Can you take Idelalisib with Myrac?

Idelalisib has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.

Cases of neutropenia have been reported with the use of idelalisib. It is recommended to monitor blood counts at least every 2 weeks for the first 6 months of therapy, and periodically thereafter. Care and close monitoring is recommended.

Idelalisib has a major potential interaction with Dermatitis, Drug-Induced.

Fatal cases of severe cutaneous reactions, including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) have occurred in patients treated with idelalisib. It is recommended that if SJS or TEN is suspected to interrupt therapy until the etiology of the reaction has been determined, and if SJS or TEN is confirmed to permanently discontinue treatment with idelalisib. Monitor patients for the development of severe cutaneous reactions and discontinue idelalisib if clinically appropriate.

Idelalisib has a major potential interaction with Diarrhea.

Severe diarrhea or colitis have been reported in patients treated with idelalisib. It is recommended to avoid concurrent use of idelalisib and other drugs that cause diarrhea. Care should be taken when using this agent in patients with diarrhea or colitis.

The minocycline in Myrac has a moderate potential interaction with Esophageal Obstruction.

The use of oral tetracycline capsules and tablets has been associated with esophageal irritation and ulceration in patients who ingested the drug without sufficient fluid shortly before bedtime. Therapy with solid formulations of tetracyclines should preferably be avoided in patients with esophageal obstruction, compression or dyskinesia. If the drugs are used, patients should be advised not to take the medication just before retiring and to drink fluids liberally.

Idelalisib has a moderate potential interaction with Gastrointestinal Perforation.

Fatal and serious intestinal perforations have been reported in patients treated with idelalisib, some patients reporting moderate to severe diarrhea at the time of perforation. Advise patients to promptly report any new or worsening abdominal pain, chills, fever, nausea, or vomiting. Discontinue therapy with idelalisib permanently in patients who experience intestinal perforation.

Idelalisib has a moderate potential interaction with Infection.

Fatal and/or serious infections, including pneumonia, sepsis, febrile neutropenia, Pneumocystis jirovecii pneumonia (PJP) or cytomegalovirus (CMV) have been reported in patients treated with idelalisib. It is recommended to monitor patients for signs and symptoms of infection and to interrupt therapy with idelalisib for Grade 3 or higher infection. Consider prophylaxis for PJP in patients at risk and interrupt therapy in patients with suspected PJP infection of any grade, and permanently discontinue treatment if PJP infection of any grade is confirmed or interrupt idelalisib in the setting of positive CMV PCR or antigen test until the infection has resolved. If therapy is subsequently resumed, patients should be monitored (by PCR or antigen test) for CMV reactivation at least monthly.

Idelalisib has a moderate potential interaction with Interstitial Lung Disease.

The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.

Idelalisib has a major potential interaction with Liver Disease.

Fatal and/or serious hepatotoxicity have been reported in patients treated with idelalisib. Monitor ALT and AST in all patients as clinically appropriate. Patients with baseline hepatic impairment should be monitored for signs of idelalisib toxicity and dose modification with idelalisib should be made accordingly. It is recommended to monitor weekly for liver toxicity if the ALT or AST rises above 3 times the upper limit of normal until resolved and withhold therapy with idelalisib if the ALT or AST is greater than 5 times the upper limit of normal, and continue to monitor AST, ALT and total bilirubin weekly until the normal levels are attained. Discontinue idelalisib for recurrent hepatotoxicity and to avoid concurrent use with other drugs that may cause liver toxicity.

The minocycline in Myrac has a moderate potential interaction with Liver Disease.

The use of tetracyclines has rarely been associated with hepatotoxicity. Histologic fatty changes of the liver, elevated liver enzymes, and jaundice have been reported, primarily in patients treated with large doses of intravenous tetracycline hydrochloride (no longer available in the U.S.) but also in patients receiving high oral doses of these drugs. Therapy with tetracyclines should be administered cautiously in patients with preexisting liver disease or biliary obstruction. Reduced dosages may be appropriate, particularly with minocycline and doxycycline, since the former is metabolized by the liver and the latter undergoes enterohepatic recycling. Liver function tests are recommended prior to and during therapy, and the concomitant use of other potentially hepatotoxic drugs should be avoided.

Idelalisib has a major potential interaction with Noninfectious Colitis.

Severe diarrhea or colitis have been reported in patients treated with idelalisib. It is recommended to avoid concurrent use of idelalisib and other drugs that cause diarrhea. Care should be taken when using this agent in patients with diarrhea or colitis.

The minocycline in Myrac has a major potential interaction with Noninfectious Colitis.

Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.

Idelalisib has a moderate potential interaction with Pulmonary Impairment.

The use of certain multikinase inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, these agents should be permanently discontinued and appropriate measures should be instituted. Treatment should be immediately withheld in patients diagnosed with ILD/pneumonitis and permanently discontinued if no other potential causes of ILD/pneumonitis have been identified.

The minocycline in Myrac has a moderate potential interaction with Renal Dysfunction.

Tetracyclines (except doxycycline) are eliminated by the kidney to various extent. Patients with renal impairment may be at greater risk for tetracycline-associated hepatic and/or renal toxicity (increased BUN with consequent azotemia, hyperphosphatemia, and acidosis) due to decreased drug clearance. Therapy with tetracyclines should be administered cautiously at reduced dosages in patients with renal impairment. Clinical monitoring of renal and liver function is recommended, and serum tetracycline levels may be necessary during prolonged therapy.