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Can you take Iopamidol with Nelarabine?

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

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Drug interactions

Major drug interactions

Major:

iopamidol nelarabine

Applies to: iopamidol and nelarabine

Before you undergo any imaging procedure where iopamidol may be injected directly into the spine, let your doctor know if you are currently being treated with nelarabine. Injection of iopamidol into the spine can sometimes cause seizures, and the risk may be increased if you are also using other medications that can cause seizures such as nelarabine. You may be more susceptible if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. Your doctor may want to withhold nelarabine for a certain length of time before and after the procedure, or you may need to be monitored more closely during the procedure. 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: 18 conditions, including High Blood Pressure, Allergies, Heart Failure, Asthma, and Hyperthyroidism.

Allergies

Moderate:

iopamidol

Iopamidol has a moderate potential interaction with Allergies.

The possibility of a reaction, including serious, life-threatening, fatal, anaphylactoid or cardiovascular reactions, should always be considered when using iopamidol. Patients at increased risk include those with a history of a previous reaction to a contrast medium, patients with a known sensitivity to iodine per se, and patients with a known clinical hypersensitivity (bronchial asthma, hay fever, and food allergies). Caution and monitoring is advised. Competent personnel and emergency facilities should be available for at least 30 to 60 minutes since severe delayed reactions may occur.

Moderate:

iopamidol

Iopamidol has a moderate potential interaction with Allergies.

Iodinated contrast media such as ioversol, can cause life-threatening or fatal hypersensitivity reactions including anaphylaxis and anaphylactic shock. Manifestations include respiratory arrest, laryngospasm, bronchospasm, angioedema, and shock. Most severe reactions develop shortly after the start of the injection (e.g. within 1 to 3 minutes), but delayed reactions may occur. There is an increased risk in patients with a history of a previous reaction to contrast agent, and known allergies (i.e., bronchial asthma, drug, or food allergies), and other hypersensitivities. Caution is advised on these patients. Premedication with antihistamines or corticosteroids to avoid or minimize possible allergic reactions may reduce both their incidence and severity.

Asthma

Moderate:

iopamidol

Iopamidol has a moderate potential interaction with Asthma.

The possibility of a reaction, including serious, life-threatening, fatal, anaphylactoid or cardiovascular reactions, should always be considered when using iopamidol. Patients at increased risk include those with a history of a previous reaction to a contrast medium, patients with a known sensitivity to iodine per se, and patients with a known clinical hypersensitivity (bronchial asthma, hay fever, and food allergies). Caution and monitoring is advised. Competent personnel and emergency facilities should be available for at least 30 to 60 minutes since severe delayed reactions may occur.

Moderate:

iopamidol

Iopamidol has a moderate potential interaction with Asthma.

Iodinated contrast media such as ioversol, can cause life-threatening or fatal hypersensitivity reactions including anaphylaxis and anaphylactic shock. Manifestations include respiratory arrest, laryngospasm, bronchospasm, angioedema, and shock. Most severe reactions develop shortly after the start of the injection (e.g. within 1 to 3 minutes), but delayed reactions may occur. There is an increased risk in patients with a history of a previous reaction to contrast agent, and known allergies (i.e., bronchial asthma, drug, or food allergies), and other hypersensitivities. Caution is advised on these patients. Premedication with antihistamines or corticosteroids to avoid or minimize possible allergic reactions may reduce both their incidence and severity.

Dehydration

Moderate:

iopamidol

Iopamidol has a moderate potential interaction with Dehydration.

When using iopamidol, preparatory dehydration is dangerous and may contribute to acute renal failure in patients with advanced vascular disease, diabetic patients, and in susceptible nondiabetic patients (often elderly with preexisting renal disease). Patients should be well hydrated prior to and following iopamidol administration.

Heart Failure

Moderate:

iopamidol

Iopamidol has a moderate potential interaction with Heart Failure.

In patients with advanced renal disease, iodinated contrast media should be used with caution, and only when the need for the examination dictates, since the excretion of the medium may be impaired. Patients with combined renal and hepatic disease, severe hypertension or congestive heart failure, and those with recent renal transplant may present an additional risk.

Moderate:

iopamidol

Iopamidol has a moderate potential interaction with Heart Failure.

After parenteral administration of a radiopaque agent such as iopamidol, competent personnel and emergency facilities should be available for at least 30 to 60 minutes since severe delayed reactions may occur. Caution should be exercised in hydrating patients with underlying conditions that may be worsened by fluid overload, such as congestive heart failure.

High Blood Pressure

Moderate:

iopamidol

Iopamidol has a moderate potential interaction with High Blood Pressure.

In patients with advanced renal disease, iodinated contrast media should be used with caution, and only when the need for the examination dictates, since the excretion of the medium may be impaired. Patients with combined renal and hepatic disease, severe hypertension or congestive heart failure, and those with recent renal transplant may present an additional risk.

History, Radiation Therapy

Major:

nelarabine

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

Severe neurologic adverse reactions have been reported with the use of nelarabine. Neurotoxicity is the dose-limiting toxicity of nelarabine. Patients treated previously or concurrently with intrathecal chemotherapy or previously with craniospinal irradiation may be at increased risk for neurologic adverse events. Close monitoring for neurologic adverse reactions is strongly recommended, when using nelarabine and therapy should be discontinued for neurologic adverse reactions of NCI Common Toxicity Criteria Grade 2 or greater.

Hyperthyroidism

Major:

iopamidol

Iopamidol has a major potential interaction with Hyperthyroidism.

Reports of thyroid storm following the use of iodinated diagnostic agents in patients with hyperthyroidism or with an autonomously functioning thyroid nodule suggest that this additional risk be evaluated in such patients before the use of any contrast medium. Some agents such as ioversol are contraindicated in symptomatic hyperthyroidism.

Hyperuricemia Secondary to Chemotherapy

Moderate:

nelarabine

Nelarabine has a moderate potential interaction with Hyperuricemia Secondary to Chemotherapy.

Patients receiving nelarabine should receive intravenous hydration according to standard medical practice for the management of hyperuricemia in patients at risk for tumor lysis syndrome. Consideration should be given to the use of allopurinol in patients at risk of hyperuricemia.

Kidney Transplant

Moderate:

iopamidol

Iopamidol has a moderate potential interaction with Kidney Transplant.

In patients with advanced renal disease, iodinated contrast media should be used with caution, and only when the need for the examination dictates, since the excretion of the medium may be impaired. Patients with combined renal and hepatic disease, severe hypertension or congestive heart failure, and those with recent renal transplant may present an additional risk.

Liver Disease

Moderate:

iopamidol

Iopamidol has a moderate potential interaction with Liver Disease.

In patients with advanced renal disease, iodinated contrast media should be used with caution, and only when the need for the examination dictates, since the excretion of the medium may be impaired. Patients with combined renal and hepatic disease, severe hypertension or congestive heart failure, and those with recent renal transplant may present an additional risk.

Moderate:

nelarabine

Nelarabine has a moderate potential interaction with Liver Disease.

The influence of hepatic impairment on the pharmacokinetics of nelarabine has not been evaluated. Because the risk of adverse reactions to this drug may be greater in patients with severe hepatic impairment (total bilirubin greater than 3 times upper limit of normal), it is recommended to closely monitor patients with severe liver dysfunction when treated with nelarabine.

Multiple Myeloma

Moderate:

iopamidol

Iopamidol has a moderate potential interaction with Multiple Myeloma.

A definite risk exists in the use of intravascular contrast agents in patients who are known to have multiple myeloma. In such cases, anuria has developed resulting in progressive uremia, renal failure and eventually death. Although neither the contrast agent nor dehydration has separately proved to be the cause of anuria in myeloma, it has been speculated that the combination of both may be causative factors. The risk in patients with myeloma is not a contraindication to the procedure; however, partial dehydration in the preparation of these patients for the examination is not recommended since this may predispose to precipitation of myeloma protein in the renal tubules. Myeloma, which occurs most commonly in persons over 40, should be considered before instituting intravascular administration of contrast agents.

Myasthenia Gravis

Moderate:

iopamidol

Iopamidol has a moderate potential interaction with Myasthenia Gravis.

The administration of iodinated contrast media may aggravate the symptoms of myasthenia gravis. Caution is advised when using these agents in patients with this condition.

Neurological Disorders

Major:

nelarabine

Nelarabine has a major potential interaction with Neurological Disorders.

Severe neurologic adverse reactions have been reported with the use of nelarabine. Neurotoxicity is the dose-limiting toxicity of nelarabine. Patients treated previously or concurrently with intrathecal chemotherapy or previously with craniospinal irradiation may be at increased risk for neurologic adverse events. Close monitoring for neurologic adverse reactions is strongly recommended, when using nelarabine and therapy should be discontinued for neurologic adverse reactions of NCI Common Toxicity Criteria Grade 2 or greater.

Pheochromocytoma

Major:

iopamidol

Iopamidol has a major potential interaction with Pheochromocytoma.

Administration of radiopaque materials to patients known or suspected of having pheochromocytoma should be performed with extreme caution. If, in the opinion of the physician, the possible benefits of such procedures outweigh the considered risk, the procedures should be performed with the absolute minimum amount of injected radiopaque medium. The blood pressure should be assessed throughout the procedure and measures for treatment of a hypertensive crisis should be available.

Renal Dysfunction

Moderate:

iopamidol

Iopamidol has a moderate potential interaction with Renal Dysfunction.

In patients with advanced renal disease, iodinated contrast media should be used with caution, and only when the need for the examination dictates, since the excretion of the medium may be impaired. Patients with combined renal and hepatic disease, severe hypertension or congestive heart failure, and those with recent renal transplant may present an additional risk.

Moderate:

nelarabine

Nelarabine has a moderate potential interaction with Renal Dysfunction.

Nelarabine has not been studied in patients with renal dysfunction. There are insufficient data to support a dose recommendation for patients with a CrCl less than 50 mL/min. Because the risk of adverse reactions to this drug may be greater in patients with moderate (CrCl 30 to 50 mL/min) or severe (CrCl less than 30 mL/min) renal impairment, these patients should be closely monitored for toxicities if treated with this drug.

Sickle Cell Anemia

Moderate:

iopamidol

Iopamidol has a moderate potential interaction with Sickle Cell Anemia.

Some contrast agents have shown to promote the phenomenon of sickling (blood cell rupture) in individuals who are homozygous for sickle cell disease when administered intravenously or intra- arterially. Caution is advised.

Tumor Lysis Syndrome

Moderate:

nelarabine

Nelarabine has a moderate potential interaction with Tumor Lysis Syndrome.

Patients receiving nelarabine should receive intravenous hydration according to standard medical practice for the management of hyperuricemia in patients at risk for tumor lysis syndrome. Consideration should be given to the use of allopurinol in patients at risk of hyperuricemia.

Vaccination

Major:

nelarabine

Nelarabine has a major potential interaction with Vaccination.

Immunocompromised patients receiving nelarabine should avoid receiving live vaccines.

More resources

iopamidol

A total of 333 drugs are known to interact with iopamidol.

nelarabine

A total of 338 drugs are known to interact with nelarabine.

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.