Drug Interaction Report

MONITOR: Coadministration of alemtuzumab with drugs that have antiplatelet or anticoagulant effects, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may increase the risk of bleeding. Use of alemtuzumab alone has been associated with autoimmune and hemolytic anemia, thrombocytopenia, prolonged myelosuppression, bone marrow aplasia, hemophilia, and pancytopenia. The mechanism for this interaction has not been clearly delineated, but is presumably due to additive antiplatelet/anticoagulant effects.

MANAGEMENT: Caution is recommended if alemtuzumab is used concomitantly with NSAIDS. Patients should be monitored for increased anticoagulant effects and bleeding complications. Patients should be advised to promptly report any signs of unusual bleeding or bruising to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, red or brown urine, or red or black stools.