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Can you take Iodine i 131 tositumomab with Ramucirumab?

1 drug interaction and 13 additional warnings found for the following 2 drugs:

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Drug interactions

Major drug interactions

Major:

iodine I 131 tositumomab ramucirumab

Applies to: iodine i 131 tositumomab and ramucirumab

Using ramucirumab together with iodine I 131 tositumomab may increase the risk of bleeding. In clinical studies, treatment with ramucirumab 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

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

Disease interactions

13 potential interactions Applies to: 13 conditions, including Underactive Thyroid, Pulmonary Embolism, Thrombotic/Thromboembolic Disorder, Liver Disease, and Bleeding Disorder.

Bleeding Disorder

Major:

ramucirumab

Ramucirumab has a major potential interaction with Bleeding Disorder.

Ramucirumab may increase the risk of bleeding. Patients have experienced gastrointestinal hemorrhage, including severe and sometimes fatal hemorrhagic events when using this agent. Permanently discontinue ramucirumab in patients experiencing severe bleeding.

Gastrointestinal Obstruction

Major:

ramucirumab

Ramucirumab has a major potential interaction with Gastrointestinal Obstruction.

Inhibitors of vascular endothelial growth factor receptors (VEGFR) may cause gastrointestinal perforation and fistulae. Avoid use of these agents in patients with ovarian cancer who have evidence of recto-sigmoid involvement by pelvic examination or bowel involvement on CT scan or clinical symptoms of bowel obstruction. Permanently discontinue these agents in patients with gastrointestinal perforation.

Gastrointestinal Perforation

Major:

ramucirumab

Ramucirumab has a major potential interaction with Gastrointestinal Perforation.

Inhibitors of vascular endothelial growth factor receptors (VEGFR) may cause gastrointestinal perforation and fistulae. Avoid use of these agents in patients with ovarian cancer who have evidence of recto-sigmoid involvement by pelvic examination or bowel involvement on CT scan or clinical symptoms of bowel obstruction. Permanently discontinue these agents in patients with gastrointestinal perforation.

History, Radiation Therapy

Major:

ramucirumab

Ramucirumab has a major potential interaction with History, Radiation Therapy.

Inhibitors of vascular endothelial growth factor receptors (VEGFR) may cause gastrointestinal perforation and fistulae. Avoid use of these agents in patients with ovarian cancer who have evidence of recto-sigmoid involvement by pelvic examination or bowel involvement on CT scan or clinical symptoms of bowel obstruction. Permanently discontinue these agents in patients with gastrointestinal perforation.

History, Thrombotic/Thromboembolic Disorder

Moderate:

ramucirumab

Ramucirumab has a moderate potential interaction with History, Thrombotic/Thromboembolic Disorder.

Venous and arterial thromboembolic events (VTE and ATE), some fatal, have been reported with the use of inhibitors of vascular endothelial growth factor receptors (VEGFR). Caution is recommended when using these agents in patients with a reported history of VTE or ATE. These agents should be discontinued in patients with serious or life-threatening VTE or ATE, including pulmonary embolism.

Hypertensive Encephalopathy

Moderate:

ramucirumab

Ramucirumab has a moderate potential interaction with Hypertensive Encephalopathy.

Inhibitors of vascular endothelial growth factor receptors (VEGFR) have been associated with severe increases in blood pressure. Therapy with these agents should be administered cautiously in patients with preexisting hypertension. Blood pressure should be assessed prior to initiating treatment, regularly during treatment and after discontinuation in patients with bevacizumab -induced or -exacerbated hypertension. Temporarily suspend these agents in patients with severe hypertension that is not controlled with medical management. Discontinue these agents in patients with hypertensive crisis or hypertensive encephalopathy.

Liver Disease

Moderate:

ramucirumab

Ramucirumab has a moderate potential interaction with Liver Disease.

The effect of hepatic impairment on the clearance of ramucirumab was evaluated in patients with mild and moderate hepatic impairment. No clinically important differences in the clearance of ramucirumab were found between patients with mild or moderate hepatic impairment compared to patients with normal hepatic function. No dose adjustment is recommended for patients with mild or moderate hepatic impairment. No PK data are available from patients with severe hepatic dysfunction.

Posterior Reversible Encephalopathy Syndrome

Moderate:

ramucirumab

Ramucirumab has a moderate potential interaction with Posterior Reversible Encephalopathy Syndrome.

Posterior Reversible Encephalopathy Syndrome (PRES) has been reported with the use of inhibitors of vascular endothelial growth factor receptors (VEGFR) in clinical studies. PRES is a neurological disorder which can present with headache, seizure, lethargy, confusion, blindness and other visual and neurologic disturbances. It is recommended to discontinue these agents in patients developing PRES. The safety of restarting therapy is not known. Cation is recommended if therapy is reinitiating in patients previously experiencing PRES.

Proteinuria

Moderate:

ramucirumab

Ramucirumab has a moderate potential interaction with Proteinuria.

The incidence and severity of proteinuria is increased in patients taking inhibitors of vascular endothelial growth factor receptors (VEGFR). Therapy with these agents should be administered cautiously in patients with renal dysfunction. Monitoring for proteinuria and hematuria is recommended and perform baseline and periodic urinalyses during treatment, with follow up measurement as clinically indicated. It is recommended to temporarily suspend these agents in patients with moderate to severe proteinuria and to discontinue therapy in patients with nephrotic syndrome.

Pulmonary Embolism

Moderate:

ramucirumab

Ramucirumab has a moderate potential interaction with Pulmonary Embolism.

Venous and arterial thromboembolic events (VTE and ATE), some fatal, have been reported with the use of inhibitors of vascular endothelial growth factor receptors (VEGFR). Caution is recommended when using these agents in patients with a reported history of VTE or ATE. These agents should be discontinued in patients with serious or life-threatening VTE or ATE, including pulmonary embolism.

Renal Dysfunction

Moderate:

ramucirumab

Ramucirumab has a moderate potential interaction with Renal Dysfunction.

The incidence and severity of proteinuria is increased in patients taking inhibitors of vascular endothelial growth factor receptors (VEGFR). Therapy with these agents should be administered cautiously in patients with renal dysfunction. Monitoring for proteinuria and hematuria is recommended and perform baseline and periodic urinalyses during treatment, with follow up measurement as clinically indicated. It is recommended to temporarily suspend these agents in patients with moderate to severe proteinuria and to discontinue therapy in patients with nephrotic syndrome.

Thrombotic/Thromboembolic Disorder

Moderate:

ramucirumab

Ramucirumab has a moderate potential interaction with Thrombotic/Thromboembolic Disorder.

Venous and arterial thromboembolic events (VTE and ATE), some fatal, have been reported with the use of inhibitors of vascular endothelial growth factor receptors (VEGFR). Caution is recommended when using these agents in patients with a reported history of VTE or ATE. These agents should be discontinued in patients with serious or life-threatening VTE or ATE, including pulmonary embolism.

Underactive Thyroid

Moderate:

ramucirumab

Ramucirumab has a moderate potential interaction with Underactive Thyroid.

Hypothyroidism has been reported in patients taking ramucirumab. Therapy with ramucirumab should be administered cautiously to patients with thyroid dysfunction. Baseline laboratory measurement of thyroid function is recommended and if appropriate, treatment per standard medical practice should be given prior to initiation of therapy. Clinical monitoring of thyroid function is recommended during therapy.

More resources

iodine i 131 tositumomab

A total of 307 drugs are known to interact with iodine i 131 tositumomab.

ramucirumab

A total of 149 drugs are known to interact with ramucirumab.

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.