Can you take Sargramostim with Thioguanine?

Thioguanine has a major potential interaction with Bleeding Disorder.

The most consistent, dose-related toxicity of thioguanine is bone marrow suppression. This may be manifested by anemia, leukopenia, thrombocytopenia, or any combination of these. However, any one of these findings may also reflect progression of the underlying disease. Since thioguanine may have a delayed effect, it is important to withdraw the medication temporarily at the first sign of an abnormally large fall in any of the formed elements of the blood. Therapy with thioguanine should be administered cautiously in patients with myelosuppression. It is recommended that evaluation of the hemoglobin concentration or hematocrit, total white blood cell count and differential count, and quantitative platelet count be obtained frequently while the patient is on thioguanine therapy.

Thioguanine has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

The most consistent, dose-related toxicity of thioguanine is bone marrow suppression. This may be manifested by anemia, leukopenia, thrombocytopenia, or any combination of these. However, any one of these findings may also reflect progression of the underlying disease. Since thioguanine may have a delayed effect, it is important to withdraw the medication temporarily at the first sign of an abnormally large fall in any of the formed elements of the blood. Therapy with thioguanine should be administered cautiously in patients with myelosuppression. It is recommended that evaluation of the hemoglobin concentration or hematocrit, total white blood cell count and differential count, and quantitative platelet count be obtained frequently while the patient is on thioguanine therapy.

Sargramostim has a major potential interaction with Cardiovascular Conditions and Disorders.

Transient supraventricular arrhythmia has been reported occasionally during sargramostim administration, particularly in patients with a history of cardiac arrhythmias. Therapy with sargramostim should be administered cautiously in patients with preexisting cardiac disease.

Thioguanine has a major potential interaction with Enzymopathy, Unspecified.

Thioguanine is closely related structurally and functionally to mercaptopurine. A rare deficiency in the enzyme thiopurine methyltransferase (TMPT) results in an increased sensitivity to the myelosuppressive effects of both drugs causing rapid bone marrow suppression following initial mercaptopurine or thioguanine administration. Therapy with thioguanine or mercaptopurine should be administered cautiously and at a reduced dose in patients with TMPT deficiency.

Thioguanine has a major potential interaction with Fever.

The most consistent, dose-related toxicity of thioguanine is bone marrow suppression. This may be manifested by anemia, leukopenia, thrombocytopenia, or any combination of these. However, any one of these findings may also reflect progression of the underlying disease. Since thioguanine may have a delayed effect, it is important to withdraw the medication temporarily at the first sign of an abnormally large fall in any of the formed elements of the blood. Therapy with thioguanine should be administered cautiously in patients with myelosuppression. It is recommended that evaluation of the hemoglobin concentration or hematocrit, total white blood cell count and differential count, and quantitative platelet count be obtained frequently while the patient is on thioguanine therapy.

Sargramostim has a moderate potential interaction with Fluid Retention.

Sargramostim may cause fluid retention. Edema, capillary leak syndrome, and pleural and/or pericardial effusion have been reported. Therapy with sargramostim should be administered cautiously in patients with preexisting fluid retention, pulmonary infiltrates, or congestive heart failure. Fluid retention caused or worsened by sargramostim is often reversible following discontinuation of therapy or reduction in dosage, with or without diuretic administration.

Sargramostim has a moderate potential interaction with Heart Failure.

Sargramostim may cause fluid retention. Edema, capillary leak syndrome, and pleural and/or pericardial effusion have been reported. Therapy with sargramostim should be administered cautiously in patients with preexisting fluid retention, pulmonary infiltrates, or congestive heart failure. Fluid retention caused or worsened by sargramostim is often reversible following discontinuation of therapy or reduction in dosage, with or without diuretic administration.

Thioguanine has a major potential interaction with Infection.

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

Sargramostim has a moderate potential interaction with Leukocytosis.

Sargramostim is a growth factor for hematopoietic progenitor cells. Therefore, it should not be used in patients with leukocytosis. During sargramostim treatment, if the absolute neutrophil count (ANC) exceeds 20,000 cells/mm3 or white blood cell count (WBC) exceeds 50,000 cells/mm3, therapy should be interrupted or the dosage reduced by half, depending on the clinical condition of the patient. Blood counts generally return to normal or baseline levels within 3 to 7 days of stopping therapy.

Thioguanine has a major potential interaction with Liver Disease.

Hepatotoxicity usually presented as hepatic veno-occlusive disease (hyperbilirubinemia, tender hepatomegaly, weight gain due to fluid retention, and ascites) or with signs of portal hypertension (splenomegaly, thrombocytopenia, and esophageal varices), has been reported during therapy with thioguanine. Therapy with thioguanine should be administered cautiously in patients with liver disease or predisposed to it. Patients should be instructed to immediately report any signs of hepatotoxicity such as jaundice, dark urine, upper right quadrant pain, or anorexia. Clinical monitoring of hepatic function and determination of the etiology of hepatic dysfunction is recommended.

Sargramostim has a moderate potential interaction with Pleural Effusion.

Sargramostim may cause fluid retention. Edema, capillary leak syndrome, and pleural and/or pericardial effusion have been reported. Therapy with sargramostim should be administered cautiously in patients with preexisting fluid retention, pulmonary infiltrates, or congestive heart failure. Fluid retention caused or worsened by sargramostim is often reversible following discontinuation of therapy or reduction in dosage, with or without diuretic administration.

Sargramostim has a moderate potential interaction with Prematurity/Underweight in Infancy.

The use of sargramostim as lyophilized powder reconstituted with Bacteriostatic Water for Injection can cause serious and fatal adverse reactions including "gasping syndrome" in neonates and infants of low birth weight. The "gasping syndrome" is characterized by central nervous system depression, metabolic acidosis, and gasping respirations. Avoid administering solutions containing benzyl alcohol (including this drug reconstituted with Bacteriostatic Water for Injection) to neonates and low birth weight infants. Instead, administer reconstituted with Sterile Water for Injection.

Sargramostim has a moderate potential interaction with Pulmonary Impairment.

Sargramostim can cause infusion-related reactions characterized by respiratory distress, hypoxia, flushing, hypotension, syncope, and/or tachycardia following the first administration of the drug in a particular cycle. Monitor closely during infusion for symptoms, particularly in patients with pre-existing lung disease. These signs have resolved with symptomatic treatment and usually do not recur with subsequent doses. If patients display dyspnea or other acute symptoms, reduce the rate of infusion by 50%, and if symptoms persist or worsen therapy should be discontinued.