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Drug Interactions between iodine i 131 tositumomab and P-A-C Analgesic

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

aspirin iodine I 131 tositumomab

Applies to: P-A-C Analgesic (aspirin / caffeine) and iodine i 131 tositumomab

MONITOR CLOSELY: Coadministration of tositumomab and iodine I 131 tositumomab with drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. Tositumomab and iodine I 131 tositumomab alone can cause severe or life-threatening thrombocytopenia. In premarketing clinical studies, NCI CTC grade 3 and 4 thrombocytopenia occurred in 53% of 230 patients, and sequelae included hemorrhage in 12% and requirement of platelet transfusions in 15% of patients. The time to thrombocyte nadir was 4 to 7 weeks and the duration of thrombocytopenia was approximately 30 days. However, 7% of the patients experienced thrombocytopenia that extended beyond 90 days following administration of the therapeutic regimen.

MANAGEMENT: Due to the frequent occurrence of severe and prolonged thrombocytopenia associated with tositumomab and iodine I 131 tositumomab, concomitant use of other medications that interfere with platelet function or coagulation should be considered cautiously. Close clinical and laboratory observation for bleeding complications is recommended during and after the therapeutic regimen. A complete blood count (CBC) with differential and platelet count should be obtained prior to and at least weekly for a minimum of 10 weeks after treatment.

References

  1. "Product Information. Bexxar I 131 Therapeutic (iodine I 131 tositumomab)." GlaxoSmithKline (2022):
  2. "Product Information. BexxarTherapy (tositumomab)." GlaxoSmithKline Inc (2006):

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Minor

aspirin caffeine

Applies to: P-A-C Analgesic (aspirin / caffeine) and P-A-C Analgesic (aspirin / caffeine)

One study has reported that coadministration of caffeine and aspirin lead to a 25% increase in the rate of appearance and 17% increase in maximum concentration of salicylate in the plasma. A significantly higher area under the plasma concentration time curve of salicylate was also reported when both drugs were administered together. The exact mechanism of this interaction has not been specified. Physicians and patients should be aware that coadministration of aspirin and caffeine may lead to higher salicylate levels faster.

References

  1. Yoovathaworn KC, Sriwatanakul K, Thithapandha A "Influence of caffeine on aspirin pharmacokinetics." Eur J Drug Metab Pharmacokinet 11 (1986): 71-6

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Drug and food interactions

Moderate

aspirin food

Applies to: P-A-C Analgesic (aspirin / caffeine)

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

References

  1. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn PROD (2002):

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Minor

caffeine food

Applies to: P-A-C Analgesic (aspirin / caffeine)

The effect of grapefruit juice on the pharmacologic activity of caffeine is controversial. One report suggests that grapefruit juice increases the effect of caffeine. The proposed mechanism is inhibition of cytochrome P-450 metabolism of caffeine. However, a well-conducted pharmacokinetic/pharmacodynamic study did not demonstrate this effect. The clinical significance of this potential interaction is unknown.

References

  1. "Grapefruit juice interactions with drugs." Med Lett Drugs Ther 37 (1995): 73-4
  2. Maish WA, Hampton EM, Whitsett TL, Shepard JD, Lovallo WR "Influence of grapefruit juice on caffeine pharmacokinetics and pharmacodynamics." Pharmacotherapy 16 (1996): 1046-52

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Minor

aspirin food

Applies to: P-A-C Analgesic (aspirin / caffeine)

One study has reported that coadministration of caffeine and aspirin lead to a 25% increase in the rate of appearance and 17% increase in maximum concentration of salicylate in the plasma. A significantly higher area under the plasma concentration time curve of salicylate was also reported when both drugs were administered together. The exact mechanism of this interaction has not been specified. Physicians and patients should be aware that coadministration of aspirin and caffeine may lead to higher salicylate levels faster.

References

  1. Yoovathaworn KC, Sriwatanakul K, Thithapandha A "Influence of caffeine on aspirin pharmacokinetics." Eur J Drug Metab Pharmacokinet 11 (1986): 71-6

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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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.

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