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Can you take Temsirolimus with Tildrakizumab?

1 drug interaction and 19 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

temsirolimus tildrakizumab

Applies to: temsirolimus and tildrakizumab

Using tildrakizumab together with temsirolimus may increase the risk of serious infections.

In addition, tildrakizumab may alter the blood levels and effects of temsirolimus. Your doctor may need to monitor you more closely and/or adjust the dosing of your medication(s). For example, you may need a dose adjustment if you have been receiving temsirolimus and are starting treatment with tildrakizumab. Likewise, if you have been receiving both medications, the dose of temsirolimus may need to be adjusted if tildrakizumab is discontinued.

Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the interaction, but has determined that this is the best course of treatment for you and is monitoring you closely for any potential complications.

Contact your doctor immediately if you develop signs and symptoms of infection such as:

  • fever
  • chills
  • diarrhea
  • sore throat
  • muscle aches
  • shortness of breath
  • blood in phlegm
  • weight loss
  • red or inflamed skin
  • body sores
  • pain or burning during urination

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:

temsirolimus Food/Lifestyle

Applies to: temsirolimus

If you are receiving therapy with temsirolimus you should avoid grapefruits and grapefruit juice.

Grapefruit can raise the levels of temsirolimus in your body and lead to dangerous side effects.

Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Disease interactions

18 potential interactions Applies to: 16 conditions, including High Cholesterol, Anaphylaxis, Diabetes Mellitus, Liver Disease, and Infection.

Anaphylaxis

Major:

temsirolimus

Temsirolimus has a major potential interaction with Anaphylaxis.

Hypersensitivity/infusion reactions, including but not limited to flushing, chest pain, dyspnea, hypotension, apnea, loss of consciousness, hypersensitivity and anaphylaxis, have been associated with the administration of temsirolimus. Caution should be exercised during the infusion and appropriate supportive care should be available. For patients who develop hypersensitivity reaction during the infusion, it is recommended to stop the infusion and close observation with the possibility of resuming therapy at a slower rate should be contemplated at the discretion of the physician. Temsirolimus infusion should be interrupted in all patients with severe infusion reactions and appropriate medical therapy administered. A benefit-risk assessment should be done prior to the continuation of therapy in patients with severe or life-threatening reactions.

Brain Tumor

Moderate:

temsirolimus

Temsirolimus has a moderate potential interaction with Brain Tumor.

Inhibition of mTOR activity results in delays of wound healing and increases the occurrence of wound-related complications, which might require surgical intervention. Patients with central nervous system tumors (primary CNS tumor or metastases) and/or receiving anticoagulation therapy may be at an increased risk of developing intracerebral bleeding (including fatal outcomes). Caution is recommended when using these agents, particularly in the perioperative period.

Coagulation Defects and Disorders

Moderate:

temsirolimus

Temsirolimus has a moderate potential interaction with Coagulation Defects and Disorders.

Inhibition of mTOR activity results in delays of wound healing and increases the occurrence of wound-related complications, which might require surgical intervention. Patients with central nervous system tumors (primary CNS tumor or metastases) and/or receiving anticoagulation therapy may be at an increased risk of developing intracerebral bleeding (including fatal outcomes). Caution is recommended when using these agents, particularly in the perioperative period.

Dermatitis, Drug-Induced

Major:

temsirolimus

Temsirolimus has a major potential interaction with Dermatitis, Drug-Induced.

Hypersensitivity/infusion reactions, including but not limited to flushing, chest pain, dyspnea, hypotension, apnea, loss of consciousness, hypersensitivity and anaphylaxis, have been associated with the administration of temsirolimus. Caution should be exercised during the infusion and appropriate supportive care should be available. For patients who develop hypersensitivity reaction during the infusion, it is recommended to stop the infusion and close observation with the possibility of resuming therapy at a slower rate should be contemplated at the discretion of the physician. Temsirolimus infusion should be interrupted in all patients with severe infusion reactions and appropriate medical therapy administered. A benefit-risk assessment should be done prior to the continuation of therapy in patients with severe or life-threatening reactions.

Diabetes Mellitus

Moderate:

temsirolimus

Temsirolimus has a moderate potential interaction with Diabetes Mellitus.

Elevations in serum blood glucose levels have been reported in patients taking inhibitors of mTOR (mammalian target of rapamycin). Monitoring of fasting serum glucose levels is recommended prior to the start of therapy and periodically thereafter. Clinicians should achieve control of glucose levels before initiating therapy with these agents.

Gastrointestinal Perforation

Major:

temsirolimus

Temsirolimus has a major potential interaction with Gastrointestinal Perforation.

Cases of fatal bowel perforation occurred in patients who received temsirolimus. Therapy with temsirolimus should be administered with caution in patients who may be at increased risk for gastrointestinal perforation, such as those with a history of diverticulitis. Patients presenting with new onset or worsening of abdominal symptoms or blood in the stools should be evaluated promptly for early identification of gastrointestinal perforation.

High Cholesterol

Moderate:

temsirolimus

Temsirolimus has a moderate potential interaction with High Cholesterol.

Elevations in cholesterol and triglyceride levels have been reported in patients taking inhibitors of mTOR (mammalian target of rapamycin). Monitoring of fasting lipid profile is recommended prior to the start of therapy and periodically thereafter. Clinicians should achieve control of lipid levels before initiating therapy with these agents.

History, Tuberculosis

Major:

tildrakizumab

Tildrakizumab has a major potential interaction with History, Tuberculosis.

Do not administer tildrakizumab to patients with active TB infection. It is recommended to assess patients for tuberculosis (TB) infection before starting treatment with this agent. Consider anti-TB therapy prior to initiation of tildrakizumab in patients with latent TB, a past history of latent or active TB in whom an adequate course of treatment cannot be confirmed. Monitor patients for signs and symptoms of active TB during and after treatment with tildrakizumab.

Infection

Moderate:

temsirolimus

Temsirolimus has a moderate potential interaction with Infection.

The immunosuppressant effect of inhibitors of mTOR (mammalian target of rapamycin) may decrease host resistance to infectious agents and may predispose patients to bacterial, fungal, viral, or protozoal infections, infections with opportunistic pathogens, and reactivation of viral infections. Therapy with these agents should be administered with caution in patients with an infection, particularly active infections or any untreated systemic fungal, bacterial, parasitic, or viral infection. It is recommended to complete the treatment of preexisting invasive fungal infections prior to starting treatment and if a diagnosis of invasive systemic fungal infection is made during treatment, discontinue and treat with appropriate antifungal therapy.

Moderate:

tildrakizumab

Tildrakizumab has a moderate potential interaction with Infection.

The use of tildrakizumab may increase the risk of infection. Treatment with tildrakizumab should not be started in patients with active infection until the infection resolves or is adequately treated. Consider the risks and benefits prior to using this agent in patients with chronic infection or a history of recurrent infection. It is recommended to monitor the patient closely and consider discontinuation of tildrakizumab if a patient develops a clinically important or serious infection or is not responding to standard therapy.

Interstitial Lung Disease

Moderate:

temsirolimus

Temsirolimus has a moderate potential interaction with Interstitial Lung Disease.

Cases of interstitial lung disease, some resulting in death, occurred in patients who received temsirolimus. It is recommended that patients undergo baseline radiographic assessment by lung computed tomography scan or chest radiograph prior to the initiation of therapy. Close monitoring for the occurrence of any new or worsening respiratory symptoms is advisable and if clinically significant respiratory symptoms develop, consider withholding administration until after recovery of symptoms and improvement of radiographic findings related to pneumonitis.

Liver Disease

Major:

temsirolimus

Temsirolimus has a major potential interaction with Liver Disease.

Temsirolimus is contraindicated in patients with bilirubin >1.5×ULN. Caution is recommended when treating patients with mild hepatic impairment and a dose reduction may be needed depending on AST and bilirubin levels. Dosage adjustment is needed based on hepatic function; therefore, assessment of AST and bilirubin levels is recommended before initiation of therapy and periodically thereafter.

Pulmonary Impairment

Moderate:

temsirolimus

Temsirolimus has a moderate potential interaction with Pulmonary Impairment.

Cases of interstitial lung disease, some resulting in death, occurred in patients who received temsirolimus. It is recommended that patients undergo baseline radiographic assessment by lung computed tomography scan or chest radiograph prior to the initiation of therapy. Close monitoring for the occurrence of any new or worsening respiratory symptoms is advisable and if clinically significant respiratory symptoms develop, consider withholding administration until after recovery of symptoms and improvement of radiographic findings related to pneumonitis.

Renal Dysfunction

Major:

temsirolimus

Temsirolimus has a major potential interaction with Renal Dysfunction.

Cases of renal failure, including acute renal failure and elevations of serum creatinine and proteinuria, some with a fatal outcome, have been observed in patients treated with inhibitors of mTOR (mammalian target of rapamycin). Therapy with these agents should be administered cautiously in patients with renal dysfunction, in particularly where patients have additional risk factors that may further impair renal function. Renal impairment is not expected to influence drug exposure, and no dosage adjustment is recommended in patients with renal impairment. Monitoring of renal function, including measurement of blood urea nitrogen (BUN), urinary protein, or serum creatinine, is recommended prior to the start of therapy and periodically thereafter.

Tuberculosis, Active

Major:

tildrakizumab

Tildrakizumab has a major potential interaction with Tuberculosis, Active.

Do not administer tildrakizumab to patients with active TB infection. It is recommended to assess patients for tuberculosis (TB) infection before starting treatment with this agent. Consider anti-TB therapy prior to initiation of tildrakizumab in patients with latent TB, a past history of latent or active TB in whom an adequate course of treatment cannot be confirmed. Monitor patients for signs and symptoms of active TB during and after treatment with tildrakizumab.

Tuberculosis, Latent

Major:

tildrakizumab

Tildrakizumab has a major potential interaction with Tuberculosis, Latent.

Do not administer tildrakizumab to patients with active TB infection. It is recommended to assess patients for tuberculosis (TB) infection before starting treatment with this agent. Consider anti-TB therapy prior to initiation of tildrakizumab in patients with latent TB, a past history of latent or active TB in whom an adequate course of treatment cannot be confirmed. Monitor patients for signs and symptoms of active TB during and after treatment with tildrakizumab.

Vaccination

Major:

temsirolimus

Temsirolimus has a major potential interaction with Vaccination.

The administration of live vaccines should be avoided during therapy with inhibitor of mTOR (mammalian target of rapamycin). It is recommended that close contact with individuals who have received live vaccines should be avoided because of the potential risk for shedding from the household contact and transmission to patient. It is recommended to be up-to-date with all required immunizations, as recommended by current immunization guidelines, before initiating therapy with these agents.

Moderate:

tildrakizumab

Tildrakizumab has a moderate potential interaction with Vaccination.

It is recommended to avoid the use of live vaccines in patients treated with tildrakizumab. Before starting therapy with tildrakizumab, consider completion of all age appropriate immunizations according to current immunization guidelines. Care should be exercised as no data are available on the response to live or inactive vaccines.

More resources

temsirolimus

A total of 733 drugs are known to interact with temsirolimus.

tildrakizumab

A total of 205 drugs are known to interact with tildrakizumab.

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.