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Drug Interactions between epcoritamab and MKO Melt Dose Pack

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

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Interactions between your drugs

Major

ketamine midazolam

Applies to: MKO Melt Dose Pack (ketamine / midazolam / ondansetron) and MKO Melt Dose Pack (ketamine / midazolam / ondansetron)

Using ketamine together with midazolam may increase side effects such as dizziness, drowsiness, confusion, difficulty concentrating, excessive sedation, and respiratory depression. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with ketamine. Also avoid activities requiring mental alertness such as driving, operating hazardous machinery, or engaging in potentially hazardous activities until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate

midazolam epcoritamab

Applies to: MKO Melt Dose Pack (ketamine / midazolam / ondansetron) and epcoritamab

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with epcoritamab may increase the plasma concentrations of drugs that are substrates of CYP450 isoenzymes. Initiation of epcoritamab treatment causes transient release of cytokines that may suppress CYP450 isoenzymes, although the potential for an interaction has not been studied. According to the manufacturer, the highest drug-drug interaction risk would be from the first dose on the first day of cycle 1, up to 14 days after the first 48 mg dose on day 15 of cycle 1, as well as during and after cytokine release syndrome.

MANAGEMENT: Caution is advised when epcoritamab is administered with drugs that are metabolized by CYP450 isoenzymes, particularly those with a narrow therapeutic range, where minimal changes to concentration may lead to significant adverse reactions, such as carbamazepine, colchicine, cyclosporine, disopyramide, phenytoin, quinidine, theophylline, warfarin, macrolide immunosuppressants, vinca alkaloids, and some narcotic analgesics. Clinical and/or laboratory monitoring are recommended, particularly at the initial phase of treatment with epcoritamab as well as during and after cytokine release syndrome, and the dosage(s) of the CYP450 substrate(s) adjusted accordingly.

Drug and food interactions

Major

ketamine food

Applies to: MKO Melt Dose Pack (ketamine / midazolam / ondansetron)

Using ketamine together with ethanol (alcohol) may increase side effects such as dizziness, drowsiness, confusion, difficulty concentrating, excessive sedation, and respiratory depression. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with ketamine. Also avoid activities requiring mental alertness such as driving, operating hazardous machinery, or engaging in potentially hazardous activities until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate

ketamine food

Applies to: MKO Melt Dose Pack (ketamine / midazolam / ondansetron)

Alcohol can increase the nervous system side effects of ketamine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should not drink alcohol during treatment with ketamine. If you have received ketamine for anesthesia, you should avoid activities requiring mental alertness such as driving or operating hazardous machinery for at least 24 hours and until you know how the medication affects you. If you are taking ketamine orally, you should also avoid the consumption of grapefruit or grapefruit juice, which can significantly increase blood levels and side effects of the medication. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Moderate

midazolam food

Applies to: MKO Melt Dose Pack (ketamine / midazolam / ondansetron)

Grapefruit and grapefruit juice may interact with midazolam and lead to potentially dangerous side effects. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. Do not drink alcohol while taking midazolam. This medication can increase the effects of alcohol. You may feel more drowsy, dizzy, or tired if you take midazolam with alcohol. Talk to your doctor or pharmacist if you have any questions or concerns.

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.