Can you take Nelarabine with Zafirlukast?

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.

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.

Zafirlukast has a major potential interaction with Liver Disease.

The use of zafirlukast may be associated with elevations of one or more liver enzymes as well as life-threatening hepatic failure. Cases of liver injury without other attributable cause have been reported from postmarketing surveillance of patients treated with the recommended dosage of zafirlukast (40 mg/day). Although most cases have been reversible following drug discontinuation, fulminant hepatitis and progression to hepatic failure, liver transplantation, and death have rarely been reported. In patients with hepatic cirrhosis, serum zafirlukast concentrations may be 50% to 60% higher than in normal patients. Zafirlukast is contraindicated in patients with hepatic impairment including hepatic cirrhosis. Periodic serum transaminase testing is recommended to enable early detection of drug-induced hepatic injury. Patients should be advised to contact their physician immediately if they experience signs or symptoms of liver dysfunction (e.g., right upper quadrant abdominal pain, nausea, fatigue, lethargy, pruritus, jaundice, flu-like symptoms, anorexia, and enlarged liver). Zafirlukast should be discontinued, and liver function tests performed immediately if hepatic injury is suspected. The drug should not be resumed if hepatic injury is confirmed. Patients in whom zafirlukast was withdrawn because of hepatic injury where no other attributable cause is identified should not be re-exposed to zafirlukast.

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.

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.

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.

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.

Nelarabine has a major potential interaction with Vaccination.

Immunocompromised patients receiving nelarabine should avoid receiving live vaccines.