Interactions between Etrasimod and Otulfi

Etrasimod has a major potential interaction with Cardiovascular Conditions and Disorders.

Etrasimod is contraindicated in patients who have experienced in the last 6 months myocardial infarction, unstable angina pectoris, stroke, transient ischemic attack, decompensated heart failure requiring hospitalization, and Class III or IV heart failure. It is also contraindicated in patients with history of Mobitz type II second or third-degree atrioventricular (AV) block, sick sinus syndrome, or sino-atrial block, unless the patient has a functioning pacemaker. Advice from a cardiologist should be sought if treatment is being considered in patients with significant QT prolongation, arrhythmias requiring treatment with Class Ia or Class II anti-arrhythmic drugs or QT prolonging drugs, unstable ischemic heart disease, Class I or III heart failure, history of cardiac arrest, cerebrovascular disease, uncontrolled hypertension, resting heart rate less than 50 beats per minute, symptomatic bradycardia, recurrent cardiogenic syncope, severe untreated sleep apnea, history of Mobitz type I second degree AV block, unless the patient has a functioning pacemaker.

Etrasimod has a major potential interaction with Heart Disease.

Etrasimod is contraindicated in patients who have experienced in the last 6 months myocardial infarction, unstable angina pectoris, stroke, transient ischemic attack, decompensated heart failure requiring hospitalization, and Class III or IV heart failure. It is also contraindicated in patients with history of Mobitz type II second or third-degree atrioventricular (AV) block, sick sinus syndrome, or sino-atrial block, unless the patient has a functioning pacemaker. Advice from a cardiologist should be sought if treatment is being considered in patients with significant QT prolongation, arrhythmias requiring treatment with Class Ia or Class II anti-arrhythmic drugs or QT prolonging drugs, unstable ischemic heart disease, Class I or III heart failure, history of cardiac arrest, cerebrovascular disease, uncontrolled hypertension, resting heart rate less than 50 beats per minute, symptomatic bradycardia, recurrent cardiogenic syncope, severe untreated sleep apnea, history of Mobitz type I second degree AV block, unless the patient has a functioning pacemaker.

The ustekinumab in Otulfi has a major potential interaction with High Blood Pressure.

The use of ustekinumab may cause posterior leukoencephalopathy syndrome. One case of reversible posterior leukoencephalopathy syndrome (RPLS) was observed in clinical studies of psoriasis and psoriatic arthritis. No cases of RPLS were observed in clinical studies of Crohn's disease. Conditions with which it has been associated include preeclampsia, eclampsia, acute hypertension, cytotoxic agents and immunosuppressive therapy. Caution and close monitoring is advised when prescribing this agent to patients at risk of RPLS. It is recommended to administer appropriate treatment and discontinue therapy if RPLS is suspected.

The ustekinumab in Otulfi has a moderate potential interaction with History, Tuberculosis.

Before initiating certain interleukin inhibitors, patients should be screened for latent tuberculosis infection with a tuberculin skin test. Do not administer these agents to patients with an active tuberculosis infection. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy. Anti-tuberculosis therapy should be considered prior to initiation of therapy in patients with a past history of latent or active tuberculosis in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent tuberculosis but having risk factors for tuberculosis infection.

The ustekinumab in Otulfi has a major potential interaction with Immunodeficiency.

The use of ustekinumab may cause posterior leukoencephalopathy syndrome. One case of reversible posterior leukoencephalopathy syndrome (RPLS) was observed in clinical studies of psoriasis and psoriatic arthritis. No cases of RPLS were observed in clinical studies of Crohn's disease. Conditions with which it has been associated include preeclampsia, eclampsia, acute hypertension, cytotoxic agents and immunosuppressive therapy. Caution and close monitoring is advised when prescribing this agent to patients at risk of RPLS. It is recommended to administer appropriate treatment and discontinue therapy if RPLS is suspected.

Etrasimod has a moderate potential interaction with Infection.

Etrasimod increases the risk of infections as it decreases the peripheral lymphocyte counts. Treatment initiation should be delayed in patients with an active infection until the infection is resolved. Patients without a confirmed history of varicella (chickenpox), or without documentation of a full course of vaccination against varicella zoster virus, should be tested for antibodies before initiating treatment. Avoid the use of live attenuated vaccines during and for up to 5 weeks after treatment.

The ustekinumab in Otulfi has a moderate potential interaction with Infection.

There have been reports of serious infections, including infections with opportunistic pathogens, and reactivation of latent infections in patients receiving interleukin inhibitors. Treatment with these agents should not be initiated in patients with an active infection until the infection resolves or is adequately treated. Caution is recommended when considering the use of interleukin inhibitors in patients with a history of recurrent infections, underlying conditions which may predispose them to infections, or chronic, latent, or localized infections.

Etrasimod has a moderate potential interaction with Liver Disease.

Elevations of transaminases have been reported in patients receiving etrasimod. Additionally, this drug undergoes extensive hepatic metabolism, and its exposure was found increased in subjects with severe hepatic dysfunction (Child-Pugh C). The use of etrasimod is not recommended on these patients. No dosage adjustment is needed in mild to moderate hepatic dysfunction.

The ustekinumab in Otulfi has a major potential interaction with Posterior Reversible Encephalopathy Syndrome.

The use of ustekinumab may cause posterior leukoencephalopathy syndrome. One case of reversible posterior leukoencephalopathy syndrome (RPLS) was observed in clinical studies of psoriasis and psoriatic arthritis. No cases of RPLS were observed in clinical studies of Crohn's disease. Conditions with which it has been associated include preeclampsia, eclampsia, acute hypertension, cytotoxic agents and immunosuppressive therapy. Caution and close monitoring is advised when prescribing this agent to patients at risk of RPLS. It is recommended to administer appropriate treatment and discontinue therapy if RPLS is suspected.

The ustekinumab in Otulfi has a major potential interaction with Skin Cancer.

In clinical trials malignancies have been observed in patients receiving ustekinumab. Patients should be monitored for non-melanoma skin cancers (NMSCs), particularly those patients who have had prior prolonged phototherapy treatment. Periodic skin examination is recommended for all patients, particularly those with risk factors for skin cancer. Caution should be exercised when considering ustekinumab for the treatment of patients with a history of malignancy, those who have a known malignancy, or in continuing treatment in patients who develop malignancy while receiving this agent.

Etrasimod has a moderate potential interaction with Skin Cancer.

Cases of malignancies, including skin malignancies have been reported in patients treated with some sphingosine -1-receptor (S1P) receptor modulators. Skin examinations are recommended prior and during treatment in all patients, particularly in those with risk factors for skin cancer. Suspicious skin lesions should be promptly evaluated, and patients at increased risk should wear protective clothing and use sunscreen with high protection factor.

The ustekinumab in Otulfi has a major potential interaction with Toxemia of pregnancy.

The use of ustekinumab may cause posterior leukoencephalopathy syndrome. One case of reversible posterior leukoencephalopathy syndrome (RPLS) was observed in clinical studies of psoriasis and psoriatic arthritis. No cases of RPLS were observed in clinical studies of Crohn's disease. Conditions with which it has been associated include preeclampsia, eclampsia, acute hypertension, cytotoxic agents and immunosuppressive therapy. Caution and close monitoring is advised when prescribing this agent to patients at risk of RPLS. It is recommended to administer appropriate treatment and discontinue therapy if RPLS is suspected.

The ustekinumab in Otulfi has a moderate potential interaction with Tuberculosis, Active.

Before initiating certain interleukin inhibitors, patients should be screened for latent tuberculosis infection with a tuberculin skin test. Do not administer these agents to patients with an active tuberculosis infection. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy. Anti-tuberculosis therapy should be considered prior to initiation of therapy in patients with a past history of latent or active tuberculosis in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent tuberculosis but having risk factors for tuberculosis infection.

The ustekinumab in Otulfi has a moderate potential interaction with Tuberculosis, Latent.

Before initiating certain interleukin inhibitors, patients should be screened for latent tuberculosis infection with a tuberculin skin test. Do not administer these agents to patients with an active tuberculosis infection. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy. Anti-tuberculosis therapy should be considered prior to initiation of therapy in patients with a past history of latent or active tuberculosis in whom an adequate course of treatment cannot be confirmed, and for patients with a negative test for latent tuberculosis but having risk factors for tuberculosis infection.

Etrasimod has a moderate potential interaction with Vaccination.

Etrasimod increases the risk of infections as it decreases the peripheral lymphocyte counts. Treatment initiation should be delayed in patients with an active infection until the infection is resolved. Patients without a confirmed history of varicella (chickenpox), or without documentation of a full course of vaccination against varicella zoster virus, should be tested for antibodies before initiating treatment. Avoid the use of live attenuated vaccines during and for up to 5 weeks after treatment.

The ustekinumab in Otulfi has a moderate potential interaction with Vaccination.

Patients requiring non-live vaccination during a course of ustekinumab may not be protected from the vaccine as the immune response might not be sufficient to prevent the disease. It is recommended to be up-to-date with all required immunizations, as recommended by current immunization guidelines, before initiating therapy with ustekinumab. BCG vaccines should not be given during treatment with ustekinumab or for one year prior to initiating treatment or one year following discontinuation of treatment. Caution is advised when administering live vaccines to household contacts of patients receiving ustekinumab because of the potential risk for shedding from the household contact and transmission to patient.