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Drug Interactions between Pravigard Pac and Y-90 Zevalin

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

aspirin ibritumomab tiuxetan

Applies to: Pravigard Pac (aspirin / pravastatin) and Y-90 Zevalin (ibritumomab)

MONITOR CLOSELY: Coadministration of radiolabeled ibritumomab tiuxetan and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. Radiolabeled ibritumomab tiuxetan commonly causes severe and prolonged thrombocytopenia, and the risk is increased further in patients with mild thrombocytopenia at the initiation of therapy. Haemorrhage, including fatal cerebral hemorrhage, has occurred in a minority of patients in clinical studies. The median time to thrombocyte nadir was 7 to 9 weeks, and the median duration of thrombocytopenia was 22 to 35 days. However, in less than 5% of the cases, patients experienced severe cytopenia that extended beyond 12 weeks following administration of the radiolabeled ibritumomab tiuxetan therapeutic regimen. Platelet transfusions were given to 22% of patients in clinical trials.

MANAGEMENT: Caution is advised if radiolabeled ibritumomab tiuxetan is used in combination with drugs that interfere with platelet function or coagulation. Close clinical and laboratory observation for bleeding complications is recommended during and after treatment.

References

  1. "Product Information. In-111 Zevalin (ibritumomab tiuxetan)." IDEC Pharmaceuticals Corporation PROD

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Drug and food interactions

Moderate

aspirin food

Applies to: Pravigard Pac (aspirin / pravastatin)

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

References

  1. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn PROD (2002):

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Moderate

pravastatin food

Applies to: Pravigard Pac (aspirin / pravastatin)

MONITOR: Concomitant use of statin medication with substantial quantities of alcohol may increase the risk of hepatic injury. Transient increases in serum transaminases have been reported with statin use and while these increases generally resolve or improve with continued therapy or a brief interruption in therapy, there have been rare postmarketing reports of fatal and non-fatal hepatic failure in patients taking statins. Patients who consume substantial quantities of alcohol and/or have a history of liver disease may be at increased risk for hepatic injury. Active liver disease or unexplained transaminase elevations are contraindications to statin use.

MANAGEMENT: Patients should be counseled to avoid substantial quantities of alcohol in combination with statin medications and clinicians should be aware of the increased risk for hepatotoxicity in these patients.

References

  1. "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb PROD (2001):
  2. "Product Information. Zocor (simvastatin)." Merck & Co., Inc PROD (2001):
  3. "Product Information. Lescol (fluvastatin)." Novartis Pharmaceuticals PROD (2001):
  4. "Product Information. Lipitor (atorvastatin)." Parke-Davis PROD (2001):
  5. "Product Information. Altocor (lovastatin)." Andrx Pharmaceuticals (2002):
  6. "Product Information. Crestor (rosuvastatin)." AstraZeneca Pharma Inc (2003):
  7. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  8. Cerner Multum, Inc. "Australian Product Information." O 0
  9. "Product Information. Livalo (pitavastatin)." Kowa Pharmaceuticals America (formerly ProEthic) (2010):
View all 9 references

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Minor

aspirin food

Applies to: Pravigard Pac (aspirin / pravastatin)

One study has reported that coadministration of caffeine and aspirin lead to a 25% increase in the rate of appearance and 17% increase in maximum concentration of salicylate in the plasma. A significantly higher area under the plasma concentration time curve of salicylate was also reported when both drugs were administered together. The exact mechanism of this interaction has not been specified. Physicians and patients should be aware that coadministration of aspirin and caffeine may lead to higher salicylate levels faster.

References

  1. Yoovathaworn KC, Sriwatanakul K, Thithapandha A "Influence of caffeine on aspirin pharmacokinetics." Eur J Drug Metab Pharmacokinet 11 (1986): 71-6

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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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.