Interactions between Vinblastine and Zelac
2 drug interactions and 7 additional warnings found for the following 2 drugs:
- vinblastine
- Zelac (bifidobacterium infantis/lactobacillus acidophilus)
Drug interactions
Moderate drug interactions
Moderate:
vinBLAStine lactobacillus acidophilus
Applies to: vinblastine and Zelac (bifidobacterium infantis / lactobacillus acidophilus)
Monitor
Probiotic use during immunosuppressant or intense antineoplastic therapy may theoretically increase the risk of infections from the live microorganisms contained in probiotic products. Patients may be immunosuppressed if they have recently received or are receiving alkylating agents, antimetabolites, radiation, some antirheumatic agents, high dosages of corticosteroids or adrenocorticotropic agents, or long-term topical or inhaled corticosteroids. Although probiotics are generally considered safe, with minimal to low pathogenicity, infections such as bacteremia and endocarditis with various strains commonly found in probiotics (e.g., lactobacilli, bifidobacteria, Bacillus subtilis) have been rarely reported, primarily in critically ill patients or patients with significant underlying medical conditions such as malignancy, organ transplantation, AIDS, valvular heart disease, diabetes mellitus, recent surgery, or compromised immune system. Lactobacillus bacteremia has also been reported following endoscopy. In addition, cases of lactobacillus pneumonia and liver abscess, as well as Saccharomyces fungemia, pneumonia, liver abscess, peritonitis and vaginitis, have been described in the medical literature.
Management
Caution is advised when probiotics are used during immunosuppressant or intense antineoplastic therapy. It may be advisable to avoid using probiotics, particularly products containing saccharomyces boulardii, in patients who are significantly immunosuppressed unless benefits are anticipated to outweigh the potential risk of infection.
References (12)
- Salminen MK, Rautelin H, Tynkkynen S, et al. (2004) "Lactobacillus bacteremia, clinical significance, and patient outcome, with special focus on probiotic L. rhamnosus GG." Clin Infect Dis, 38, p. 62-9
- Salminen MK, Tynkkynen S, Rautelin H, et al. (2002) "Lactobacillus bacteremia during a rapid increase in probiotic use of Lactobacillus rhamnosus GG in Finland." Clin Infect Dis, 35, p. 1155-60
- Rautio M, Jousimies-Somer H, Kauma H, et al. (1999) "Liver abscess due to a Lactobacillus rhamnosus strain indistinguishable from L. rhamnosus strain GG." Clin Infect Dis, 28, p. 1159-60
- Schlegel L, Lemerle S, Geslin P (1998) "Lactobacillus species as opportunistic pathogens in immunocompromised patients." Eur J Clin Microbiol Infect Dis, 17, p. 887-8
- Saxelin M, Chuang NH, Chassy B, et al. (1996) "Lactobacilli and bacteremia in southern Finland, 1989-1992" Clin Infect Dis, 22, p. 564-6
- Husni RN, Gordon SM, Washington JA, Longworth DL (1997) "Lactobacillus bacteremia and endocarditis: review of 45 cases." Clin Infect Dis, 25, p. 1048-55
- Oggioni MR, Pozzi G, Valensin PE, Galieni P, Bigazzi C (1998) "Recurrent septicemia in an immunocompromised patient due to probiotic strains of Bacillus subtilis." J Clin Microbiol, 36, p. 325-6
- Mackay AD, Taylor MB, Kibbler CC, Hamilton-Miller JM (1999) "Lactobacillus endocarditis caused by a probiotic organism." Clin Microbiol Infect, 5, p. 290-2
- Borriello SP, Hammes WP, Holzapfel W, et al. (2003) "Safety of probiotics that contain lactobacilli or bifidobacteria." Clin Infect Dis, 36, p. 775-80
- Lolis N, Veldekis D, Moraitou H, et al. (2008) "Saccharomyces boulardii fungaemia in an intensive care unit patient treated with caspofungin." Crit Care, 12, epub
- Boyle RJ, Robins-Browne RM, Tang ML (2006) "Probiotic use in clinical practice: what are the risks?" Am J Clin Nutr, 83, p. 1256-64
- Pruccoli G, Silvestro E, Napoleone CP, Aidala E, Garazzino S, Scolfaro C (2024) Are probiotics safe? Bifidobacterium bacteremia in a child with severe heart failure. https://www.researchgate.net/publication/333853508_Are_probiotics_safe_Bifidobacterium_bacteremia_in_a_child_with_severe_heart_failure
Moderate:
vinBLAStine bifidobacterium infantis
Applies to: vinblastine and Zelac (bifidobacterium infantis / lactobacillus acidophilus)
Monitor
Probiotic use during immunosuppressant or intense antineoplastic therapy may theoretically increase the risk of infections from the live microorganisms contained in probiotic products. Patients may be immunosuppressed if they have recently received or are receiving alkylating agents, antimetabolites, radiation, some antirheumatic agents, high dosages of corticosteroids or adrenocorticotropic agents, or long-term topical or inhaled corticosteroids. Although probiotics are generally considered safe, with minimal to low pathogenicity, infections such as bacteremia and endocarditis with various strains commonly found in probiotics (e.g., lactobacilli, bifidobacteria, Bacillus subtilis) have been rarely reported, primarily in critically ill patients or patients with significant underlying medical conditions such as malignancy, organ transplantation, AIDS, valvular heart disease, diabetes mellitus, recent surgery, or compromised immune system. Lactobacillus bacteremia has also been reported following endoscopy. In addition, cases of lactobacillus pneumonia and liver abscess, as well as Saccharomyces fungemia, pneumonia, liver abscess, peritonitis and vaginitis, have been described in the medical literature.
Management
Caution is advised when probiotics are used during immunosuppressant or intense antineoplastic therapy. It may be advisable to avoid using probiotics, particularly products containing saccharomyces boulardii, in patients who are significantly immunosuppressed unless benefits are anticipated to outweigh the potential risk of infection.
References (12)
- Salminen MK, Rautelin H, Tynkkynen S, et al. (2004) "Lactobacillus bacteremia, clinical significance, and patient outcome, with special focus on probiotic L. rhamnosus GG." Clin Infect Dis, 38, p. 62-9
- Salminen MK, Tynkkynen S, Rautelin H, et al. (2002) "Lactobacillus bacteremia during a rapid increase in probiotic use of Lactobacillus rhamnosus GG in Finland." Clin Infect Dis, 35, p. 1155-60
- Rautio M, Jousimies-Somer H, Kauma H, et al. (1999) "Liver abscess due to a Lactobacillus rhamnosus strain indistinguishable from L. rhamnosus strain GG." Clin Infect Dis, 28, p. 1159-60
- Schlegel L, Lemerle S, Geslin P (1998) "Lactobacillus species as opportunistic pathogens in immunocompromised patients." Eur J Clin Microbiol Infect Dis, 17, p. 887-8
- Saxelin M, Chuang NH, Chassy B, et al. (1996) "Lactobacilli and bacteremia in southern Finland, 1989-1992" Clin Infect Dis, 22, p. 564-6
- Husni RN, Gordon SM, Washington JA, Longworth DL (1997) "Lactobacillus bacteremia and endocarditis: review of 45 cases." Clin Infect Dis, 25, p. 1048-55
- Oggioni MR, Pozzi G, Valensin PE, Galieni P, Bigazzi C (1998) "Recurrent septicemia in an immunocompromised patient due to probiotic strains of Bacillus subtilis." J Clin Microbiol, 36, p. 325-6
- Mackay AD, Taylor MB, Kibbler CC, Hamilton-Miller JM (1999) "Lactobacillus endocarditis caused by a probiotic organism." Clin Microbiol Infect, 5, p. 290-2
- Borriello SP, Hammes WP, Holzapfel W, et al. (2003) "Safety of probiotics that contain lactobacilli or bifidobacteria." Clin Infect Dis, 36, p. 775-80
- Lolis N, Veldekis D, Moraitou H, et al. (2008) "Saccharomyces boulardii fungaemia in an intensive care unit patient treated with caspofungin." Crit Care, 12, epub
- Boyle RJ, Robins-Browne RM, Tang ML (2006) "Probiotic use in clinical practice: what are the risks?" Am J Clin Nutr, 83, p. 1256-64
- Pruccoli G, Silvestro E, Napoleone CP, Aidala E, Garazzino S, Scolfaro C (2024) Are probiotics safe? Bifidobacterium bacteremia in a child with severe heart failure. https://www.researchgate.net/publication/333853508_Are_probiotics_safe_Bifidobacterium_bacteremia_in_a_child_with_severe_heart_failure
Food/lifestyle interactions
No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Disease interactions
7 potential interactions Applies to: 7 conditions, including Fever, Liver Disease, Bleeding Disorder, Infection, and Immunodeficiency.
Bleeding Disorder
Major:
vinblastine
vinBLAStine has a major potential interaction with Bleeding Disorder.
The use of vinblastine is contraindicated in patients with significant granulocytopenia. Vinblastine induces dose-dependent leukopenia. Thrombocytopenia and anemia have been reported infrequently during vinblastine therapy. Therapy with vinblastine should be administered cautiously in patients whose bone marrow reserve may be severely depressed by prior chemotherapy or irradiation or whose marrow function is recovering from previous cytotoxic therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended.
Bone Marrow Depression/Low Blood Counts
Major:
vinblastine
vinBLAStine has a major potential interaction with Bone Marrow Depression/Low Blood Counts.
The use of vinblastine is contraindicated in patients with significant granulocytopenia. Vinblastine induces dose-dependent leukopenia. Thrombocytopenia and anemia have been reported infrequently during vinblastine therapy. Therapy with vinblastine should be administered cautiously in patients whose bone marrow reserve may be severely depressed by prior chemotherapy or irradiation or whose marrow function is recovering from previous cytotoxic therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended.
Fever
Major:
vinblastine
vinBLAStine has a major potential interaction with Fever.
The use of vinblastine is contraindicated in patients with significant granulocytopenia. Vinblastine induces dose-dependent leukopenia. Thrombocytopenia and anemia have been reported infrequently during vinblastine therapy. Therapy with vinblastine should be administered cautiously in patients whose bone marrow reserve may be severely depressed by prior chemotherapy or irradiation or whose marrow function is recovering from previous cytotoxic therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended.
Immunodeficiency
Moderate:
Zelac
The bifidobacterium infantis and lactobacillus acidophilus in Zelac both have a moderate potential interaction with Immunodeficiency.
Probiotics, especially those containing lactobacillus, should be used with caution in immunosuppressed patients.
Infection
Major:
vinblastine
vinBLAStine has a major potential interaction with Infection.
The use of vinblastine is contraindicated in patients with known infectious diseases. Vinblastine can induce myelosuppression. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during therapy with vinblastine. Close clinical monitoring of hematopoietic function is recommended. Vinblastine should not be used in patients with neutrophil counts below 1000/mm3.
Liver Disease
Moderate:
vinblastine
vinBLAStine has a moderate potential interaction with Liver Disease.
Vinblastine is metabolized by the liver and eliminated primarily via biliary excretion. Patients with hepatic impairment may be at increased risk for toxicity associated with vinblastine therapy. Therapy with vinblastine should be administered cautiously in patients with compromised hepatic function.
Pulmonary Impairment
Major:
vinblastine
vinBLAStine has a major potential interaction with Pulmonary Impairment.
Acute shortness of breath and bronchospasm, some severe and life-threatening, have been reported with the use of vinca alkaloids. These reactions were observed most often during combination therapy with mitomycin C, occurring within minutes to several hours after administration of the vinca alkaloid or up to 2 weeks following the mitomycin dose. Therapy with vinca alkaloids should be administered cautiously in patients with preexisting pulmonary dysfunction. Aggressive treatment may be necessary, including use of supplemental oxygen, bronchodilators, and/or corticosteroids. In patients who develop progressive dyspnea requiring chronic therapy, vinca alkaloid should not be readministered.
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vinblastine
A total of 530 drugs are known to interact with vinblastine.
- Vinblastine is in the drug class mitotic inhibitors.
- Vinblastine is used to treat the following conditions:
Zelac
A total of 370 drugs are known to interact with Zelac.
- Zelac is in the drug class probiotics.
- Zelac is used to treat Dietary Supplementation.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.