Can you take Lomustine with Rilonacept?
1 drug interaction and 13 additional warnings found for the following 2 drugs:
- lomustine
- rilonacept
Drug interactions
Moderate drug interactions
Moderate:
lomustine rilonacept
Applies to: lomustine and rilonacept
Using rilonacept together with lomustine may increase the risk of serious infections.
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.
Contact your doctor immediately 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
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: 10 conditions, including High Cholesterol, Fever, Liver Disease, Infection, and Bleeding Disorder.
Bleeding Disorder
Major:
lomustine
Lomustine has a major potential interaction with Bleeding Disorder.
Nitrosoureas induce delayed bone marrow suppression that is cumulative and dose-related. Thrombocytopenia is usually more severe than leukopenia. Anemia occurs less frequently and is less severe. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, bleeding or symptoms of anemia. Therapy with nitrosoureas should be administered cautiously in patients with bone marrow suppression. Blood counts should be monitored at least six weeks after a dose and dosage adjustments made based on the nadir blood counts of the previous dose.
Bone Marrow Depression/Low Blood Counts
Major:
lomustine
Lomustine has a major potential interaction with Bone Marrow Depression/Low Blood Counts.
Nitrosoureas induce delayed bone marrow suppression that is cumulative and dose-related. Thrombocytopenia is usually more severe than leukopenia. Anemia occurs less frequently and is less severe. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, bleeding or symptoms of anemia. Therapy with nitrosoureas should be administered cautiously in patients with bone marrow suppression. Blood counts should be monitored at least six weeks after a dose and dosage adjustments made based on the nadir blood counts of the previous dose.
Fever
Major:
lomustine
Lomustine has a major potential interaction with Fever.
Nitrosoureas induce delayed bone marrow suppression that is cumulative and dose-related. Thrombocytopenia is usually more severe than leukopenia. Anemia occurs less frequently and is less severe. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, bleeding or symptoms of anemia. Therapy with nitrosoureas should be administered cautiously in patients with bone marrow suppression. Blood counts should be monitored at least six weeks after a dose and dosage adjustments made based on the nadir blood counts of the previous dose.
High Cholesterol
Moderate:
rilonacept
Rilonacept has a moderate potential interaction with High Cholesterol.
Patients treated with rilonacept experienced increases in their mean total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. The mean increases from baseline for total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides were 19 mg/dL, 2 mg/dL, 10 mg/dL, and 57 mg/dL respectively after 6 weeks of open-label therapy. Physicians should monitor the lipid profiles of their patients especially those with hyperlipidemias, and consider lipid-lowering therapies as needed based upon cardiovascular risk factors and current guidelines.
Infection
Major:
lomustine
Lomustine has a major potential interaction with Infection.
Nitrosoureas can induce delayed myelosuppression. The use of nitrosoureas may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during therapy with nitrosoureas. Close clinical monitoring of hematopoietic function is recommended.
Moderate:
rilonacept
Rilonacept has a moderate potential interaction with Infection.
Interleukin-1 (IL-1) blockade may interfere with the immune response to infections. Treatment with other medication as rilonacept, that work through inhibition of IL-1 has been associated with an increased risk of serious infections, and serious infections have been reported in patients taking rilonacept compared with placebo. Rilonacept should be discontinued if a patient develops a serious infection. Treatment with rilonacept should not be initiated in patients with an active or chronic infection. Additionally, latent tuberculosis can be reactivated and should be treated before initiating therapy with rilonacept.
Liver Disease
Moderate:
rilonacept
Rilonacept has a moderate potential interaction with Liver Disease.
No formal studies have been conducted to examine the pharmacokinetics of rilonacept administered subcutaneously in patients with hepatic impairment. Caution is advised if used on these patients.
Minor:
lomustine
Lomustine has a minor potential interaction with Liver Disease.
A reversible increase in liver transaminase, alkaline phosphatase, and bilirubin levels has been reported during therapy with nitrosoureas. Therapy with nitrosoureas should be administered cautiously in patients with a history of or predisposition to compromised hepatic function.
Pulmonary Impairment
Major:
lomustine
Lomustine has a major potential interaction with Pulmonary Impairment.
Pulmonary infiltrates and/or fibrosis have been reported during lomustine therapy. Toxicity occurred after 6 months of cumulative doses usually > 1100 mg/m2. Late reduction in pulmonary function, progressive fibrosis, and death have been noted. It is recommended to permanently discontinue therapy in patients diagnosed with pulmonary fibrosis. Therapy with lomustine should be administered cautiously in patients with preexisting pulmonary dysfunction. Pulmonary function studies prior to and during therapy are recommended.
Renal Dysfunction
Moderate:
lomustine
Lomustine has a moderate potential interaction with Renal Dysfunction.
Renal abnormalities such as azotemia, and progressive decline in renal function have been reported after prolonged therapy with large doses of carmustine and lomustine. Lower total doses have also resulted in kidney damage. Therapy with carmustine or lomustine should be administered cautiously in patients with a history of or predisposition to renal dysfunction. Clinical monitoring of renal function is recommended.
Moderate:
rilonacept
Rilonacept has a moderate potential interaction with Renal Dysfunction.
No formal studies have been conducted to examine the pharmacokinetics of rilonacept administered subcutaneously in patients with renal impairment. Caution is advised if used on these patients.
Tuberculosis, Latent
Moderate:
rilonacept
Rilonacept has a moderate potential interaction with Tuberculosis, Latent.
Interleukin-1 (IL-1) blockade may interfere with the immune response to infections. Treatment with other medication as rilonacept, that work through inhibition of IL-1 has been associated with an increased risk of serious infections, and serious infections have been reported in patients taking rilonacept compared with placebo. Rilonacept should be discontinued if a patient develops a serious infection. Treatment with rilonacept should not be initiated in patients with an active or chronic infection. Additionally, latent tuberculosis can be reactivated and should be treated before initiating therapy with rilonacept.
Vaccination
Major:
rilonacept
Rilonacept has a major potential interaction with Vaccination.
Live vaccines should not be given concurrently with rilonacept. Rilonacept may interfere with normal immune response to new antigens; therefore, vaccinations may not be effective in patients receiving rilonacept. No data are available on the effectiveness of vaccination with inactivated (killed) antigens in patients receiving rilonacept. Because IL-1 blockade may interfere with immune response to infections, it is recommended that prior to initiation of therapy with rilonacept adult and pediatric patients receive all recommended vaccinations, as appropriate, including pneumococcal vaccine and inactivated influenza vaccine.
More resources
lomustine
A total of 296 drugs are known to interact with lomustine.
- Lomustine is in the drug class alkylating agents.
- Lomustine is used to treat the following conditions:
rilonacept
A total of 535 drugs are known to interact with rilonacept.
- Rilonacept is in the drug class interleukin inhibitors.
- Rilonacept 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.