Drug Interaction Report

ADJUST DOSING INTERVAL: The safety and efficacy of recombinant human granulocyte colony-stimulating factors (rhG-CSF) administered simultaneously with cytotoxic agents, including cancer chemotherapy, have not been established. Theoretical concerns exist regarding their concomitant administration because hematopoietic growth factors stimulate myeloid cell proliferation while antineoplastic agents primarily target rapidly dividing cells.

MANAGEMENT: The prescribing information for pegfilgrastim, eflapegrastim, and efbemalenograstim alfa recommends that these products not be administered between 14 days before and 24 hours after antineoplastic agents.

GENERALLY AVOID: Case histories have suggested that levamisole is associated with some side effects (including headache, fever, shivers, and dizziness) that suggest an disulfiram-like interaction with alcohol. These side effects could be alleviated by total abstinence from alcohol. No mechanism has been established for this interaction.

MANAGEMENT: Patients receiving levamisole should avoid alcohol.