Interactions between Nilotinib and Oncaspar

The pegaspargase in Oncaspar has a major potential interaction with Bleeding Disorder.

The use of pegaspargase is contraindicated in patients who developed significant bleeding with previous L-asparaginase therapy. Pegaspargase interferes with coagulation factors, and both thrombosis and hemorrhage have been observed. Therapy with pegaspargase should be administered with extreme caution to patients with or predisposed to coagulopathies. Patients should be instructed to immediately report any signs or symptoms of thrombosis or bleeding. Close clinical monitoring of hematopoetic function and coagulation profiles is recommended.

Nilotinib has a moderate potential interaction with Cardiovascular Conditions and Disorders.

Cardiovascular events (including arterial vascular occlusive events, peripheral arterial occlusive disease, and ischemic cerebrovascular events) have been reported in patients receiving BCR-ABL tyrosine kinase inhibitors. Patients should seek immediate medical attention if acute signs or symptoms of cardiovascular events occur. Cardiovascular status should be evaluated, and cardiovascular risk factors should be monitored and actively managed during treatment.

The pegaspargase in Oncaspar has a moderate potential interaction with Diabetes Mellitus.

Hyperglycemia requiring insulin therapy has been reported during pegaspargase therapy. Therapy with pegaspargase should be administered cautiously to patients with diabetes mellitus.

Nilotinib has a moderate potential interaction with Electrolyte Abnormalities.

Nilotinib can cause hypophosphatemia, hypokalemia, hyperkalemia, hypocalcemia, and hyponatremia. Electrolyte abnormalities should be corrected prior to initiating nilotinib and during therapy; these electrolytes should be monitored periodically during therapy.

The pegaspargase in Oncaspar has a major potential interaction with History, Thrombotic/Thromboembolic Disorder.

The use of pegaspargase is contraindicated in patients who developed significant bleeding with previous L-asparaginase therapy. Pegaspargase interferes with coagulation factors, and both thrombosis and hemorrhage have been observed. Therapy with pegaspargase should be administered with extreme caution to patients with or predisposed to coagulopathies. Patients should be instructed to immediately report any signs or symptoms of thrombosis or bleeding. Close clinical monitoring of hematopoetic function and coagulation profiles is recommended.

Nilotinib has a major potential interaction with Hypokalemia.

The use of nilotinib is contraindicated in patients with hypokalemia, hypomagnesemia, or long QT syndrome. Nilotinib prolongs the QT interval in a concentration-dependent manner; QT prolongation may lead to torsade de pointes, which can result in syncope, seizures, and/or death. Before initiating nilotinib and periodically, electrolyte, calcium, and magnesium blood levels should be tested. Hypokalemia or hypomagnesemia must be corrected before starting treatment and these electrolytes should be monitored periodically. ECGs should be obtained at baseline, 7 days after starting nilotinib, following dose adjustments, and periodically as clinically indicated.

Nilotinib has a moderate potential interaction with Intestinal Anastomoses.

Nilotinib exposure is reduced in patients with total gastrectomy. More frequent monitoring of these patients is recommended; a dose increase or alternative therapy should be considered.

Nilotinib has a moderate potential interaction with Lactose Intolerance.

Nilotinib capsule formulations contain lactose and are not recommended for patients with rare hereditary problems of galactose intolerance, severe lactase deficiency with a severe degree of intolerance to lactose-containing products, or glucose-galactose malabsorption.

Nilotinib has a moderate potential interaction with Liver Disease.

Nilotinib exposure is increased in patients with hepatic impairment. If possible, alternative therapies should be considered; if nilotinib use is necessary, the dosage should be reduced and the QT interval should be monitored closely. Nilotinib may cause hepatotoxicity as measured by elevations in bilirubin, AST, ALT, and alkaline phosphatase; liver function tests should be monitored monthly or as clinically indicated and after dosage adjustments.

The pegaspargase in Oncaspar has a moderate potential interaction with Liver Disease.

Reversible liver abnormalities such as elevated liver transaminase and bilirubin levels and decreased albumin synthesis have been reported during pegaspargase therapy. Fatty changes and liver failure have occurred. Patients should be instructed to immediately report any sign or symptoms of hepatic dysfunction such as jaundice, dark urine, right upper quadrant pain, or anorexia. Therapy with pegaspargase should be administered cautiously to patients with or predisposed to compromised hepatic function. Clinical monitoring of hepatic function is recommended.

Nilotinib has a major potential interaction with Long QT Syndrome.

The use of nilotinib is contraindicated in patients with hypokalemia, hypomagnesemia, or long QT syndrome. Nilotinib prolongs the QT interval in a concentration-dependent manner; QT prolongation may lead to torsade de pointes, which can result in syncope, seizures, and/or death. Before initiating nilotinib and periodically, electrolyte, calcium, and magnesium blood levels should be tested. Hypokalemia or hypomagnesemia must be corrected before starting treatment and these electrolytes should be monitored periodically. ECGs should be obtained at baseline, 7 days after starting nilotinib, following dose adjustments, and periodically as clinically indicated.

Nilotinib has a major potential interaction with Magnesium Imbalance.

The use of nilotinib is contraindicated in patients with hypokalemia, hypomagnesemia, or long QT syndrome. Nilotinib prolongs the QT interval in a concentration-dependent manner; QT prolongation may lead to torsade de pointes, which can result in syncope, seizures, and/or death. Before initiating nilotinib and periodically, electrolyte, calcium, and magnesium blood levels should be tested. Hypokalemia or hypomagnesemia must be corrected before starting treatment and these electrolytes should be monitored periodically. ECGs should be obtained at baseline, 7 days after starting nilotinib, following dose adjustments, and periodically as clinically indicated.

The pegaspargase in Oncaspar has a major potential interaction with Pancreatitis.

The use of pegaspargase is contraindicated in patients with or a history of pancreatitis. Pegaspargase can cause decreased insulin synthesis or inflammation and/or necrosis of cells of the pancreas. Fulminant and fatal pancreatitis has occurred. Clinical monitoring of pancreatic function, including serum amylase levels, is recommended.

Nilotinib has a moderate potential interaction with Pancreatitis.

Nilotinib can increase serum lipase. Patients with a history of pancreatitis may be at greater risk of elevated serum lipase. Serum lipase should be monitored monthly or as clinically indicated. If lipase elevations occur with abdominal symptoms, treatment should be interrupted and appropriate diagnostic evaluation should be considered to exclude pancreatitis.

The pegaspargase in Oncaspar has a major potential interaction with Thrombotic/Thromboembolic Disorder.

The use of pegaspargase is contraindicated in patients who developed significant bleeding with previous L-asparaginase therapy. Pegaspargase interferes with coagulation factors, and both thrombosis and hemorrhage have been observed. Therapy with pegaspargase should be administered with extreme caution to patients with or predisposed to coagulopathies. Patients should be instructed to immediately report any signs or symptoms of thrombosis or bleeding. Close clinical monitoring of hematopoetic function and coagulation profiles is recommended.