Drug Interactions between efalizumab and Vyxeos

MONITOR: The concomitant or sequential administration of multiple antineoplastic agents may result in additive toxicities, particularly in the bone marrow, gastrointestinal tract and heart.

MANAGEMENT: Close clinical and laboratory monitoring for hematologic and nonhematologic toxicities are recommended when antineoplastic agents are administered concurrently or during close intervals. Dosing adjustments may be necessary. The manufacturers' recommendations and institutional protocols for dosage, treatment regimens, monitoring, and management of toxicities should be consulted.

GENERALLY AVOID: The use of efalizumab with other immunosuppressive or myelosuppressive agents may increase the risk of infections. Efalizumab alone can cause serious infections requiring hospitalization, and the risk may theoretically increase when coadministered with other immunosuppressive therapy. Agents that may be significantly myelo- or immunosuppressive include antineoplastic agents, radiation, zidovudine, linezolid, some antirheumatic agents, high dosages of corticosteroids or adrenocorticotropic agents (greater than 10 mg/day to 1 mg/kg/day, whichever is less, of prednisone or equivalent for more than 2 weeks), and long-term topical or inhaled corticosteroids.

MANAGEMENT: The safety and efficacy of efalizumab in combination with other immunosuppressive agents or phototherapy have not been evaluated. Patients receiving other immunosuppressive agents should not be treated with efalizumab because of the possibility of excessive immunosuppression. The duration of the period following treatment with efalizumab before one should consider starting other immunosuppressive therapy has not been evaluated.