Can you take Fexinidazole with Tildrakizumab?

Fexinidazole has a moderate potential interaction with Alcoholism.

Nitroimidazoles (e.g., metronidazole, tinidazole, fexinidazole, secnidazole) may inhibit alcohol dehydrogenase and occasionally precipitate a disulfiram-like reaction in patients who consume alcohol while being treated. Symptoms may include abdominal cramps, nausea, vomiting, headache, flushing, rash, weakness, diarrhea, abdominal pain, dizziness, sweating, and hypotension. Patients should be instructed to avoid alcohol-containing products during nitroimidazole therapy and for at least 48 hours (fexinidazole, secnidazole) to 72 hours (metronidazole, tinidazole) after the last dose. Therapy with nitroimidazoles should be administered cautiously in patients who might be prone to acute alcohol intake. An alternative therapy may be appropriate.

Fexinidazole has a moderate potential interaction with Arrhythmia.

Fexinidazole prolongs the QT interval in a concentration-dependent manner; treatment with fexinidazole caused an average increase of 19 msec in the QTcF interval (corrected QT interval by Fridericia). Fexinidazole should be avoided in patients who have: QTcF interval greater than 470 msec; history of torsade de pointes, congenital long QT syndrome, cardiac arrhythmias, uncompensated heart failure, or family history of sudden death; uncorrected hypokalemia.

Fexinidazole has a moderate potential interaction with Depression.

In a clinical trial, adult patients treated with fexinidazole reported a higher percentage of CNS and psychiatric-related side effects than those treated with nifurtimox-eflornithine combination therapy (NECT). Increased incidence of insomnia, headache, and tremor was observed in patients treated with fexinidazole compared to NECT. In the same trial, side effects signifying mood changes and psychiatric disorders (e.g., agitation, anxiety, abnormal behavior, depression, nightmares, hallucination, personality change) were more common with fexinidazole compared to NECT; suicidal ideation was also seen with fexinidazole. In patients with current or history of psychiatric disorders, alternative therapy or increased monitoring of the patient (including hospitalization) should be considered.

Fexinidazole has a moderate potential interaction with Heart Failure.

Fexinidazole prolongs the QT interval in a concentration-dependent manner; treatment with fexinidazole caused an average increase of 19 msec in the QTcF interval (corrected QT interval by Fridericia). Fexinidazole should be avoided in patients who have: QTcF interval greater than 470 msec; history of torsade de pointes, congenital long QT syndrome, cardiac arrhythmias, uncompensated heart failure, or family history of sudden death; uncorrected hypokalemia.

Tildrakizumab has a major potential interaction with History, Tuberculosis.

Do not administer tildrakizumab to patients with active TB infection. It is recommended to assess patients for tuberculosis (TB) infection before starting treatment with this agent. Consider anti-TB therapy prior to initiation of tildrakizumab in patients with latent TB, a past history of latent or active TB in whom an adequate course of treatment cannot be confirmed. Monitor patients for signs and symptoms of active TB during and after treatment with tildrakizumab.

Fexinidazole has a moderate potential interaction with Hypokalemia.

Fexinidazole prolongs the QT interval in a concentration-dependent manner; treatment with fexinidazole caused an average increase of 19 msec in the QTcF interval (corrected QT interval by Fridericia). Fexinidazole should be avoided in patients who have: QTcF interval greater than 470 msec; history of torsade de pointes, congenital long QT syndrome, cardiac arrhythmias, uncompensated heart failure, or family history of sudden death; uncorrected hypokalemia.

Tildrakizumab has a moderate potential interaction with Infection.

The use of tildrakizumab may increase the risk of infection. Treatment with tildrakizumab should not be started in patients with active infection until the infection resolves or is adequately treated. Consider the risks and benefits prior to using this agent in patients with chronic infection or a history of recurrent infection. It is recommended to monitor the patient closely and consider discontinuation of tildrakizumab if a patient develops a clinically important or serious infection or is not responding to standard therapy.

Fexinidazole has a major potential interaction with Liver Disease.

Fexinidazole is contraindicated in patients with liver dysfunction since it is extensively metabolized by the liver. However, the pharmacokinetics of fexinidazole in patients with liver dysfunction is unknown. Liver-related laboratory tests should be evaluated at the start and during therapy with fexinidazole. Patients who develop abnormal liver-related laboratory tests during treatment with fexinidazole should be monitored.

Fexinidazole has a moderate potential interaction with Psychosis.

In a clinical trial, adult patients treated with fexinidazole reported a higher percentage of CNS and psychiatric-related side effects than those treated with nifurtimox-eflornithine combination therapy (NECT). Increased incidence of insomnia, headache, and tremor was observed in patients treated with fexinidazole compared to NECT. In the same trial, side effects signifying mood changes and psychiatric disorders (e.g., agitation, anxiety, abnormal behavior, depression, nightmares, hallucination, personality change) were more common with fexinidazole compared to NECT; suicidal ideation was also seen with fexinidazole. In patients with current or history of psychiatric disorders, alternative therapy or increased monitoring of the patient (including hospitalization) should be considered.

Fexinidazole has a moderate potential interaction with Renal Dysfunction.

The use of fexinidazole should be avoided in patients with severe renal dysfunction (estimated GFR less than 30 mL/min/1.73 m2); the pharmacokinetics of fexinidazole in patients with severe renal dysfunction is unknown. No dosage adjustment is necessary for patients with mild to moderate renal dysfunction.

Tildrakizumab has a major potential interaction with Tuberculosis, Active.

Do not administer tildrakizumab to patients with active TB infection. It is recommended to assess patients for tuberculosis (TB) infection before starting treatment with this agent. Consider anti-TB therapy prior to initiation of tildrakizumab in patients with latent TB, a past history of latent or active TB in whom an adequate course of treatment cannot be confirmed. Monitor patients for signs and symptoms of active TB during and after treatment with tildrakizumab.

Tildrakizumab has a major potential interaction with Tuberculosis, Latent.

Do not administer tildrakizumab to patients with active TB infection. It is recommended to assess patients for tuberculosis (TB) infection before starting treatment with this agent. Consider anti-TB therapy prior to initiation of tildrakizumab in patients with latent TB, a past history of latent or active TB in whom an adequate course of treatment cannot be confirmed. Monitor patients for signs and symptoms of active TB during and after treatment with tildrakizumab.

Tildrakizumab has a moderate potential interaction with Vaccination.

It is recommended to avoid the use of live vaccines in patients treated with tildrakizumab. Before starting therapy with tildrakizumab, consider completion of all age appropriate immunizations according to current immunization guidelines. Care should be exercised as no data are available on the response to live or inactive vaccines.