Can you take Iodine i 131 tositumomab with Omcazio?
1 drug interaction and 12 additional warnings found for the following 2 drugs:
- iodine i 131 tositumomab
- Omcazio (cabozantinib)
Drug interactions
Major drug interactions
Major:
iodine I 131 tositumomab cabozantinib
Applies to: iodine i 131 tositumomab and Omcazio (cabozantinib)
Using cabozantinib together with iodine I 131 tositumomab may increase the risk of bleeding. In clinical studies, treatment with cabozantinib alone has been associated with severe and sometimes fatal hemorrhage. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness; lightheadedness; red or black, tarry stools; coughing up or vomiting fresh or dried blood that looks like coffee grounds; severe headache; and weakness. 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
Moderate food/lifestyle interactions
Moderate:
cabozantinib Food/Lifestyle
Applies to: Omcazio (cabozantinib)
Cabozantinib should be taken on an empty stomach, one hour before or two hours after a meal. Do not consume grapefruit, grapefruit juice, or any supplements that contain grapefruit extract during treatment with cabozantinib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of cabozantinib. You may be more likely to experience side effects such as nausea; vomiting; diarrhea; loss of appetite; weight loss; mouth sores; abdominal pain; skin rash (primarily on the palms of the hands and soles of the feet); delayed wound healing; high blood pressure; and impaired bone marrow function resulting in low numbers of different types of blood cells, which can increase the risk of bleeding problems and infections. 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.
Disease interactions
11 potential interactions Applies to: 11 conditions, including High Blood Pressure, Heart Attack, Diverticulitis, Thrombotic/Thromboembolic Disorder, and Liver Disease.
Bleeding Disorder
Major:
Omcazio
The cabozantinib in Omcazio has a major potential interaction with Bleeding Disorder.
Fatal hemorrhagic events have been reported with the use of cabozantinib. Therapy with cabozantinib is not recommended in patients that have or are at risk for severe hemorrhage.
Diverticulitis
Moderate:
Omcazio
The cabozantinib in Omcazio has a moderate potential interaction with Diverticulitis.
Therapy with cabozantinib should be used with caution in patients who may be at increased risk for gastrointestinal perforation, such as those with a history of diverticulitis. Patients presenting with new onset of abdominal symptoms should be evaluated promptly for early identification of gastrointestinal perforation. It is recommended to monitor for symptoms of gastrointestinal perforation or fistula periodically throughout the treatment. Discontinue cabozantinib in patients who experience a fistula which cannot be appropriately managed or a GI perforation.
Gastrointestinal Perforation
Moderate:
Omcazio
The cabozantinib in Omcazio has a moderate potential interaction with Gastrointestinal Perforation.
Therapy with cabozantinib should be used with caution in patients who may be at increased risk for gastrointestinal perforation, such as those with a history of diverticulitis. Patients presenting with new onset of abdominal symptoms should be evaluated promptly for early identification of gastrointestinal perforation. It is recommended to monitor for symptoms of gastrointestinal perforation or fistula periodically throughout the treatment. Discontinue cabozantinib in patients who experience a fistula which cannot be appropriately managed or a GI perforation.
Heart Attack
Moderate:
Omcazio
The cabozantinib in Omcazio has a moderate potential interaction with Heart Attack.
Arterial and venous thromboembolic events have been reported with the use of cabozantinib. Use with caution in patients who are at risk, or have a history of these events. It is recommended to monitor closely for signs and symptoms of thromboembolism. Discontinue cabozantinib in patients who develop an acute myocardial infarction or any other arterial thromboembolic complication.
High Blood Pressure
Moderate:
Omcazio
The cabozantinib in Omcazio has a moderate potential interaction with High Blood Pressure.
The use of cabozantinib causes hypertension. Blood pressure should be well-controlled prior to initiating cabozantinib and monitored and treated as needed with standard anti-hypertensive therapy. It is recommended to reduce the dose in case of persistent hypertension despite use of anti-hypertensive medications and to discontinue therapy if hypertension is severe and persistent despite these measures. Discontinue cabozantinib therapy for severe hypertension that cannot be controlled with anti-hypertensive therapy and if there is evidence of hypertensive crisis or severe hypertension despite optimal medical management. Close monitoring is recommended.
Interstitial Lung Disease
Moderate:
Omcazio
The cabozantinib in Omcazio 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.
Liver Disease
Moderate:
Omcazio
The cabozantinib in Omcazio has a moderate potential interaction with Liver Disease.
Increased exposure to cabozantinib has been observed in patients with mild to moderate hepatic impairment. It is recommended to reduce the cabozantinib dose in patients with mild or moderate hepatic impairment. The use of cabozantinib is not recommended in patients with severe hepatic impairment. It is recommended to monitor liver function and urine bilirubin tests periodically during therapy.
Posterior Reversible Encephalopathy Syndrome
Moderate:
Omcazio
The cabozantinib in Omcazio has a moderate potential interaction with Posterior Reversible Encephalopathy Syndrome.
Reversible posterior leukoencephalopathy syndrome (RPLS) has been reported in patients receiving cabozantinib. It is recommended to discontinue therapy in patients developing RPLS. The safety of reinitiating therapy in patients previously experiencing RPLS is not known. Care and close monitoring should be considered in these patients.
Pulmonary Impairment
Moderate:
Omcazio
The cabozantinib in Omcazio 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.
Renal Dysfunction
Moderate:
Omcazio
The cabozantinib in Omcazio has a moderate potential interaction with Renal Dysfunction.
No dose adjustment is required in patients with mild or moderate renal impairment. There is no experience with cabozantinib in patients with severe renal impairment. Care should be exercised in these patients.
Thrombotic/Thromboembolic Disorder
Moderate:
Omcazio
The cabozantinib in Omcazio has a moderate potential interaction with Thrombotic/Thromboembolic Disorder.
Arterial and venous thromboembolic events have been reported with the use of cabozantinib. Use with caution in patients who are at risk, or have a history of these events. It is recommended to monitor closely for signs and symptoms of thromboembolism. Discontinue cabozantinib in patients who develop an acute myocardial infarction or any other arterial thromboembolic complication.
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More resources
iodine i 131 tositumomab
A total of 307 drugs are known to interact with iodine i 131 tositumomab.
- Iodine i 131 tositumomab is in the following drug classes: CD20 monoclonal antibodies, therapeutic radiopharmaceuticals.
- Iodine i 131 tositumomab is used to treat Non-Hodgkin's Lymphoma.
Omcazio
A total of 560 drugs are known to interact with Omcazio.
- Omcazio is in the following drug classes: multikinase inhibitors, VEGF/VEGFR inhibitors.
- Omcazio is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.