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Can you take Interferon alfa-2b with Temozolomide?

1 drug interaction and 23 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

interferon alfa-2b temozolomide

Applies to: interferon alfa-2b and temozolomide

Using interferon alfa-2b together with temozolomide or other chemotherapy drugs may increase the risk of side effects, especially those that affect the bone marrow or gastrointestinal tract.

You may experience a greater number or more severe side effects such as:

  • nausea
  • vomiting
  • diarrhea
  • loss of appetite
  • mouth sores
  • abdominal pain
  • delayed wound healing
  • impaired bone marrow function resulting in low numbers of different types of blood cells

You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts.

You should seek medical attention if you develop:

  • paleness
  • fatigue
  • dizziness
  • fainting
  • unusual bruising or bleeding
  • fever
  • chills
  • diarrhea
  • sore throat
  • muscle aches
  • shortness of breath
  • blood in phlegm
  • weight loss
  • red or inflamed skin
  • body sores
  • pain or burning during urination

You may need a dose adjustment or more frequent monitoring by your doctor to safely use these 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

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Disease interactions

23 potential interactions Applies to: 20 conditions, including Depression, Allergies, Underactive Thyroid, Heart Failure, and Seizures.

Allergies

Major:

temozolomide

Temozolomide has a major potential interaction with Allergies.

Temozolomide is contraindicated in patients with a history of urticaria, allergic reaction including anaphylaxis, toxic epidermal necrolysis, and Stevens-Johnson syndrome.

Arrhythmia

Major:

interferon alfa-2b

Interferon alfa-2b has a major potential interaction with Arrhythmia.

Hypertension, arrhythmias, angina, myocardial infarction, cardiomyopathy, and congestive heart failure have been reported during interferon therapy. Therapy with interferons should be administered with caution in patients with compromised cardiac function.

Autoimmune Disorders

Major:

interferon alfa-2b

Interferon alfa-2b has a major potential interaction with Autoimmune Disorders.

Antiviral interferons may exacerbate autoimmune disorders such as myositis, thyroiditis, systemic lupus erythematosus, rheumatoid arthritis, psoriasis, or autoimmune hepatitis. Therapy should be avoided or administered with extreme caution in patients with autoimmune disorders.

Bone Marrow Depression/Low Blood Counts

Moderate:

interferon alfa-2b

Interferon alfa-2b has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.

Interferons (alfa and gamma) induce a dose-dependent, generally mild, myelosuppression. Leukopenia is the primary manifestation. Thrombocytopenia and anemia occur less frequently. Therapy with interferons (alfa and gamma) should be administered cautiously to patients with bone marrow suppression. Clinical monitoring of hematopoietic function is recommended.

Moderate:

temozolomide

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

Patients treated with temozolomide may experience myelosuppression, including prolonged pancytopenia, which may result in aplastic anemia, which in some cases has resulted in a fatal outcome. Prior to dosing, patients must have an absolute neutrophil count (ANC) greater than or equal to 1.5 × 109/L and a platelet count greater than or equal to 100 × 109/L. A complete blood count should be obtained on Day 22 (21 days after the first dose) or within 48 hours of that day, and weekly until the ANC is above 1.5 × 109/L and platelet count exceeds 100 × 109/L. Therapy with temozolomide should be administered cautiously in patients with compromised bone marrow reserve. Close clinical monitoring of hematopoietic function is recommended.

Cardiovascular Conditions and Disorders

Major:

interferon alfa-2b

Interferon alfa-2b has a major potential interaction with Cardiovascular Conditions and Disorders.

Hypertension, arrhythmias, angina, myocardial infarction, cardiomyopathy, and congestive heart failure have been reported during interferon therapy. Therapy with interferons should be administered with caution in patients with compromised cardiac function.

Depression

Major:

interferon alfa-2b

Interferon alfa-2b has a major potential interaction with Depression.

Interferons (alfa or beta) can induce depression and suicidal behavior. Suicidal attempts and suicides have been reported. Therapy with interferons (alfa or beta) should be administered cautiously to patients with or predisposed to mental depression. Clinical monitoring of psychological status is recommended.

Diabetes Mellitus

Moderate:

interferon alfa-2b

Interferon alfa-2b has a moderate potential interaction with Diabetes Mellitus.

Flu-like symptoms frequently associated with interferon-alfa therapy can precipitate ketoacidosis in diabetic patients. Therapy with interferon alfa should be administered cautiously in patients with diabetes mellitus. Clinical monitoring of blood glucose concentrations and anti-diabetic therapy is recommended.

Heart Failure

Major:

interferon alfa-2b

Interferon alfa-2b has a major potential interaction with Heart Failure.

Hypertension, arrhythmias, angina, myocardial infarction, cardiomyopathy, and congestive heart failure have been reported during interferon therapy. Therapy with interferons should be administered with caution in patients with compromised cardiac function.

Hyperthyroidism

Major:

interferon alfa-2b

Interferon alfa-2b has a major potential interaction with Hyperthyroidism.

Thyroid abnormalities, hypothyroidism or hyperthyroidism, have been reported in patients administered interferons. Therapy with interferons should be administered cautiously to patients with thyroid dysfunction. If thyroid control cannot be maintained within normal limits with medication, interferon-alfa should be discontinued. Clinical monitoring of thyroid function is recommended.

Ischemic Heart Disease

Major:

interferon alfa-2b

Interferon alfa-2b has a major potential interaction with Ischemic Heart Disease.

Hypertension, arrhythmias, angina, myocardial infarction, cardiomyopathy, and congestive heart failure have been reported during interferon therapy. Therapy with interferons should be administered with caution in patients with compromised cardiac function.

Liver Disease

Major:

interferon alfa-2b

Interferon alfa-2b has a major potential interaction with Liver Disease.

Hepatotoxicity, including fatal cases, has been reported in patients treated with interferon alpha. Additionally, the risk of hepatic decompensation and death is increased in patients with cirrhosis. Any patient developing liver function abnormalities during treatment should be monitored closely and treatment should be discontinued if appropriate. Interferon-alfa is contraindicated in patients with autoimmune hepatitis and decompensated liver disease.

Moderate:

temozolomide

Temozolomide has a moderate potential interaction with Liver Disease.

A study showed that the pharmacokinetics of temozolomide in patients with mild-to-moderate hepatic impairment (Child-Pugh Class I - II) were similar to those observed in patients with normal hepatic function. Caution should be exercised when temozolomide is administered to patients with severe hepatic impairment.

Pancytopenia

Moderate:

temozolomide

Temozolomide has a moderate potential interaction with Pancytopenia.

Patients treated with temozolomide may experience myelosuppression, including prolonged pancytopenia, which may result in aplastic anemia, which in some cases has resulted in a fatal outcome. Prior to dosing, patients must have an absolute neutrophil count (ANC) greater than or equal to 1.5 × 109/L and a platelet count greater than or equal to 100 × 109/L. A complete blood count should be obtained on Day 22 (21 days after the first dose) or within 48 hours of that day, and weekly until the ANC is above 1.5 × 109/L and platelet count exceeds 100 × 109/L. Therapy with temozolomide should be administered cautiously in patients with compromised bone marrow reserve. Close clinical monitoring of hematopoietic function is recommended.

Parkinsonism

Major:

interferon alfa-2b

Interferon alfa-2b has a major potential interaction with Parkinsonism.

Reversible CNS effects such as seizures, mental status changes, manic behavior or psychotic reactions, gait disturbances, and dizziness have occurred in patients receiving interferons. Therapy with interferons should be administered cautiously in patients with or predisposed to seizures, psychiatric disorders, or conditions affecting posture or gait.

Peripheral Neuropathy

Moderate:

interferon alfa-2b

Interferon alfa-2b has a moderate potential interaction with Peripheral Neuropathy.

Paresthesia and numbness have been reported during interferon therapy. Therapy with interferons should be administered cautiously in patients with or predisposed to peripheral neuropathy.

Psychosis

Major:

interferon alfa-2b

Interferon alfa-2b has a major potential interaction with Psychosis.

Reversible CNS effects such as seizures, mental status changes, manic behavior or psychotic reactions, gait disturbances, and dizziness have occurred in patients receiving interferons. Therapy with interferons should be administered cautiously in patients with or predisposed to seizures, psychiatric disorders, or conditions affecting posture or gait.

Renal Dysfunction

Major:

interferon alfa-2b

Interferon alfa-2b has a major potential interaction with Renal Dysfunction.

Proteinuria (rare), not associated with a decrease in serum protein, is the most common renal toxicity observed with interferon- alfa therapy. Increased BUN and serum creatinine levels, hematuria, acute renal failure and nephrotic syndrome have also been reported. Therapy with interferon alfa should be administered cautiously to patients with severe renal dysfunction. Renal function should be evaluated in all patients before initiation of interferon- alfa therapy. In addition, patients with any degree of renal impairment should be carefully monitored for laboratory abnormalities and decreased creatinine clearance. A reduced dose of medication is recommended in patients with low CrCl (less than 50 mL/min - 30 mL/min).

Moderate:

temozolomide

Temozolomide has a moderate potential interaction with Renal Dysfunction.

Temozolomide population pharmacokinetic analysis indicated that creatinine clearance over the range of 36 to 130 mL/min/m2 has no effect on its clearance after oral administration. The pharmacokinetics of temozolomide have not been studied in patients with severely impaired renal function (CrCl <36 mL/min/m2). Caution should be exercised when temozolomide is administered to patients with severe renal impairment. Temozolomide has not been studied in patients on dialysis.

Seizures

Major:

interferon alfa-2b

Interferon alfa-2b has a major potential interaction with Seizures.

Reversible CNS effects such as seizures, mental status changes, manic behavior or psychotic reactions, gait disturbances, and dizziness have occurred in patients receiving interferons. Therapy with interferons should be administered cautiously in patients with or predisposed to seizures, psychiatric disorders, or conditions affecting posture or gait.

Ulcerative Colitis

Moderate:

interferon alfa-2b

Interferon alfa-2b has a moderate potential interaction with Ulcerative Colitis.

Fatal and nonfatal ulcerative or hemorrhagic/ischemic colitis have been observed within 12 weeks of the start of alpha interferon treatment. Abdominal pain, bloody diarrhea, and fever are the typical manifestations. Treatment should be discontinued immediately in patients who develop these signs and symptoms. The colitis usually resolves within 1 to 3 weeks of discontinuation of alpha interferons.

Underactive Thyroid

Major:

interferon alfa-2b

Interferon alfa-2b has a major potential interaction with Underactive Thyroid.

Thyroid abnormalities, hypothyroidism or hyperthyroidism, have been reported in patients administered interferons. Therapy with interferons should be administered cautiously to patients with thyroid dysfunction. If thyroid control cannot be maintained within normal limits with medication, interferon-alfa should be discontinued. Clinical monitoring of thyroid function is recommended.

Urticaria

Major:

temozolomide

Temozolomide has a major potential interaction with Urticaria.

Temozolomide is contraindicated in patients with a history of urticaria, allergic reaction including anaphylaxis, toxic epidermal necrolysis, and Stevens-Johnson syndrome.

More resources

interferon alfa-2b

A total of 272 drugs are known to interact with interferon alfa-2b.

temozolomide

A total of 286 drugs are known to interact with temozolomide.

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.