Can you take Ixabepilone with Natalizumab?
1 drug interaction and 15 additional warnings found for the following 2 drugs:
- ixabepilone
- natalizumab
Drug interactions
Major drug interactions
Major:
natalizumab ixabepilone
Applies to: natalizumab and ixabepilone
Using natalizumab together with ixabepilone, or using them sequentially with little to no time in between, may increase the risk of serious and potentially life-threatening infections.
Of particular concern is an infection known as progressive multifocal leukoencephalopathy (PML), which is a rare but serious viral infection of the brain that may lead to disability and death.
If you are currently being treated or have recently been treated with ixabepilone, you may not be able to use natalizumab, or you may require close monitoring and special tests by your doctor to minimize the risk of infection during treatment.
Let your doctor know if you develop signs and symptoms of infection such as:
- 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
Also seek immediate medical attention if you experience:
- progressive weakness on one side of the body
- clumsiness of limbs
- disturbance of vision
- confusion
- changes in thinking, memory and personality
These may be early symptoms of PML.
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:
ixabepilone Food/Lifestyle
Applies to: ixabepilone
Do not consume grapefruit or grapefruit juice during treatment with ixabepilone unless specifically directed otherwise by your doctor.
Ixabepilone can interact with grapefruit and grapefruit juice and the interaction may increase the effects of ixabepilone.
You should discuss the use of grapefruit and grapefruit juice with your doctor.
Disease interactions
14 potential interactions Applies to: 12 conditions, including Peripheral Neuropathy, Arrhythmia, Diabetes Mellitus, Liver Disease, and Infection.
Arrhythmia
Moderate:
ixabepilone
Ixabepilone has a moderate potential interaction with Arrhythmia.
The use of ixabepilone in combination with capecitabine may increase cardiac adverse reactions, such as myocardial ischemia and ventricular dysfunction. Care should be exercised when using this agent in combination with capecitabine in patients with a history of cardiac disease. It is recommended to discontinue treatment in patients who develop cardiac ischemia or impaired cardiac function.
Cardiovascular Conditions and Disorders
Moderate:
ixabepilone
Ixabepilone has a moderate potential interaction with Cardiovascular Conditions and Disorders.
The use of ixabepilone in combination with capecitabine may increase cardiac adverse reactions, such as myocardial ischemia and ventricular dysfunction. Care should be exercised when using this agent in combination with capecitabine in patients with a history of cardiac disease. It is recommended to discontinue treatment in patients who develop cardiac ischemia or impaired cardiac function.
Diabetes Mellitus
Moderate:
ixabepilone
Ixabepilone has a moderate potential interaction with Diabetes Mellitus.
The use of ixabepilone in combination with capecitabine may cause peripheral neuropathy. Patients treated with ixabepilone in combination with capecitabine should be monitored for symptoms of neuropathy. Patients experiencing new or worsening symptoms may require a reduction or delay in the dose. Caution should be used when treating patients with diabetes mellitus or preexisting peripheral neuropathy.
Herpes Zoster Meningitis
Moderate:
natalizumab
Natalizumab has a moderate potential interaction with Herpes Zoster Meningitis.
Natalizumab increases the risk of developing encephalitis and meningitis caused by herpes simplex and varicella zoster viruses. It is recommended to monitor patients receiving natalizumab for signs and symptoms of meningitis and encephalitis. If herpes encephalitis or meningitis occurs, treatment should be discontinued, and appropriate treatment for herpes encephalitis/meningitis should be administered.
Hyperbilirubinemia
Major:
ixabepilone
Ixabepilone has a major potential interaction with Hyperbilirubinemia.
The use of ixabepilone in combination with capecitabine is contraindicated in patients with AST or ALT >2.5 x ULN or bilirubin >1 x ULN due to increased risk of toxicity and neutropenia-related death.
Immunodeficiency
Major:
ixabepilone
Ixabepilone has a major potential interaction with Immunodeficiency.
Ixabepilone is contraindicated in patients who have a neutrophil count <1500 cells/mm3 or a platelet count <100,000 cells/mm3.
Major:
natalizumab
Natalizumab has a major potential interaction with Immunodeficiency.
Immunosuppressive agents may increase the risk of progressive multifocal leukoencephalopathy (PML). Certain agents are contraindicated in patients who have or have had PML. Patients receiving chronic immunosuppressant or immunomodulatory therapy or who have systemic medical conditions resulting in significantly compromised immune system function should not be treated with these agents. Health care professionals should monitor patients for any new sign or symptom suggestive of PML. Therapy dosing should be withheld immediately and an appropriate diagnostic evaluation should be performed at the first sign or symptom suggestive of PML.
Infection
Major:
natalizumab
Natalizumab has a major potential interaction with Infection.
Serious and sometimes fatal infections have been reported in patients receiving immunosuppressive agents. Patients receiving immunosuppressants are at increased risk of developing bacterial, viral, fungal, and protozoal infections, and new or reactivated viral infections including opportunistic infections. Caution should be exercised when considering their use in patients with severe or chronic infections. It is recommended to interrupt therapy in patients who develop a new infection while undergoing treatment and to monitor these patients closely for any sign or symptom indicative of infection.
Ischemic Heart Disease
Moderate:
ixabepilone
Ixabepilone has a moderate potential interaction with Ischemic Heart Disease.
The use of ixabepilone in combination with capecitabine may increase cardiac adverse reactions, such as myocardial ischemia and ventricular dysfunction. Care should be exercised when using this agent in combination with capecitabine in patients with a history of cardiac disease. It is recommended to discontinue treatment in patients who develop cardiac ischemia or impaired cardiac function.
Liver Disease
Major:
ixabepilone
Ixabepilone has a major potential interaction with Liver Disease.
The use of ixabepilone in combination with capecitabine is contraindicated in patients with AST or ALT >2.5 x ULN or bilirubin >1 x ULN due to increased risk of toxicity and neutropenia-related death.
Moderate:
natalizumab
Natalizumab has a moderate potential interaction with Liver Disease.
Postmarketing reports have associated the use of natalizumab with severe hepatic toxicity, including acute liver failure requiring transplant. Natalizumab should be discontinued in patients with jaundice or other evidence of significant liver injury and appropriate therapy should be instituted according to clinical guidelines.
Neutropenia
Major:
ixabepilone
Ixabepilone has a major potential interaction with Neutropenia.
Ixabepilone is contraindicated in patients who have a neutrophil count <1500 cells/mm3 or a platelet count <100,000 cells/mm3.
Peripheral Neuropathy
Moderate:
ixabepilone
Ixabepilone has a moderate potential interaction with Peripheral Neuropathy.
The use of ixabepilone in combination with capecitabine may cause peripheral neuropathy. Patients treated with ixabepilone in combination with capecitabine should be monitored for symptoms of neuropathy. Patients experiencing new or worsening symptoms may require a reduction or delay in the dose. Caution should be used when treating patients with diabetes mellitus or preexisting peripheral neuropathy.
Thrombocytopenia
Major:
ixabepilone
Ixabepilone has a major potential interaction with Thrombocytopenia.
Ixabepilone is contraindicated in patients who have a neutrophil count <1500 cells/mm3 or a platelet count <100,000 cells/mm3.
More resources
ixabepilone
A total of 450 drugs are known to interact with ixabepilone.
- Ixabepilone is in the drug class mitotic inhibitors.
- Ixabepilone is used to treat the following conditions:
natalizumab
A total of 434 drugs are known to interact with natalizumab.
- Natalizumab is in the drug class selective immunosuppressants.
- Natalizumab 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.