fatal infections have been reported in patients receiving immunosuppressive agents. Patients receiving immunosuppressants are at increased risk of developing bacterial, viral, fungal, and protozoal infections, and new or reactivated viral infections including opportunistic infections. Caution should be exercised when considering their use in patients with severe or chronic infections. It is recommended to interrupt therapy in patients who develop a new infection while undergoing treatment and to monitor these patients closely for any sign or symptom indicative of infection.

riTUXimab has a moderate potential interaction with Infection.

Rituximab can cause serious, including fatal, bacterial, fungal, and new or reactivated viral infections during and following the completion of rituximab-based therapy. Infections have been reported in some patients with prolonged hypogammaglobulinemia (defined as hypogammaglobulinemia >11 months after rituximab exposure). New or reactivated viral infections included cytomegalovirus, herpes simplex virus, parvovirus B19, varicella zoster virus, West Nile virus, and hepatitis B and C. The manufacturer recommends discontinuing rituximab for serious infections and institute appropriate anti-infective therapy.

Eculizumab has a major potential interaction with Infectious Gastroenteritis.

Eculizumab is contraindicated in patients with unresolved serious Neisseria meningitidis infection, in those who are not currently vaccinated against Neisseria meningitidis, unless the risks of delaying treatment outweigh the risks of developing a meningococcal infection. Life-threatening and fatal meningococcal infections have occurred in patients treated with eculizumab. The use of eculizumab increases a patient's susceptibility to serious meningococcal infections (septicemia and/or meningitis). Closely monitor patients for early signs and symptoms of meningococcal infection and evaluate patients immediately if an infection is suspected. Meningococcal infection may become rapidly life-threatening or fatal if not recognized and treated early. It is recommended to discontinue eculizumab in patients who are undergoing treatment for serious meningococcal infections.

riTUXimab has a major potential interaction with Infectious Hepatitis.

Rituximab, as other drugs classified as CD20-directed cytolytic antibodies can cause hepatitis B virus (HBV) reactivation, in some cases resulting in fulminant hepatitis, hepatic failure and death. Cases have been reported in patients who are hepatitis B surface antigen (HBsAg) positive and in patients who are HBsAg negative but are hepatitis B core antibody (anti-HBc) positive. Reactivation also has occurred in patients who appear to have resolved hepatitis B infection (i.e., HBsAg negative, anti-HBc positive and hepatitis B surface antibody [anti-HBs] positive). Screen all patients for HBV infection by measuring HBsAg and anti-HBc before initiating treatment with rituximab. Monitor patients with evidence of current or prior HBV infection for clinical and laboratory signs of hepatitis or HBV reactivation during and for several months following rituximab therapy. In patients who develop reactivation of HBV while on rituximab, immediately discontinue rituximab and any concomitant chemotherapy, and institute appropriate treatment.

riTUXimab has a major potential interaction with Ischemic Heart Disease.

Cardiotoxicity has been reported in a few patients receiving rituximab infusion during clinical studies. Patients with a history of angina or arrhythmias have experienced recurrences of these conditions during administration of rituximab. Therapy with rituximab should be administered cautiously in patients with preexisting arrhythmias or coronary artery or ischemic heart disease. Clinical monitoring of cardiac function throughout infusion and immediately post-infusion is recommended.

riTUXimab has a major potential interaction with Lymphoma.

JC virus infection resulting in Progressive Multifocal Leukoencephalopathy (PML) and death can occur in rituximab-treated patients with hematologic malignancies or with autoimmune diseases. Consider the diagnosis of PML in any patient presenting with new-onset neurologic manifestations. Discontinue rituximab and consider discontinuation or reduction of any concomitant chemotherapy or immunosuppressive therapy in patients who develop PML.

riTUXimab has a major potential interaction with Myeloproliferative Disorders.

JC virus infection resulting in Progressive Multifocal Leukoencephalopathy (PML) and death can occur in rituximab-treated patients with hematologic malignancies or with autoimmune diseases. Consider the diagnosis of PML in any patient presenting with new-onset neurologic manifestations. Discontinue rituximab and consider discontinuation or reduction of any concomitant chemotherapy or immunosuppressive therapy in patients who develop PML.

Eculizumab has a moderate potential interaction with Neutropenia.

Eculizumab blocks terminal complement activation; therefore, patients may have increased susceptibility to infections, especially with encapsulated bacteria. Caution is advised when using this agent in immunocompromised and neutropenic patients as Aspergillus infections may occur. It is recommended to administer vaccinations for the prevention of Streptococcus pneumoniae and Haemophilus influenza type b (Hib) infections according to the Advisory Committee on Immunization Practices (ACIP) guidelines and to use caution when administering to patients with any systemic infection.

riTUXimab has a moderate potential interaction with Renal Dysfunction.

Severe, including fatal, renal toxicity can occur after rituximab administration in patients with Non-Hodgkin's Lymphoma (NHL). Renal toxicity has occurred in patients who experience tumor lysis syndrome and in patients with NHL administered concomitant cisplatin therapy during clinical trials. The combination of cisplatin and rituximab is not an approved treatment regimen. Monitor closely for signs of renal failure and discontinue rituximab in patients with a rising serum creatinine or oliguria. No formal studies have been conducted to examine the effects of renal impairment on the pharmacokinetics of rituximab.

riTUXimab has a major potential interaction with Tumor Lysis Syndrome.

Acute renal failure, hyperkalemia, hypocalcemia, hyperuricemia, or hyperphosphatemia from tumor lysis, some fatal, can occur within 12-24 hours after the first infusion of rituximab in patients with Non-Hodgkin Lymphoma (NHL). Administer aggressive intravenous hydration and anti-hyperuricemic therapy in patients at high risk for Tumor Lysis Syndrome (TLS). Correct electrolyte abnormalities, monitor renal function and fluid balance, and administer supportive care, including dialysis as indicated.