Drug Interaction Report

MONITOR: Immunosuppressed patients may have diminished response to diagnostic skin test antigens due to suppression of cell-mediated, delayed-type hypersensitivity. Falsely insignificant or false-negative results may occur in such patients, which may include those who have recently received or are receiving immunosuppressive agents, antilymphocyte globulins, alkylating agents, antimetabolites, radiation, some antirheumatic agents, high dosages of corticosteroids or adrenocorticotropic agents (e.g., greater than or equal to 2 mg/kg/day or 20 mg/day of prednisone or equivalent for 14 consecutive days or more), or long-term topical or inhaled corticosteroids.

MANAGEMENT: Clinicians should be aware of the potential for falsely insignificant or false-negative results when administering diagnostic skin test antigens to patients treated with immunosuppressive agents.

ADJUST DOSING INTERVAL: Oral cladribine may increase the bioavailability of other drugs, which may increase the risk or severity of adverse reactions. Cladribine tablets may contain hydroxypropyl betadex, which could form a complex with the active ingredients of other drugs, especially agents with low solubility. The clinical relevance of this interaction remains unknown.

MANAGEMENT: Administration of oral cladribine should be separated from any other oral drug by at least 3 hours.