Drug Interaction Report

GENERALLY AVOID: Coadministration of omacetaxine and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. Treatment with omacetaxine is associated with a high frequency of thrombocytopenia. In one study, the overall incidence of grade 3 and 4 thrombocytopenia was 85% and 88%. Fatal cerebral hemorrhages occurred in 2% of patients receiving omacetaxine and nonfatal gastrointestinal hemorrhages occurred in 2%.

MANAGEMENT: Concomitant use of other medications that interfere with platelet function or coagulation should be avoided if the patient's platelet count is less than 50,000 per microliter. Close clinical and laboratory observation for bleeding complications is recommended during therapy. The CBC and platelet count should be monitored according to the manufacturer's recommendations. Patients should be advised to immediately report signs of hemorrhage including unusual bleeding, bruising, blood in the urine or feces, confusion, blurry vision, or slurred speech.

GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.

MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.