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Can you take Polatuzumab vedotin with Tykerb?

1 drug interaction and 22 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

lapatinib polatuzumab vedotin

Applies to: Tykerb (lapatinib) and polatuzumab vedotin

Lapatinib may increase the blood levels of polatuzumab vedotin in some patients. This may increase the risk and/or severity of side effects such as nausea; vomiting; diarrhea; liver problems; tingling, numbness or burning in the hands and feet; muscle weakness; and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. 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

Moderate food/lifestyle interactions

Moderate:

lapatinib Food/Lifestyle

Applies to: Tykerb (lapatinib)

Take lapatinib on an empty stomach 1 hour before or 1 hour after a meal unless otherwise directed by your doctor. This will make it easier for your body to absorb the medication. The lapatinib dose is administered once daily and should not be divided. The usual dose of lapatinib is equal to 5 tablets. You may swallow each tablet one at a time, but take the entire lapatinib dose at the same time each day. If you are receiving therapy with lapatinib you should be advised to avoid grapefruits and grapefruit juice. Grapefruit can raise the levels of lapatinib in your body and lead to dangerous side effects.

Disease interactions

21 potential interactions Applies to: 17 conditions, including High Blood Pressure, Heart Failure, Heart Attack, Peripheral Neuropathy, and Arrhythmia.

Arrhythmia

Major:

Tykerb

The lapatinib in Tykerb has a major potential interaction with Arrhythmia.

QT prolongation was observed in patients treated with certain EGFR inhibitors. These agents should be administered with caution in patients with congenital long QTc syndrome, congestive heart failure, electrolyte abnormalities, or those who are taking medications known to prolong the QTc interval. Serum electrolytes should be corrected prior to initiating therapy with these agents. Periodic monitoring of ECGs and electrolytes is recommended in these patients. Permanently discontinue the use of these agents in patients who develop QTc interval prolongation with signs/symptoms of life-threatening arrhythmia.

Moderate:

Tykerb

The lapatinib in Tykerb has a moderate potential interaction with Arrhythmia.

Decreases in left ventricular ejection fraction (LVEF) have been reported with agents that block HER2 activity. Patients who have received prior anthracyclines, those who received anthracycline after stopping therapy with agents that block HER2 activity, or patients who received prior radiotherapy to the chest area may be at higher risk of decreased LVEF. Therapy with these agents should be administered cautiously in patients with a previous history of heart conditions. Evaluate cardiac function before, during, and upon completion of treatment. Withhold or discontinue therapy with agents that block HER2 activity as appropriate, and for a confirmed clinically significant decrease in left ventricular function, or if the LVEF has not improved or has declined further. It is recommended to monitor overall cardiac function and LVEF by echocardiogram or MUGA scan as appropriate.

Bone Marrow Depression/Low Blood Counts

Moderate:

polatuzumab vedotin

Polatuzumab vedotin has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.

The use of polatuzumab vedotin can cause serious or severe myelosuppression including neutropenia, thrombocytopenia, and anemia. Cytopenias may require a delay, dose reduction, or discontinuation of polatuzumab vedotin. It is recommended to monitor complete blood counts during treatment. Consider prophylactic granulocyte colony stimulating factor administration if needed.

Dermatitis, Drug-Induced

Major:

Tykerb

The lapatinib in Tykerb has a major potential interaction with Dermatitis, Drug-Induced.

Cutaneous reactions, in some cases severe, have been reported with the use of EGFR inhibitors. Monitor patients who develop dermatologic or soft tissue toxicities while receiving these agents for the development of inflammatory or infectious sequelae. It is recommended to withhold treatment, and appropriate measures should be instituted as appropriate or discontinue the use of these agents for dermatologic or soft tissue toxicity associated with severe or life-threatening inflammatory or infectious complications. Advise patients to wear sunscreen and hats and limit sun exposure while receiving therapy with these agents as exposure to sunlight can exacerbate dermatologic toxicities.

Fever

Major:

Tykerb

The lapatinib in Tykerb has a major potential interaction with Fever.

The use of certain EGFR inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, permanently discontinue these agents and institute appropriate measures.

Heart Attack

Moderate:

Tykerb

The lapatinib in Tykerb has a moderate potential interaction with Heart Attack.

Decreases in left ventricular ejection fraction (LVEF) have been reported with agents that block HER2 activity. Patients who have received prior anthracyclines, those who received anthracycline after stopping therapy with agents that block HER2 activity, or patients who received prior radiotherapy to the chest area may be at higher risk of decreased LVEF. Therapy with these agents should be administered cautiously in patients with a previous history of heart conditions. Evaluate cardiac function before, during, and upon completion of treatment. Withhold or discontinue therapy with agents that block HER2 activity as appropriate, and for a confirmed clinically significant decrease in left ventricular function, or if the LVEF has not improved or has declined further. It is recommended to monitor overall cardiac function and LVEF by echocardiogram or MUGA scan as appropriate.

Heart Failure

Major:

Tykerb

The lapatinib in Tykerb has a major potential interaction with Heart Failure.

QT prolongation was observed in patients treated with certain EGFR inhibitors. These agents should be administered with caution in patients with congenital long QTc syndrome, congestive heart failure, electrolyte abnormalities, or those who are taking medications known to prolong the QTc interval. Serum electrolytes should be corrected prior to initiating therapy with these agents. Periodic monitoring of ECGs and electrolytes is recommended in these patients. Permanently discontinue the use of these agents in patients who develop QTc interval prolongation with signs/symptoms of life-threatening arrhythmia.

Moderate:

Tykerb

The lapatinib in Tykerb has a moderate potential interaction with Heart Failure.

Decreases in left ventricular ejection fraction (LVEF) have been reported with agents that block HER2 activity. Patients who have received prior anthracyclines, those who received anthracycline after stopping therapy with agents that block HER2 activity, or patients who received prior radiotherapy to the chest area may be at higher risk of decreased LVEF. Therapy with these agents should be administered cautiously in patients with a previous history of heart conditions. Evaluate cardiac function before, during, and upon completion of treatment. Withhold or discontinue therapy with agents that block HER2 activity as appropriate, and for a confirmed clinically significant decrease in left ventricular function, or if the LVEF has not improved or has declined further. It is recommended to monitor overall cardiac function and LVEF by echocardiogram or MUGA scan as appropriate.

High Blood Pressure

Moderate:

Tykerb

The lapatinib in Tykerb has a moderate potential interaction with High Blood Pressure.

Decreases in left ventricular ejection fraction (LVEF) have been reported with agents that block HER2 activity. Patients who have received prior anthracyclines, those who received anthracycline after stopping therapy with agents that block HER2 activity, or patients who received prior radiotherapy to the chest area may be at higher risk of decreased LVEF. Therapy with these agents should be administered cautiously in patients with a previous history of heart conditions. Evaluate cardiac function before, during, and upon completion of treatment. Withhold or discontinue therapy with agents that block HER2 activity as appropriate, and for a confirmed clinically significant decrease in left ventricular function, or if the LVEF has not improved or has declined further. It is recommended to monitor overall cardiac function and LVEF by echocardiogram or MUGA scan as appropriate.

History - Myocardial Infarction

Moderate:

Tykerb

The lapatinib in Tykerb has a moderate potential interaction with History - Myocardial Infarction.

Decreases in left ventricular ejection fraction (LVEF) have been reported with agents that block HER2 activity. Patients who have received prior anthracyclines, those who received anthracycline after stopping therapy with agents that block HER2 activity, or patients who received prior radiotherapy to the chest area may be at higher risk of decreased LVEF. Therapy with these agents should be administered cautiously in patients with a previous history of heart conditions. Evaluate cardiac function before, during, and upon completion of treatment. Withhold or discontinue therapy with agents that block HER2 activity as appropriate, and for a confirmed clinically significant decrease in left ventricular function, or if the LVEF has not improved or has declined further. It is recommended to monitor overall cardiac function and LVEF by echocardiogram or MUGA scan as appropriate.

Infection

Moderate:

polatuzumab vedotin

Polatuzumab vedotin has a moderate potential interaction with Infection.

Fatal and/or serious infections, including opportunistic infections such as sepsis, pneumonia (including Pneumocystis jiroveci and other fungal pneumonia), herpesvirus infection, and cytomegalovirus infection have occurred in patients treated with polatuzumab vedotin. Hold polatuzumab vedotin and any concomitant chemotherapy if progressive multifocal leukoencephalopathy (PML) is suspected, and permanently discontinue if the diagnosis is confirmed. Closely monitor patients during treatment for signs of infection. It is recommended to administer prophylaxis for Pneumocystis jiroveci pneumonia and herpesvirus.

Liver Disease

Major:

Tykerb

The lapatinib in Tykerb has a major potential interaction with Liver Disease.

Lapatinib undergoes extensive metabolism in the liver. Hepatotoxicity has been associated with the use of lapatinib and it may be severe and fatal. The hepatotoxicity may occur days to several months after initiation of treatment. Therapy with lapatinib should be administered cautiously in patients with severe hepatic impairment and a dose reduction should be considered for patients with severe pre-existing hepatic impairment. Clinical monitoring of hepatic function (transaminases, bilirubin, and alkaline phosphatase) is recommended before initiation of treatment, every 4 to 6 weeks during treatment, and as clinically indicated. In patients who develop severe hepatotoxicity while on therapy, lapatinib should be discontinued and patients should not be retreated.

Moderate:

polatuzumab vedotin

Polatuzumab vedotin has a moderate potential interaction with Liver Disease.

No adjustment in the starting dose of polatuzumab vedotin is required in patients with mild hepatic impairment. The use of polatuzumab vedotin in patients with moderate or severe hepatic impairment should be avoided. Serious cases of hepatotoxicity that were consistent with hepatocellular injury, including elevations of transaminases and/or bilirubin, have occurred in patients treated with polatuzumab vedotin. This agent has not been studied in patients with moderate or severe hepatic impairment. Patients with moderate or severe hepatic impairment are likely to have increased exposure to the MMAE component, which may increase the risk of adverse reactions. Preexisting liver disease, elevated baseline liver enzymes, and concomitant medications may increase the risk of hepatotoxicity. Monitor liver enzymes and bilirubin level as appropriate.

Peripheral Neuropathy

Moderate:

polatuzumab vedotin

Polatuzumab vedotin has a moderate potential interaction with Peripheral Neuropathy.

Polatuzumab vedotin can cause peripheral neuropathy, including severe cases. Care should be exercised when using this agent in patients with preexisting peripheral neuropathy as it may exacerbate the condition. It is recommended to monitor for symptoms of peripheral neuropathy and if experiencing new or worsening peripheral neuropathy patients may require a delay, dose reduction, or discontinuation of treatment.

Post MI Syndrome

Moderate:

Tykerb

The lapatinib in Tykerb has a moderate potential interaction with Post MI Syndrome.

Decreases in left ventricular ejection fraction (LVEF) have been reported with agents that block HER2 activity. Patients who have received prior anthracyclines, those who received anthracycline after stopping therapy with agents that block HER2 activity, or patients who received prior radiotherapy to the chest area may be at higher risk of decreased LVEF. Therapy with these agents should be administered cautiously in patients with a previous history of heart conditions. Evaluate cardiac function before, during, and upon completion of treatment. Withhold or discontinue therapy with agents that block HER2 activity as appropriate, and for a confirmed clinically significant decrease in left ventricular function, or if the LVEF has not improved or has declined further. It is recommended to monitor overall cardiac function and LVEF by echocardiogram or MUGA scan as appropriate.

Pulmonary Impairment

Major:

Tykerb

The lapatinib in Tykerb has a major potential interaction with Pulmonary Impairment.

Pulmonary toxicity, sometimes fatal has been reported with agents that block HER2 activity. Pulmonary toxicity includes dyspnea, interstitial pneumonitis, pulmonary infiltrates, pleural effusions, non-cardiogenic pulmonary edema, pulmonary insufficiency and hypoxia, acute respiratory distress syndrome, and pulmonary fibrosis. Patients with symptomatic intrinsic lung disease or with extensive tumor involvement of the lungs, resulting in dyspnea at rest may be at increased risk of pulmonary toxicity and appear to have more severe toxicity. Patients should be monitored for pulmonary symptoms. Permanently discontinue treatment with these agents in patients diagnosed with interstitial lung disease or pneumonitis and institute appropriate care.

Major:

Tykerb

The lapatinib in Tykerb has a major potential interaction with Pulmonary Impairment.

The use of certain EGFR inhibitors has been associated with pulmonary toxicity. Serious cases of interstitial lung disease (ILD), including fatal cases and interstitial pneumonitis or pulmonary fibrosis have been reported. Caution is recommended when using these agents in patients with a history of interstitial pneumonitis or pulmonary fibrosis or those patients presenting with acute onset of new or progressive unexplained pulmonary symptoms such as dyspnea, cough, and fever pending diagnostic evaluation. If ILD is confirmed, permanently discontinue these agents and institute appropriate measures.

Renal Dysfunction

Moderate:

Tykerb

The lapatinib in Tykerb has a moderate potential interaction with Renal Dysfunction.

Lapatinib pharmacokinetics have not been specifically studied in patients with renal impairment or in patients undergoing hemodialysis. Close monitoring is recommended.

Thrombocytopenia

Moderate:

Tykerb

The lapatinib in Tykerb has a moderate potential interaction with Thrombocytopenia.

Thrombocytopenia has been reported with the use of agents that block HER2 activity. Monitor platelet counts prior to initiation of therapy and prior to each dose. If appropriate modify the dose according to clinical guidelines. Patients with decreased platelet count and patients on anti-coagulant treatment should be closely monitored during treatment with these agents.

Tumor Lysis Syndrome

Moderate:

polatuzumab vedotin

Polatuzumab vedotin has a moderate potential interaction with Tumor Lysis Syndrome.

The use of polatuzumab vedotin may cause tumor lysis syndrome. Patients with high tumor burden and rapidly proliferative tumor may be at increased risk of tumor lysis syndrome. It is recommended to closely monitor for signs of tumor lysis syndrome and to take appropriate measures, including tumor lysis syndrome prophylaxis as appropriate.

Ventricular Arrhythmia

Major:

Tykerb

The lapatinib in Tykerb has a major potential interaction with Ventricular Arrhythmia.

Cardiomyopathy was observed in clinical trials of certain EGFR inhibitors. Assess Left Ventricular Ejection Fraction (LVEF) by echocardiogram or multigated acquisition (MUGA) scan before initiation of these agents and then at 3 month intervals while on treatment. Caution is recommended when prescribing these agents to patients with conditions that could impair left ventricular function and it is recommended to withhold treatment with these agents if ejection fraction drops below the established lower limit of normal. For symptomatic congestive heart failure or persistent, asymptomatic LV dysfunction that does not resolve within 4 weeks, permanently discontinue these agents.

More resources

polatuzumab vedotin

A total of 431 drugs are known to interact with polatuzumab vedotin.

Tykerb

A total of 663 drugs are known to interact with Tykerb.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.