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.

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.