Drug Interaction Report

MONITOR: Neither the leukapheresis procedure nor sipuleucel-T have been studied for use in combination with chemotherapy or immunosuppressive agents (e.g., systemic corticosteroids). Since sipuleucel-T is designed to stimulate the immune system, concurrent use of myelo- or immunosuppressive agents may alter the efficacy and/or safety of sipuleucel-T.

MANAGEMENT: Patients should be carefully evaluated to determine whether it is medically appropriate to reduce or discontinue chemotherapy or immunosuppressive agents prior to treatment with sipuleucel-T.

ADJUST DOSING INTERVAL: Consumption of food can decrease the rate and extent of gastrointestinal absorption of sirolimus. Also, the consumption of grapefruit juice may result in increased sirolimus trough concentrations.

MANAGEMENT: Experts recommend that this drug be taken either at least one hour prior to eating or consistently with or without food to avoid variations in sirolimus blood levels. The manufacturer recommends against using grapefruit juice for dilution of sirolimus doses. Patients should be monitored for clinical and laboratory evidence of altered immunosuppressant effects.