Drug Interaction Report

The DOCEtaxel in Docivyx has a moderate potential interaction with Alcoholism.

The alcohol content in a dose of docetaxel injection may affect the central nervous system. Cases of intoxication have been reported with some formulations of docetaxel due to the alcohol content. Close monitoring is recommended in alcoholic patients. Consideration should be given to the alcohol content in docetaxel injection on the ability to drive or use machines immediately after the infusion.

Nefazodone has a moderate potential interaction with Bipolar Disorder.

All antidepressants may occasionally cause mania or hypomania, particularly in patients with bipolar disorder. Therapy with antidepressants should be administered cautiously in patients with a history of mania/hypomania.

Nefazodone has a moderate potential interaction with Bipolar Disorder.

Adults, young adults and children patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. Phenylpiperazine antidepressants are not approved for use in pediatric patients.

The DOCEtaxel in Docivyx has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

The use of docetaxel is contraindicated in patients with a neutrophil count < 1500/mm3. Docetaxel induces dose-related myelosuppression resulting in neutropenia, thrombocytopenia, and anemia. Neutropenia occurs in all patients administered 60-100 mg/m2 of docetaxel. Grade 4 neutropenia (< 500/mm3) occurs in nearly all patients administered 100 mg/m2 of docetaxel. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, or local infection. Therapy should be administered cautiously to patients with compromised bone marrow reserve and should be withheld until neutrophil levels is > 1500/mm3 and/or platelet counts is > 100,000/mm3. A 25% reduction in dosage is recommended during subsequent cycles following severe neutropenia (< 500/mm3). It is recommended to performed frequent blood cell counts on all patients receiving docetaxel.

Nefazodone has a major potential interaction with Cerebrovascular Insufficiency.

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Nefazodone has a major potential interaction with Dehydration.

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Nefazodone has a moderate potential interaction with Depression.

Adults, young adults and children patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. Phenylpiperazine antidepressants are not approved for use in pediatric patients.

Nefazodone has a major potential interaction with Diarrhea.

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

The DOCEtaxel in Docivyx has a major potential interaction with Fever.

The use of docetaxel is contraindicated in patients with a neutrophil count < 1500/mm3. Docetaxel induces dose-related myelosuppression resulting in neutropenia, thrombocytopenia, and anemia. Neutropenia occurs in all patients administered 60-100 mg/m2 of docetaxel. Grade 4 neutropenia (< 500/mm3) occurs in nearly all patients administered 100 mg/m2 of docetaxel. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, or local infection. Therapy should be administered cautiously to patients with compromised bone marrow reserve and should be withheld until neutrophil levels is > 1500/mm3 and/or platelet counts is > 100,000/mm3. A 25% reduction in dosage is recommended during subsequent cycles following severe neutropenia (< 500/mm3). It is recommended to performed frequent blood cell counts on all patients receiving docetaxel.

The DOCEtaxel in Docivyx has a major potential interaction with Fluid Retention.

Severe fluid retention characterized by peripheral edema, generalized edema, pleural effusion, dyspnea at rest, cardiac tamponade, or abdominal distention due to ascites has been reported during docetaxel therapy. Therapy with docetaxel should be administered cautiously to patients adversely affected by fluid retention. Prophylaxis with a five day dexamethasone premedication regimen is recommended, however, fluid retention has occurred despite this pretreatment.

Nefazodone has a moderate potential interaction with Glaucoma, Narrow Angle.

Some antidepressants exert mydriatic activity that can induce increased intraocular pressure and result in angle-closure (narrow-angle) glaucoma in a patient with anatomically narrow angles who does not have a patent iridectomy. Prior to initiating therapy with these agents, patients should be examined to determine whether they are susceptible to angle closure, and have a prophylactic procedure (e.g., iridectomy), if they are susceptible. The use of these drugs in patients with untreated anatomically narrow angles should be avoided.

Nefazodone has a major potential interaction with History - Cerebrovascular Disease.

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Nefazodone has a major potential interaction with History - Myocardial Infarction.

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

Nefazodone has a major potential interaction with Hypotension.

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

The DOCEtaxel in Docivyx 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.

Nefazodone has a major potential interaction with Ischemic Heart Disease.

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

The DOCEtaxel in Docivyx has a major potential interaction with Liver Disease.

Docetaxel is extensively metabolized by the liver. Total body clearance of docetaxel has been reported to be reduced as much as 27% in patients with mild to moderate hepatic impairment resulting in a 38% increase of docetaxel serum concentration. Patients with elevated transaminase levels (>1.5 times the upper limits of normal) and alkaline phosphatase (>2.5 times the upper limits of normal) should not be administered docetaxel. The incidence of docetaxel related deaths is increased in patients with impaired hepatic function. Bilirubin, transaminase, and alkaline phosphatase levels should be obtained prior to each cycle of docetaxel therapy. Patients with combined abnormalities of transaminases and alkaline phosphatase should not be treated with this agent.

Nefazodone has a major potential interaction with Liver Disease.

In general, treatment with nefazodone should not be initiated in patients with active liver disease or elevated baseline serum transaminase levels. Cases of hepatic failure resulting in death or liver transplant, at an estimated rate of 1 per 250,000 to 300,000 patient-years of nefazodone treatment in the U.S. (approximately 3 to 4 times the background rate), have been reported during postmarketing use. The time to liver injury for the reported cases typically ranged from 2 weeks to 6 months of use. Dark urine and nonspecific prodromal symptoms (e.g., nausea, anorexia, malaise, gastrointestinal complaints) were reported in some, but not all, cases prior to the onset of jaundice. There is no evidence that preexisting liver disease increases the likelihood of developing liver failure. However, baseline abnormalities can delay the recognition or confound the diagnosis of a drug-induced hepatotoxic effect, thus use of nefazodone is discouraged in this population. In patients who do receive nefazodone therapy, routine liver function testing should be considered to permit early detection of hepatic injury. Nefazodone therapy should be promptly discontinued if clinical signs or symptoms suggestive of liver injury occur, or if serum transaminase levels exceed 3 times the upper limit of normal. Therapy should be permanently discontinued in patients with presumed or confirmed drug-induced hepatotoxicity. In addition, the use of nefazodone is contraindicated in patients who were withdrawn from nefazodone because of evidence of liver injury.

The DOCEtaxel in Docivyx has a major potential interaction with Macular Edema.

Cystoid macular edema has been reported with the use of docetaxel. Patients with impaired vision should undergo a prompt and comprehensive ophthalmologic examination prior to therapy with this agent. If cystoid macular edema is diagnosed, treatment should be discontinued and appropriate treatment initiated. Alternative non-taxane cancer treatment should be considered.

Nefazodone has a moderate potential interaction with Mania.

All antidepressants may occasionally cause mania or hypomania, particularly in patients with bipolar disorder. Therapy with antidepressants should be administered cautiously in patients with a history of mania/hypomania.

The DOCEtaxel in Docivyx has a moderate potential interaction with Peripheral Neuropathy.

Severe neurosensory symptoms such as paresthesia, dysesthesia, and pain have been reported during docetaxel therapy. Therapy with docetaxel should be administered cautiously to patients with or predisposition to neurosensory symptoms. Although reversible with discontinuation of docetaxel therapy, the dosage must be adjusted if neurosensory symptoms occur and therapy discontinued if symptoms persist.

Nefazodone has a moderate potential interaction with Seizures.

The use of most antidepressants is associated with a risk of seizures. There have been only rare reports of convulsions, including grand mal seizures, following the administration of nefazodone or trazodone. Although a causal relationship has not been established, therapy with these agents should be administered cautiously in patients with a history of seizures.

Nefazodone has a major potential interaction with Vomiting.

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.