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Drug Interactions between Purinethol and tbo-filgrastim

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

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Interactions between your drugs

Moderate

mercaptopurine tbo-filgrastim

Applies to: Purinethol (mercaptopurine) and tbo-filgrastim

ADJUST DOSING INTERVAL: The safety and efficacy of hematopoietic growth factors such as colony-stimulating factors (G-CSF and GM-CSF) and stem cell factors (SCF) given simultaneously with cancer chemotherapy have not been established. Theoretical concerns exist regarding their concomitant administration because hematopoietic growth factors stimulate myeloid cell proliferation while antineoplastic agents primarily target rapidly dividing cells.

MANAGEMENT: Because of the potential sensitivity of rapidly dividing myeloid cells to cancer chemotherapy, hematopoietic growth factors should not be used within 24 hours before or 24 hours after administration of antineoplastic agents.

References

  1. "Product Information. Neupogen (filgrastim)." Amgen PROD (2002):
  2. "Product Information. Leukine (sargramostim)." Immunex Corporation PROD (2001):
  3. "Product Information. Stemgen (ancestim)." Amgen PROD (2001):
  4. "Product Information. Granix (tbo-filgrastim)." Teva Pharmaceuticals USA (2013):
View all 4 references

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Drug and food interactions

Moderate

mercaptopurine food

Applies to: Purinethol (mercaptopurine)

ADJUST DOSING INTERVAL: Limited data suggest that food may decrease the oral bioavailability of 6-mercaptopurine (6-MP). In one study, the pharmacokinetics of 6-MP were studied on two separate occasions in seven patients. A single dose of 6-MP was administered after an overnight fast on one occasion and 15 minutes after a standard breakfast on the other. The authors reported that peak plasma levels of 6-MP were lower and took longer to reach following administration in the fed state. In addition, plasma levels were undetectable (less than 20 ng/mL) in two patients.

MANAGEMENT: Until more information is available regarding the effect of food on 6-MP absorption, it may be advisable to take 6-MP on an empty stomach 1 hour before or 2 hours after a meal.

References

  1. Schmidt LE, Dalhoff K "Food-drug interactions." Drugs 62 (2002): 1481-502

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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.

See also

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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.

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