Drug Interaction Report

amphotericin B has a moderate potential interaction with Anemia.

Intravenous amphotericin B therapy may depress erythropoietin and red blood cell production and commonly causes a normocytic, normochromic anemia. Although the anemia is well tolerated by most patients and usually reverses completely within several months of stopping therapy, it may be problematic in patients with preexisting anemia. Intravenous therapy with amphotericin B should be administered cautiously in anemic patients or those predisposed to anemia. Frequent monitoring of blood counts and hemoglobin concentrations are recommended.

Chlorambucil has a major potential interaction with Bleeding Disorder.

Chlorambucil can severely suppress bone marrow function. It induces a slowly progressive lymphopenia and dose-related neutropenia. Thrombocytopenia and anemia may also occur. Irreversible bone marrow suppression has been reported and is associated with a total dose of or > 6.5 mg/kg in one course of continuous dosing. Therapy with chlorambucil should be administered cautiously and at a reduced dosage in patients whose bone marrow reserve may be 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.

Chlorambucil has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

Chlorambucil can severely suppress bone marrow function. It induces a slowly progressive lymphopenia and dose-related neutropenia. Thrombocytopenia and anemia may also occur. Irreversible bone marrow suppression has been reported and is associated with a total dose of or > 6.5 mg/kg in one course of continuous dosing. Therapy with chlorambucil should be administered cautiously and at a reduced dosage in patients whose bone marrow reserve may be 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.

amphotericin B has a moderate potential interaction with Electrolyte Abnormalities.

Intravenously administered amphotericin B is nephrotoxic and may commonly cause hypo- or hyperkalemia, hypomagnesemia, and hypocalcemia secondary to renal impairment. Renal function and serum electrolytes should be closely monitored in all patients receiving intravenous therapy with amphotericin B, but in particular, those with preexisting renal and/or electrolyte abnormalities. Mineral and electrolyte supplementation is frequently required. Complications of electrolyte imbalances include muscle weakness, tetany, seizures and cardiac disturbances. Amphotericin B-related electrolyte abnormalities generally improve following cessation of therapy but may persist long after because of the drug's long terminal elimination half-life.

Chlorambucil has a major potential interaction with Fever.

Chlorambucil can severely suppress bone marrow function. It induces a slowly progressive lymphopenia and dose-related neutropenia. Thrombocytopenia and anemia may also occur. Irreversible bone marrow suppression has been reported and is associated with a total dose of or > 6.5 mg/kg in one course of continuous dosing. Therapy with chlorambucil should be administered cautiously and at a reduced dosage in patients whose bone marrow reserve may be 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.

amphotericin B has a moderate potential interaction with Hyperkalemia.

Intravenously administered amphotericin B is nephrotoxic and may commonly cause hypo- or hyperkalemia, hypomagnesemia, and hypocalcemia secondary to renal impairment. Renal function and serum electrolytes should be closely monitored in all patients receiving intravenous therapy with amphotericin B, but in particular, those with preexisting renal and/or electrolyte abnormalities. Mineral and electrolyte supplementation is frequently required. Complications of electrolyte imbalances include muscle weakness, tetany, seizures and cardiac disturbances. Amphotericin B-related electrolyte abnormalities generally improve following cessation of therapy but may persist long after because of the drug's long terminal elimination half-life.

amphotericin B has a moderate potential interaction with Hypocalcemia.

Intravenously administered amphotericin B is nephrotoxic and may commonly cause hypo- or hyperkalemia, hypomagnesemia, and hypocalcemia secondary to renal impairment. Renal function and serum electrolytes should be closely monitored in all patients receiving intravenous therapy with amphotericin B, but in particular, those with preexisting renal and/or electrolyte abnormalities. Mineral and electrolyte supplementation is frequently required. Complications of electrolyte imbalances include muscle weakness, tetany, seizures and cardiac disturbances. Amphotericin B-related electrolyte abnormalities generally improve following cessation of therapy but may persist long after because of the drug's long terminal elimination half-life.

amphotericin B has a moderate potential interaction with Hypokalemia.

Intravenously administered amphotericin B is nephrotoxic and may commonly cause hypo- or hyperkalemia, hypomagnesemia, and hypocalcemia secondary to renal impairment. Renal function and serum electrolytes should be closely monitored in all patients receiving intravenous therapy with amphotericin B, but in particular, those with preexisting renal and/or electrolyte abnormalities. Mineral and electrolyte supplementation is frequently required. Complications of electrolyte imbalances include muscle weakness, tetany, seizures and cardiac disturbances. Amphotericin B-related electrolyte abnormalities generally improve following cessation of therapy but may persist long after because of the drug's long terminal elimination half-life.

Chlorambucil has a major potential interaction with Infection.

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

Chlorambucil has a moderate potential interaction with Liver Disease.

No formal studies have been conducted in patients with hepatic impairment. As chlorambucil is primarily metabolized in the liver, patients with hepatic impairment should be closely monitored for toxicity. A dose reduction may be considered in patients with hepatic impairment when treated with chlorambucil.

amphotericin B has a moderate potential interaction with Magnesium Imbalance.

Intravenously administered amphotericin B is nephrotoxic and may commonly cause hypo- or hyperkalemia, hypomagnesemia, and hypocalcemia secondary to renal impairment. Renal function and serum electrolytes should be closely monitored in all patients receiving intravenous therapy with amphotericin B, but in particular, those with preexisting renal and/or electrolyte abnormalities. Mineral and electrolyte supplementation is frequently required. Complications of electrolyte imbalances include muscle weakness, tetany, seizures and cardiac disturbances. Amphotericin B-related electrolyte abnormalities generally improve following cessation of therapy but may persist long after because of the drug's long terminal elimination half-life.

Chlorambucil has a moderate potential interaction with Pulmonary Impairment.

Interstitial pneumonitis and/or fibrosis have been reported during chlorambucil therapy. Pulmonary complications may not be reversible in all patients. Patients should be instructed to immediately report signs and symptoms of pulmonary dysfunction such as cough, dyspnea or congestion. Therapy with chlorambucil should be administered cautiously in patients with or predisposed to pulmonary dysfunction.

amphotericin B has a moderate potential interaction with Renal Dysfunction.

Intravenously administered amphotericin B is nephrotoxic and may commonly cause decreased renal function and abnormalities including azotemia, hypo- and hyperkalemia, hypomagnesemia, hyposthenuria, renal tubular acidosis, and nephrocalcinosis. Renal function should be closely monitored in all patients receiving intravenous therapy with amphotericin B but in particular, patients with preexisting renal impairment. Dosage reductions are recommended. Serum creatinine, BUN, potassium and magnesium levels should be evaluated frequently, and dosing adjusted or discontinued accordingly.

Chlorambucil has a moderate potential interaction with Seizures.

An increased risk of seizures has been reported in patients administered high pulse doses of chlorambucil and in children with nephrotic syndromes. Focal and/or generalized seizures have been reported rarely at daily therapeutic doses. Therapy with chlorambucil should be administered cautiously in patients with a history of seizure disorders or head trauma.