Interactions between Hyrimoz and Paclitaxel

PACLitaxel has a moderate potential interaction with Anaphylaxis.

Anaphylaxis and severe hypersensitivity reactions characterized by dyspnea and hypotension requiring treatment, angioedema, and generalized urticaria have occurred in patients receiving paclitaxel. It is recommended that all patients should be pretreated with corticosteroids, diphenhydramine, and H2 antagonists. Patients who have developed severe hypersensitivity reactions should not be rechallenged with paclitaxel injection.

PACLitaxel has a major potential interaction with Arrhythmia.

Severe conduction abnormalities, some requiring pacemaker placement, have been reported during paclitaxel therapy. Therapy with paclitaxel should be administered cautiously in patients with or predisposed to conduction disorders. Clinical monitoring of cardiac function is recommended during subsequent paclitaxel therapy.

PACLitaxel has a major potential interaction with Bleeding Disorder.

Paclitaxel induces dose-dependent myelosuppression, primarily affecting neutrophils. Anemia characterized as a red blood cell count <11 g/dl has been reported in 78% of patients administered paclitaxel. Thrombocytopenia is uncommon and rarely severe. Therapy with paclitaxel should be administered cautiously in patients whose bone marrow reserve may be severely depressed and should be withheld when neutrophil counts fall below 1500/mm3 and/or platelet counts fall below 100,000/mm3. Paclitaxel injection should not be used in patients with solid tumors with baseline neutrophil counts less than 1500/mm3 or in patients with AIDS-related Kaposi's sarcoma with baseline neutrophil counts of less than 1000/mm3. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended.

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

Paclitaxel induces dose-dependent myelosuppression, primarily affecting neutrophils. Anemia characterized as a red blood cell count <11 g/dl has been reported in 78% of patients administered paclitaxel. Thrombocytopenia is uncommon and rarely severe. Therapy with paclitaxel should be administered cautiously in patients whose bone marrow reserve may be severely depressed and should be withheld when neutrophil counts fall below 1500/mm3 and/or platelet counts fall below 100,000/mm3. Paclitaxel injection should not be used in patients with solid tumors with baseline neutrophil counts less than 1500/mm3 or in patients with AIDS-related Kaposi's sarcoma with baseline neutrophil counts of less than 1000/mm3. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended.

The adalimumab in Hyrimoz has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.

Cases of leukopenia, neutropenia, thrombocytopenia, and pancytopenia, some with a fatal outcome, have been reported in patients treated with TNF blocking agents. Caution should be exercised when treating patients who have ongoing or a history of significant hematologic abnormalities. Discontinuation of therapy should be considered in patients with confirmed significant hematologic abnormalities.

The adalimumab in Hyrimoz has a major potential interaction with Central Nervous System Disorders.

The use of TNF blocking agents has been associated with rare cases of CNS manifestations of systemic vasculitis, seizure and new onset or exacerbation of clinical symptoms and/or radiographic evidence of central nervous system demyelinating disorders, including multiple sclerosis and optic neuritis, and peripheral demyelinating disorders, including Guillain-Barré syndrome. Care should be exercised when considering the use of these agents in patients with neurologic disorders and discontinuing the agent is recommended if these disorders develop during therapy.

The adalimumab in Hyrimoz has a moderate potential interaction with COPD.

In controlled trials of other TNF blockers, other than adalimumab, in adult patients at higher risk for malignancies (i.e., patients with COPD with a significant smoking history and cyclophosphamide-treated patients with Wegener's granulomatosis), a greater portion of malignancies occurred in the TNF blocker group compared to the control group.

PACLitaxel has a major potential interaction with Fever.

Paclitaxel induces dose-dependent myelosuppression, primarily affecting neutrophils. Anemia characterized as a red blood cell count <11 g/dl has been reported in 78% of patients administered paclitaxel. Thrombocytopenia is uncommon and rarely severe. Therapy with paclitaxel should be administered cautiously in patients whose bone marrow reserve may be severely depressed and should be withheld when neutrophil counts fall below 1500/mm3 and/or platelet counts fall below 100,000/mm3. Paclitaxel injection should not be used in patients with solid tumors with baseline neutrophil counts less than 1500/mm3 or in patients with AIDS-related Kaposi's sarcoma with baseline neutrophil counts of less than 1000/mm3. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended.

The adalimumab in Hyrimoz has a moderate potential interaction with Heart Failure.

Cases of worsening congestive heart failure (CHF) and new onset CHF have been reported with TNF blockers. Cases of worsening CHF have also been observed with adalimumab. Adalimumab has not been formally studied in patients with CHF; however, in clinical trials of another TNF blocker, a higher rate of serious CHF-related adverse reactions was observed. Exercise caution when using adalimumab in patients who have heart failure and monitor them carefully.

The adalimumab in Hyrimoz has a major potential interaction with History, Skin Cancer.

In clinical trials malignancies have been observed in patients receiving TNF-blockers agents. Patients with psoriasis should be monitored for non-melanoma skin cancers (NMSCs), particularly those patients who have had prior prolonged phototherapy treatment. Melanoma and Merkel cell carcinoma have been reported in patients treated with TNF blocker therapy. Periodic skin examination is recommended for all patients, particularly those with risk factors for skin cancer. Postmarketing cases of fatal hepatosplenic T-cell lymphoma (HSTCL) have been reported in patients treated with TNF blockers. Caution should be exercised when considering these agents in the treatment of patients with a history of malignancies or in continuing treatment in patients who develop malignancies while receiving these agents.

The adalimumab in Hyrimoz has a major potential interaction with Infection.

There have been reports of serious infections, including sepsis and opportunistic infections due to bacterial, mycobacterial, invasive fungal, viral, parasitic, or other opportunistic pathogens including aspergillosis, blastomycosis, candidiasis, coccidioidomycosis, histoplasmosis, legionellosis, listeriosis, pneumocystosis and tuberculosis with TNF blockers. Treatment with these agents should not be initiated in patients with an active infection, including clinically important localized infections. Caution and close monitoring is recommended when considering their use in patients with a history of recurrent infections, underlying conditions which may predispose them to infections, or chronic, latent, or localized infections. Administration of these agents should be discontinued if a patient develops a serious infection or sepsis.

PACLitaxel has a major potential interaction with Infection.

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

The adalimumab in Hyrimoz has a moderate potential interaction with Infectious Hepatitis.

The use of TNF blockers has been associated with reactivation of hepatitis B, in some cases fatal, in patients who were previously infected with the hepatitis B virus (HBV). Therefore, screening for viral hepatitis should be performed in accordance with published guidelines before starting therapy with these agents. Monitor patients at risk or with evidence of current or prior HBV infection for clinical and laboratory signs of hepatitis or HBV reactivation. Prescribers should exercise caution in prescribing TNF blockers in patients previously infected with HBV. It is recommended to monitor patients with evidence of current or prior HBV infection for clinical and laboratory signs of hepatitis or HBV reactivation during and for several months following therapy. In patients who develop HBV reactivation, therapy should be stopped and antiviral therapy with appropriate supportive treatment should be initiated. The safety of resuming these agents after HBV reactivation is controlled is not known. Therefore, prescribers should weigh the risks and benefits when considering resumption of therapy.

PACLitaxel has a major potential interaction with Liver Disease.

Paclitaxel is extensively metabolized by the liver. Patients with moderate to severe hepatic impairment may be at increased risk for hepatotoxicity. Additionally, myelotoxicity of paclitaxel may be exacerbated in patients with serum total bilirubin >2 times ULN. Therapy with paclitaxel should be administered cautiously and at a reduced dosage in patients with compromised hepatic function.

The adalimumab in Hyrimoz has a major potential interaction with Lymphoma.

In clinical trials malignancies have been observed in patients receiving TNF-blockers agents. Patients with psoriasis should be monitored for non-melanoma skin cancers (NMSCs), particularly those patients who have had prior prolonged phototherapy treatment. Melanoma and Merkel cell carcinoma have been reported in patients treated with TNF blocker therapy. Periodic skin examination is recommended for all patients, particularly those with risk factors for skin cancer. Postmarketing cases of fatal hepatosplenic T-cell lymphoma (HSTCL) have been reported in patients treated with TNF blockers. Caution should be exercised when considering these agents in the treatment of patients with a history of malignancies or in continuing treatment in patients who develop malignancies while receiving these agents.

The adalimumab in Hyrimoz has a moderate potential interaction with Pancytopenia.

Cases of leukopenia, neutropenia, thrombocytopenia, and pancytopenia, some with a fatal outcome, have been reported in patients treated with TNF blocking agents. Caution should be exercised when treating patients who have ongoing or a history of significant hematologic abnormalities. Discontinuation of therapy should be considered in patients with confirmed significant hematologic abnormalities.

PACLitaxel has a major potential interaction with Peripheral Neuropathy.

Dose-dependent peripheral neuropathy has been reported in 60% of patients during paclitaxel therapy. Severe peripheral neuropathy is rare and requires a 20% reduction in dosage of paclitaxel. Therapy with paclitaxel should be administered cautiously in patients with or predisposed to peripheral neuropathy.

The adalimumab in Hyrimoz has a major potential interaction with Skin Cancer.

In clinical trials malignancies have been observed in patients receiving TNF-blockers agents. Patients with psoriasis should be monitored for non-melanoma skin cancers (NMSCs), particularly those patients who have had prior prolonged phototherapy treatment. Melanoma and Merkel cell carcinoma have been reported in patients treated with TNF blocker therapy. Periodic skin examination is recommended for all patients, particularly those with risk factors for skin cancer. Postmarketing cases of fatal hepatosplenic T-cell lymphoma (HSTCL) have been reported in patients treated with TNF blockers. Caution should be exercised when considering these agents in the treatment of patients with a history of malignancies or in continuing treatment in patients who develop malignancies while receiving these agents.

The adalimumab in Hyrimoz has a major potential interaction with Tuberculosis, Active.

Cases of reactivation of tuberculosis or new tuberculosis infections have been observed in patients receiving TNF blocking agents, including patients who have previously received treatment for latent or active tuberculosis. Cases of active tuberculosis have also occurred in patients being treated with these agents during treatment for latent tuberculosis. Prior to initiating TNF blocking agents, patients should be screened for latent tuberculosis infection with a tuberculin skin test and periodically during therapy. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy with TNF blocking agents. Anti-tuberculosis therapy should also 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. Tuberculosis should be strongly considered in patients who develop a new infection during treatment, especially in patients who have previously or recently traveled to countries with a high prevalence of tuberculosis, or who have had close contact with a person with active tuberculosis.

The adalimumab in Hyrimoz has a major potential interaction with Tuberculosis, Latent.

Cases of reactivation of tuberculosis or new tuberculosis infections have been observed in patients receiving TNF blocking agents, including patients who have previously received treatment for latent or active tuberculosis. Cases of active tuberculosis have also occurred in patients being treated with these agents during treatment for latent tuberculosis. Prior to initiating TNF blocking agents, patients should be screened for latent tuberculosis infection with a tuberculin skin test and periodically during therapy. Patients testing positive in tuberculosis screening should be treated by standard medical practice prior to therapy with TNF blocking agents. Anti-tuberculosis therapy should also 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. Tuberculosis should be strongly considered in patients who develop a new infection during treatment, especially in patients who have previously or recently traveled to countries with a high prevalence of tuberculosis, or who have had close contact with a person with active tuberculosis.