Interactions between Neulasta and Teniposide

Teniposide has a major potential interaction with Bleeding Disorder.

Teniposide induces severe myelosuppression at doses recommended to treat ALL. Leukopenia, primarily affecting neutrophils, thrombocytopenia, and anemia have been reported during teniposide therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Hemoglobin, white blood cell count and differential, and platelet count should be obtained before treatment initiation. Close clinical monitoring of hematopoietic function is recommended during treatment. If necessary, repeat bone marrow examination should be performed prior to the decision to continue therapy in the setting of severe myelosuppression. Patients with both Down syndrome and leukemia may be especially sensitive to myelosuppressive chemotherapy, therefore, initial dosing with teniposide should be reduced in these patients. It is suggested that the first course of teniposide should be given at half the usual dose.

Teniposide has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

Teniposide induces severe myelosuppression at doses recommended to treat ALL. Leukopenia, primarily affecting neutrophils, thrombocytopenia, and anemia have been reported during teniposide therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Hemoglobin, white blood cell count and differential, and platelet count should be obtained before treatment initiation. Close clinical monitoring of hematopoietic function is recommended during treatment. If necessary, repeat bone marrow examination should be performed prior to the decision to continue therapy in the setting of severe myelosuppression. Patients with both Down syndrome and leukemia may be especially sensitive to myelosuppressive chemotherapy, therefore, initial dosing with teniposide should be reduced in these patients. It is suggested that the first course of teniposide should be given at half the usual dose.

Teniposide has a major potential interaction with Down Syndrome.

Teniposide induces severe myelosuppression at doses recommended to treat ALL. Leukopenia, primarily affecting neutrophils, thrombocytopenia, and anemia have been reported during teniposide therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Hemoglobin, white blood cell count and differential, and platelet count should be obtained before treatment initiation. Close clinical monitoring of hematopoietic function is recommended during treatment. If necessary, repeat bone marrow examination should be performed prior to the decision to continue therapy in the setting of severe myelosuppression. Patients with both Down syndrome and leukemia may be especially sensitive to myelosuppressive chemotherapy, therefore, initial dosing with teniposide should be reduced in these patients. It is suggested that the first course of teniposide should be given at half the usual dose.

Teniposide has a major potential interaction with Fever.

Teniposide induces severe myelosuppression at doses recommended to treat ALL. Leukopenia, primarily affecting neutrophils, thrombocytopenia, and anemia have been reported during teniposide therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Hemoglobin, white blood cell count and differential, and platelet count should be obtained before treatment initiation. Close clinical monitoring of hematopoietic function is recommended during treatment. If necessary, repeat bone marrow examination should be performed prior to the decision to continue therapy in the setting of severe myelosuppression. Patients with both Down syndrome and leukemia may be especially sensitive to myelosuppressive chemotherapy, therefore, initial dosing with teniposide should be reduced in these patients. It is suggested that the first course of teniposide should be given at half the usual dose.

Teniposide has a major potential interaction with Infection.

Teniposide can induce severe myelosuppression at therapeutic doses. The use of teniposide 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 teniposide. Close clinical monitoring of hematopoietic function is recommended.

The pegfilgrastim in Neulasta has a major potential interaction with Leukocytosis.

Filgrastim and pegfilgrastim are growth factors for neutrophil progenitor cells. Therefore, these should not be used in patients with leukocytosis. If excessive white blood cell counts occur during CSF therapy, treatment should be interrupted or the dosage reduced.

Teniposide has a moderate potential interaction with Liver Disease.

The pharmacokinetic disposition of teniposide has not been fully assessed in patients with hepatic impairment. Patients with hepatic impairment may be at increased risk for teniposide toxicity. Therapy with teniposide should be administered cautiously and dosage modification considered in patients with compromised hepatic function.

The pegfilgrastim in Neulasta has a major potential interaction with Myeloproliferative Disorders.

Colony stimulating factors primarily stimulates the proliferation of neutrophils but may also, theoretically, enhance tumor growth, particularly in myeloid malignancies. Therapy with these drugs should be administered cautiously in patients with myeloid tumors. Additionally, if used for PBPC (peripheral blood progenitor cell) collection in such patients, tumor cells may be released from the marrow and collected in the leukapheresis product. The effect of reinfusion of tumor cells is uncertain at this time.

The pegfilgrastim in Neulasta has a major potential interaction with Renal Dysfunction.

Although it has been reported that renal dysfunction has no effect on the pharmacokinetics of colony stimulating factors (CSF), filgrastim and pegfilgrastim may cause glomerulonephritis. Symptoms include swelling of the face or ankles, dark colored urine, or blood in the urine, or a decrease in urine production. Advise patients to report signs or symptoms of glomerulonephritis immediately. Monitoring of patients with renal dysfunction is recommended.

Teniposide has a moderate potential interaction with Renal Dysfunction.

Teniposide is primarily eliminated by the kidney. Approximately 44% of teniposide is excreted in the urine unchanged (10%) and as metabolites. The pharmacokinetic disposition of teniposide has not been fully assessed in patients with renal impairment. Therapy with teniposide should be administered cautiously and dosage modification considered in patients with compromised renal function. Clinical monitoring of renal function is recommended.