Can you take Lomustine with Xbryk?
1 drug interaction and 12 additional warnings found for the following 2 drugs:
- lomustine
- Xbryk (denosumab)
Drug interactions
Moderate drug interactions
Moderate:
lomustine denosumab
Applies to: lomustine and Xbryk (denosumab)
Using denosumab together with lomustine can increase the risk of serious infections involving the skin, lower stomach area (abdomen), bladder, ear, or inner lining of the heart. 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 fever or chills; red, swollen skin or skin that is hot or tender to the touch; itching or rash; blisters; severe abdominal pain; or frequent, urgent, or painful/burning 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
12 potential interactions Applies to: 11 conditions, including Fever, Hypocalcemia, Hypoparathyroidism, Thyroid Disease, and Liver Disease.
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.
Hypocalcemia
Major:
Xbryk
The denosumab in Xbryk has a major potential interaction with Hypocalcemia.
Preexisting hypocalcemia must be corrected prior to initiating treatment with denosumab. Caution should be exercised in patients predisposed to hypocalcemia and any disturbances of mineral metabolism, such as history of hypoparathyroidism, thyroid or parathyroid surgery, malabsorption syndromes, excision of small intestine, severe renal impairment or dialysis. Clinical monitoring of calcium and mineral levels (phosphorus and magnesium) are highly recommended within 14 days of denosumab injection. It is important to maintain calcium levels with adequate calcium and vitamin D supplementation.
Hypoparathyroidism
Major:
Xbryk
The denosumab in Xbryk has a major potential interaction with Hypoparathyroidism.
Preexisting hypocalcemia must be corrected prior to initiating treatment with denosumab. Caution should be exercised in patients predisposed to hypocalcemia and any disturbances of mineral metabolism, such as history of hypoparathyroidism, thyroid or parathyroid surgery, malabsorption syndromes, excision of small intestine, severe renal impairment or dialysis. Clinical monitoring of calcium and mineral levels (phosphorus and magnesium) are highly recommended within 14 days of denosumab injection. It is important to maintain calcium levels with adequate calcium and vitamin D supplementation.
Immunodeficiency
Moderate:
Xbryk
The denosumab in Xbryk has a moderate potential interaction with Immunodeficiency.
Denosumab should be used with caution in patients with impaired immune systems or taking concomitant immunosuppressant agents as they may be at increased risk for serious infections.
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.
Liver Disease
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
Major:
Xbryk
The denosumab in Xbryk has a major potential interaction with Renal Dysfunction.
Preexisting hypocalcemia must be corrected prior to initiating treatment with denosumab. Caution should be exercised in patients predisposed to hypocalcemia and any disturbances of mineral metabolism, such as history of hypoparathyroidism, thyroid or parathyroid surgery, malabsorption syndromes, excision of small intestine, severe renal impairment or dialysis. Clinical monitoring of calcium and mineral levels (phosphorus and magnesium) are highly recommended within 14 days of denosumab injection. It is important to maintain calcium levels with adequate calcium and vitamin D supplementation.
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.
Thyroid Disease
Major:
Xbryk
The denosumab in Xbryk has a major potential interaction with Thyroid Disease.
Preexisting hypocalcemia must be corrected prior to initiating treatment with denosumab. Caution should be exercised in patients predisposed to hypocalcemia and any disturbances of mineral metabolism, such as history of hypoparathyroidism, thyroid or parathyroid surgery, malabsorption syndromes, excision of small intestine, severe renal impairment or dialysis. Clinical monitoring of calcium and mineral levels (phosphorus and magnesium) are highly recommended within 14 days of denosumab injection. It is important to maintain calcium levels with adequate calcium and vitamin D supplementation.
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:
Xbryk
A total of 324 drugs are known to interact with Xbryk.
- Xbryk is in the drug class miscellaneous bone resorption inhibitors.
- Xbryk 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.