Drug Interaction Report

The darbepoetin alfa in Aranesp has a major potential interaction with Cerebral Vascular Disorder.

The use of erythropoiesis-stimulating agents may be associated with an increased risk of thrombotic events and mortality. During clinical trials, an increased risk was observed in: 1) patients with chronic renal failure (CRF) and ischemic heart disease or congestive heart failure targeted to a maintenance hematocrit of 42%, and 2) in patients without CRF undergoing coronary artery bypass surgery. Although a causal relationship has not been established, therapy with these agents should be administered cautiously in patients with preexisting cardiovascular disease and/or a history of thrombotic events.

The darbepoetin alfa in Aranesp has a major potential interaction with Heart Failure.

The use of erythropoiesis-stimulating agents may be associated with an increased risk of thrombotic events and mortality. During clinical trials, an increased risk was observed in: 1) patients with chronic renal failure (CRF) and ischemic heart disease or congestive heart failure targeted to a maintenance hematocrit of 42%, and 2) in patients without CRF undergoing coronary artery bypass surgery. Although a causal relationship has not been established, therapy with these agents should be administered cautiously in patients with preexisting cardiovascular disease and/or a history of thrombotic events.

The darbepoetin alfa in Aranesp has a major potential interaction with Hemodialysis.

The increase in hematocrit and decrease in plasma volume associated with erythropoiesis-stimulating agents therapy may, theoretically, affect dialysis efficiency. Patients may require adjustments in their dialysis prescription after initiation of erythropoiesis stimulating agents. During hemodialysis, patients may require increased anticoagulation with heparin to prevent clotting.

The darbepoetin alfa in Aranesp has a major potential interaction with High Blood Pressure.

The use of erythropoiesis-stimulating agents is contraindicated in patients with uncontrolled hypertension. These agents may cause blood pressure to rise. Hypertensive encephalopathy and seizures have been observed in patients with chronic renal failure treated with these agents. Blood pressure should be adequately controlled prior to initiation of therapy, and monitored closely during treatment. Aggressive antihypertensive measures may be necessary, particularly early on in treatment when the hematocrit is increasing. It is recommended to reduce or withhold the use of these agents if blood pressure becomes difficult to control.

Rilonacept has a moderate potential interaction with High Cholesterol.

Patients treated with rilonacept experienced increases in their mean total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. The mean increases from baseline for total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides were 19 mg/dL, 2 mg/dL, 10 mg/dL, and 57 mg/dL respectively after 6 weeks of open-label therapy. Physicians should monitor the lipid profiles of their patients especially those with hyperlipidemias, and consider lipid-lowering therapies as needed based upon cardiovascular risk factors and current guidelines.

The darbepoetin alfa in Aranesp has a major potential interaction with History, Thrombotic/Thromboembolic Disorder.

The use of erythropoiesis-stimulating agents may be associated with an increased risk of thrombotic events and mortality. During clinical trials, an increased risk was observed in: 1) patients with chronic renal failure (CRF) and ischemic heart disease or congestive heart failure targeted to a maintenance hematocrit of 42%, and 2) in patients without CRF undergoing coronary artery bypass surgery. Although a causal relationship has not been established, therapy with these agents should be administered cautiously in patients with preexisting cardiovascular disease and/or a history of thrombotic events.

Rilonacept has a moderate potential interaction with Infection.

Interleukin-1 (IL-1) blockade may interfere with the immune response to infections. Treatment with other medication as rilonacept, that work through inhibition of IL-1 has been associated with an increased risk of serious infections, and serious infections have been reported in patients taking rilonacept compared with placebo. Rilonacept should be discontinued if a patient develops a serious infection. Treatment with rilonacept should not be initiated in patients with an active or chronic infection. Additionally, latent tuberculosis can be reactivated and should be treated before initiating therapy with rilonacept.

The darbepoetin alfa in Aranesp has a major potential interaction with Ischemic Heart Disease.

The use of erythropoiesis-stimulating agents may be associated with an increased risk of thrombotic events and mortality. During clinical trials, an increased risk was observed in: 1) patients with chronic renal failure (CRF) and ischemic heart disease or congestive heart failure targeted to a maintenance hematocrit of 42%, and 2) in patients without CRF undergoing coronary artery bypass surgery. Although a causal relationship has not been established, therapy with these agents should be administered cautiously in patients with preexisting cardiovascular disease and/or a history of thrombotic events.

Rilonacept has a moderate potential interaction with Liver Disease.

No formal studies have been conducted to examine the pharmacokinetics of rilonacept administered subcutaneously in patients with hepatic impairment. Caution is advised if used on these patients.

The darbepoetin alfa in Aranesp has a major potential interaction with Peripheral Arterial Disease.

The use of erythropoiesis-stimulating agents may be associated with an increased risk of thrombotic events and mortality. During clinical trials, an increased risk was observed in: 1) patients with chronic renal failure (CRF) and ischemic heart disease or congestive heart failure targeted to a maintenance hematocrit of 42%, and 2) in patients without CRF undergoing coronary artery bypass surgery. Although a causal relationship has not been established, therapy with these agents should be administered cautiously in patients with preexisting cardiovascular disease and/or a history of thrombotic events.

The darbepoetin alfa in Aranesp has a major potential interaction with Renal Dysfunction.

The use of erythropoiesis stimulating agents increases the risk of seizures in patients with chronic renal failure. Seizure development may be related to the rate of rise in hematocrit, which is also associated with blood pressure elevations. It is recommended to monitor patients closely for the development of premonitory neurologic symptoms during the first several months after the administration of these agents. Patients with epilepsy or predisposed to seizures should be monitored closely for blood pressure changes and neurologic symptoms during therapy with these agents.

Rilonacept has a moderate potential interaction with Renal Dysfunction.

No formal studies have been conducted to examine the pharmacokinetics of rilonacept administered subcutaneously in patients with renal impairment. Caution is advised if used on these patients.

The darbepoetin alfa in Aranesp has a major potential interaction with Seizures.

The use of erythropoiesis stimulating agents increases the risk of seizures in patients with chronic renal failure. Seizure development may be related to the rate of rise in hematocrit, which is also associated with blood pressure elevations. It is recommended to monitor patients closely for the development of premonitory neurologic symptoms during the first several months after the administration of these agents. Patients with epilepsy or predisposed to seizures should be monitored closely for blood pressure changes and neurologic symptoms during therapy with these agents.

The darbepoetin alfa in Aranesp has a major potential interaction with Thrombotic/Thromboembolic Disorder.

The use of erythropoiesis-stimulating agents may be associated with an increased risk of thrombotic events and mortality. During clinical trials, an increased risk was observed in: 1) patients with chronic renal failure (CRF) and ischemic heart disease or congestive heart failure targeted to a maintenance hematocrit of 42%, and 2) in patients without CRF undergoing coronary artery bypass surgery. Although a causal relationship has not been established, therapy with these agents should be administered cautiously in patients with preexisting cardiovascular disease and/or a history of thrombotic events.

Rilonacept has a moderate potential interaction with Tuberculosis, Latent.

Interleukin-1 (IL-1) blockade may interfere with the immune response to infections. Treatment with other medication as rilonacept, that work through inhibition of IL-1 has been associated with an increased risk of serious infections, and serious infections have been reported in patients taking rilonacept compared with placebo. Rilonacept should be discontinued if a patient develops a serious infection. Treatment with rilonacept should not be initiated in patients with an active or chronic infection. Additionally, latent tuberculosis can be reactivated and should be treated before initiating therapy with rilonacept.

Rilonacept has a major potential interaction with Vaccination.

Live vaccines should not be given concurrently with rilonacept. Rilonacept may interfere with normal immune response to new antigens; therefore, vaccinations may not be effective in patients receiving rilonacept. No data are available on the effectiveness of vaccination with inactivated (killed) antigens in patients receiving rilonacept. Because IL-1 blockade may interfere with immune response to infections, it is recommended that prior to initiation of therapy with rilonacept adult and pediatric patients receive all recommended vaccinations, as appropriate, including pneumococcal vaccine and inactivated influenza vaccine.