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Can you take Hyaluronidase / pertuzumab / trastuzumab with Zidovudine?

1 drug interaction and 18 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

zidovudine trastuzumab

Applies to: zidovudine and hyaluronidase / pertuzumab / trastuzumab

Talk to your doctor before using zidovudine together with trastuzumab. Combining these medications may increase the risk of side effects that affect your bone marrow function, resulting in low numbers of different types of blood cells. You may be more likely to develop anemia, bleeding problems, or infections. Contact your doctor if you experience potential signs and symptoms of these conditions such as paleness, fatigue, dizziness, fainting, unusual bleeding or bruising, fever, chills, sore throat, body aches, or other flu-like symptoms. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. 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.

Food/lifestyle interactions

Minor food/lifestyle interactions

Minor:

zidovudine Food/Lifestyle

Applies to: zidovudine

Information for this minor interaction is available on the professional version.

Disease interactions

17 potential interactions Applies to: 16 conditions, including High Blood Pressure, Heart Failure, Heart Attack, Peripheral Neuropathy, and Arrhythmia.

Alcoholism

Major:

zidovudine

Zidovudine has a major potential interaction with Alcoholism.

Hepatotoxicity including lactic acidosis, severe hepatomegaly with steatosis, fulminant hepatitis, and hepatic failure has been associated with the use of some nucleoside reverse transcriptase inhibitors (NRTIs) alone or in combination with other antiretroviral agents. Therapy with NRTIs should be administered cautiously in patients with preexisting liver disease, a history of alcohol abuse, or hepatitis. Therapy should be suspended if clinical or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicity occur. The use of abacavir is contraindicated in patients with moderate to severe liver dysfunction as its safety and efficacy have not been established in these patients.

Arrhythmia

Moderate:

hyaluronidase / pertuzumab / trastuzumab

The pertuzumab and trastuzumab in hyaluronidase / pertuzumab / trastuzumab both have a moderate potential interaction with Arrhythmia.

Decreases in left ventricular ejection fraction (LVEF) have been reported with agents that block HER2 activity. Patients who have received prior anthracyclines, those who received anthracycline after stopping therapy with agents that block HER2 activity, or patients who received prior radiotherapy to the chest area may be at higher risk of decreased LVEF. Therapy with these agents should be administered cautiously in patients with a previous history of heart conditions. Evaluate cardiac function before, during, and upon completion of treatment. Withhold or discontinue therapy with agents that block HER2 activity as appropriate, and for a confirmed clinically significant decrease in left ventricular function, or if the LVEF has not improved or has declined further. It is recommended to monitor overall cardiac function and LVEF by echocardiogram or MUGA scan as appropriate.

Bone Marrow Depression/Low Blood Counts

Major:

zidovudine

Zidovudine has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

Zidovudine (AZT) may cause bone marrow toxicity, most commonly manifested as granulocytopenia and anemia, particularly in patients with advanced, symptomatic HIV disease. Thrombocytopenia not related to HIV may also occasionally occur. Zidovudine should be given with extreme caution to patients with preexisting bone marrow depression (indicated by a granulocyte count below 1000 cells/mm3 or hemoglobin less than 9.5 g/dL) or blood dyscrasias. Routine blood counts are recommended, and generally should occur more frequently in patients with advanced HIV disease. Dosage reductions may be necessary.

Diabetes Mellitus

Moderate:

hyaluronidase / pertuzumab / trastuzumab

The pertuzumab and trastuzumab in hyaluronidase / pertuzumab / trastuzumab both have a moderate potential interaction with Diabetes Mellitus.

Peripheral neuropathy has been reported with the use of agents that block HER2 activity. Patients experiencing peripheral neuropathy may require temporary interruption, dose reduction, or treatment discontinuation of these agents. Withhold dosing temporarily for patients experiencing Grade 3 or 4 peripheral neuropathy until resolution. Close monitoring is recommended when using these agents in patients at risk, and all patients should be monitored on an ongoing basis for signs or symptoms of neurotoxicity.

Heart Attack

Moderate:

hyaluronidase / pertuzumab / trastuzumab

The pertuzumab and trastuzumab in hyaluronidase / pertuzumab / trastuzumab both have a moderate potential interaction with Heart Attack.

Decreases in left ventricular ejection fraction (LVEF) have been reported with agents that block HER2 activity. Patients who have received prior anthracyclines, those who received anthracycline after stopping therapy with agents that block HER2 activity, or patients who received prior radiotherapy to the chest area may be at higher risk of decreased LVEF. Therapy with these agents should be administered cautiously in patients with a previous history of heart conditions. Evaluate cardiac function before, during, and upon completion of treatment. Withhold or discontinue therapy with agents that block HER2 activity as appropriate, and for a confirmed clinically significant decrease in left ventricular function, or if the LVEF has not improved or has declined further. It is recommended to monitor overall cardiac function and LVEF by echocardiogram or MUGA scan as appropriate.

Heart Failure

Moderate:

hyaluronidase / pertuzumab / trastuzumab

The pertuzumab and trastuzumab in hyaluronidase / pertuzumab / trastuzumab both have a moderate potential interaction with Heart Failure.

Decreases in left ventricular ejection fraction (LVEF) have been reported with agents that block HER2 activity. Patients who have received prior anthracyclines, those who received anthracycline after stopping therapy with agents that block HER2 activity, or patients who received prior radiotherapy to the chest area may be at higher risk of decreased LVEF. Therapy with these agents should be administered cautiously in patients with a previous history of heart conditions. Evaluate cardiac function before, during, and upon completion of treatment. Withhold or discontinue therapy with agents that block HER2 activity as appropriate, and for a confirmed clinically significant decrease in left ventricular function, or if the LVEF has not improved or has declined further. It is recommended to monitor overall cardiac function and LVEF by echocardiogram or MUGA scan as appropriate.

High Blood Pressure

Moderate:

hyaluronidase / pertuzumab / trastuzumab

The pertuzumab and trastuzumab in hyaluronidase / pertuzumab / trastuzumab both have a moderate potential interaction with High Blood Pressure.

Decreases in left ventricular ejection fraction (LVEF) have been reported with agents that block HER2 activity. Patients who have received prior anthracyclines, those who received anthracycline after stopping therapy with agents that block HER2 activity, or patients who received prior radiotherapy to the chest area may be at higher risk of decreased LVEF. Therapy with these agents should be administered cautiously in patients with a previous history of heart conditions. Evaluate cardiac function before, during, and upon completion of treatment. Withhold or discontinue therapy with agents that block HER2 activity as appropriate, and for a confirmed clinically significant decrease in left ventricular function, or if the LVEF has not improved or has declined further. It is recommended to monitor overall cardiac function and LVEF by echocardiogram or MUGA scan as appropriate.

History - Myocardial Infarction

Moderate:

hyaluronidase / pertuzumab / trastuzumab

The pertuzumab and trastuzumab in hyaluronidase / pertuzumab / trastuzumab both have a moderate potential interaction with History - Myocardial Infarction.

Decreases in left ventricular ejection fraction (LVEF) have been reported with agents that block HER2 activity. Patients who have received prior anthracyclines, those who received anthracycline after stopping therapy with agents that block HER2 activity, or patients who received prior radiotherapy to the chest area may be at higher risk of decreased LVEF. Therapy with these agents should be administered cautiously in patients with a previous history of heart conditions. Evaluate cardiac function before, during, and upon completion of treatment. Withhold or discontinue therapy with agents that block HER2 activity as appropriate, and for a confirmed clinically significant decrease in left ventricular function, or if the LVEF has not improved or has declined further. It is recommended to monitor overall cardiac function and LVEF by echocardiogram or MUGA scan as appropriate.

Liver Disease

Major:

zidovudine

Zidovudine has a major potential interaction with Liver Disease.

Hepatotoxicity including lactic acidosis, severe hepatomegaly with steatosis, fulminant hepatitis, and hepatic failure has been associated with the use of some nucleoside reverse transcriptase inhibitors (NRTIs) alone or in combination with other antiretroviral agents. Therapy with NRTIs should be administered cautiously in patients with preexisting liver disease, a history of alcohol abuse, or hepatitis. Therapy should be suspended if clinical or laboratory findings suggestive of lactic acidosis or pronounced hepatotoxicity occur. The use of abacavir is contraindicated in patients with moderate to severe liver dysfunction as its safety and efficacy have not been established in these patients.

Myoneural Disorder

Major:

zidovudine

Zidovudine has a major potential interaction with Myoneural Disorder.

Prolonged use of certain nucleoside reverse transcriptase inhibitors (NRTIs) such as zidovudine and telbivudine may commonly cause myopathy, including rare cases of rhabdomyolysis. The myopathy may be dose-related and is characterized by persistent, unexplained muscle aches and/or weakness in conjunction with increases in creatine phosphokinase (CPK) values. Therapy with these NRTIs should be administered cautiously in patients with preexisting myopathy or a myoneural disorder, since it may delay the recognition or confound the diagnosis of a drug-induced musculoskeletal effect. Patients should be advised to report promptly any unusual muscle pain, tenderness or weakness, particularly if accompanied by malaise or fever. NRTI therapy should be interrupted if drug-related myopathy is suspected, and discontinued if myopathy is diagnosed.

Myopathy

Major:

zidovudine

Zidovudine has a major potential interaction with Myopathy.

Prolonged use of certain nucleoside reverse transcriptase inhibitors (NRTIs) such as zidovudine and telbivudine may commonly cause myopathy, including rare cases of rhabdomyolysis. The myopathy may be dose-related and is characterized by persistent, unexplained muscle aches and/or weakness in conjunction with increases in creatine phosphokinase (CPK) values. Therapy with these NRTIs should be administered cautiously in patients with preexisting myopathy or a myoneural disorder, since it may delay the recognition or confound the diagnosis of a drug-induced musculoskeletal effect. Patients should be advised to report promptly any unusual muscle pain, tenderness or weakness, particularly if accompanied by malaise or fever. NRTI therapy should be interrupted if drug-related myopathy is suspected, and discontinued if myopathy is diagnosed.

Peripheral Neuropathy

Moderate:

hyaluronidase / pertuzumab / trastuzumab

The pertuzumab and trastuzumab in hyaluronidase / pertuzumab / trastuzumab both have a moderate potential interaction with Peripheral Neuropathy.

Peripheral neuropathy has been reported with the use of agents that block HER2 activity. Patients experiencing peripheral neuropathy may require temporary interruption, dose reduction, or treatment discontinuation of these agents. Withhold dosing temporarily for patients experiencing Grade 3 or 4 peripheral neuropathy until resolution. Close monitoring is recommended when using these agents in patients at risk, and all patients should be monitored on an ongoing basis for signs or symptoms of neurotoxicity.

Post MI Syndrome

Moderate:

hyaluronidase / pertuzumab / trastuzumab

The pertuzumab and trastuzumab in hyaluronidase / pertuzumab / trastuzumab both have a moderate potential interaction with Post MI Syndrome.

Decreases in left ventricular ejection fraction (LVEF) have been reported with agents that block HER2 activity. Patients who have received prior anthracyclines, those who received anthracycline after stopping therapy with agents that block HER2 activity, or patients who received prior radiotherapy to the chest area may be at higher risk of decreased LVEF. Therapy with these agents should be administered cautiously in patients with a previous history of heart conditions. Evaluate cardiac function before, during, and upon completion of treatment. Withhold or discontinue therapy with agents that block HER2 activity as appropriate, and for a confirmed clinically significant decrease in left ventricular function, or if the LVEF has not improved or has declined further. It is recommended to monitor overall cardiac function and LVEF by echocardiogram or MUGA scan as appropriate.

Pulmonary Impairment

Major:

hyaluronidase / pertuzumab / trastuzumab

The pertuzumab and trastuzumab in hyaluronidase / pertuzumab / trastuzumab both have a major potential interaction with Pulmonary Impairment.

Pulmonary toxicity, sometimes fatal has been reported with agents that block HER2 activity. Pulmonary toxicity includes dyspnea, interstitial pneumonitis, pulmonary infiltrates, pleural effusions, non-cardiogenic pulmonary edema, pulmonary insufficiency and hypoxia, acute respiratory distress syndrome, and pulmonary fibrosis. Patients with symptomatic intrinsic lung disease or with extensive tumor involvement of the lungs, resulting in dyspnea at rest may be at increased risk of pulmonary toxicity and appear to have more severe toxicity. Patients should be monitored for pulmonary symptoms. Permanently discontinue treatment with these agents in patients diagnosed with interstitial lung disease or pneumonitis and institute appropriate care.

Renal Dysfunction

Moderate:

hyaluronidase / pertuzumab / trastuzumab

The pertuzumab in hyaluronidase / pertuzumab / trastuzumab has a moderate potential interaction with Renal Dysfunction.

No dose adjustment of pertuzumab is necessary in patients with mild or moderate renal impairment. Caution should be exercised if pertuzumab is used in patients with severe renal impairment as there is limited pharmacokinetic data available. Clinical monitoring of renal function is recommended.

Moderate:

zidovudine

Zidovudine has a moderate potential interaction with Renal Dysfunction.

The apparent oral clearance of nucleoside reverse transcriptase inhibitors is decreased in patients with renal dysfunction. Dosage adjustments are recommended for lamivudine and stavudine in patients with CrCl less than 50 mL/min; zidovudine dosage should be reduced in patients with CrCl less than 15 mL/min. Fixed-dose combination products containing lamivudine are not recommended for patients with CrCl less than 30 or 50 mL/min; the manufacturer product information should be consulted.

Thrombocytopenia

Moderate:

hyaluronidase / pertuzumab / trastuzumab

The pertuzumab and trastuzumab in hyaluronidase / pertuzumab / trastuzumab both have a moderate potential interaction with Thrombocytopenia.

Thrombocytopenia has been reported with the use of agents that block HER2 activity. Monitor platelet counts prior to initiation of therapy and prior to each dose. If appropriate modify the dose according to clinical guidelines. Patients with decreased platelet count and patients on anti-coagulant treatment should be closely monitored during treatment with these agents.

More resources

hyaluronidase / pertuzumab / trastuzumab

A total of 287 drugs are known to interact with hyaluronidase / pertuzumab / trastuzumab.

zidovudine

A total of 398 drugs are known to interact with zidovudine.

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.