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Drug Interactions between Purixan and topotecan

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

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Interactions between your drugs

Moderate

mercaptopurine topotecan

Applies to: Purixan (mercaptopurine) and topotecan

MONITOR: The use of topotecan with other cytotoxic agents is likely to result in greater myelosuppression due to additive or synergistic pharmacologic effects. Severe neutropenia and neutropenic sepsis resulting in death were reported with topotecan and cisplatin.

MANAGEMENT: Caution is advised if topotecan is used with other cytotoxic agents. Dosage reductions may be required, and bone marrow function should be closely monitored. Patients should be advised to contact their physician if they develop signs and symptoms of myelosuppression such as pallor, dizziness, fatigue, lethargy, fainting, easy bruising or bleeding, or signs of infection such as fever, chills, sore throat, body aches, and other influenza-like symptoms.

References

  1. (2001) "Product Information. Hycamtin (topotecan)." SmithKline Beecham

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Drug and food interactions

Moderate

mercaptopurine food

Applies to: Purixan (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 (2002) "Food-drug interactions." Drugs, 62, p. 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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