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Clofarabine and Theraflu Warming Relief Nighttime Severe Cold

Determining the interaction of Clofarabine and Theraflu Warming Relief Nighttime Severe Cold and the possibility of their joint administration.

Check result:
Clofarabine <> Theraflu Warming Relief Nighttime Severe Cold
Relevance: 22.08.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Clofarabine may cause liver problems, and using it with other medications that can also affect the liver such as acetaminophen may increase that risk. You should avoid or limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. Talk to your doctor or pharmacist if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

GENERALLY AVOID: The liver is a known target organ for clofarabine toxicity, and concomitant use of other potentially hepatotoxic agents may increase the risk of liver injury. Severe and fatal hepatotoxicity has occurred with the use of clofarabine alone. In clinical studies, grade 3 to 4 liver enzyme elevations were frequently observed in pediatric patients during treatment, with aspartate aminotransferase (AST) and alanine aminotransferase (ALT) elevations reported in 36% and 44% of patients, respectively. Liver enzyme elevations typically occurred within 10 days of clofarabine administration and returned to grade 2 or lower within 15 days. Grade 3 or 4 bilirubin elevations occurred in 13% of patients, with 2 cases reported as grade 4 hyperbilirubinemia (2%), one of which resulted in treatment discontinuation and the other in multi-organ failure and death. Eight patients (7%) had grade 3 or 4 elevations in serum bilirubin at the last time point measured, all of whom died due to sepsis and/or multi-organ failure.

MANAGEMENT: Concomitant use of clofarabine with other potentially hepatotoxic agents should be avoided whenever possible (e.g., acetaminophen; alcohol; androgens and anabolic steroids; antituberculous agents; azole antifungal agents; ACE inhibitors; disulfiram; endothelin receptor antagonists; interferons; ketolide and macrolide antibiotics; kinase inhibitors; minocycline; nonsteroidal anti-inflammatory agents; nucleoside reverse transcriptase inhibitors; proteasome inhibitors; retinoids; sulfonamides; tamoxifen; thiazolidinediones; tolvaptan; vincristine; zileuton; anticonvulsants such as carbamazepine, hydantoins, felbamate, and valproic acid; lipid-lowering medications such as fenofibrate, lomitapide, mipomersen, niacin, and statins; herbals and nutritional supplements such as black cohosh, chaparral, comfrey, DHEA, kava, pennyroyal oil, and red yeast rice). Hepatic function should be monitored during clofarabine administration, and therapy discontinued if grade 3 to 4 liver enzyme or bilirubin elevations occur. Patients should be advised to seek medical attention if they experience potential signs and symptoms of hepatotoxicity such as fever, rash, itching, anorexia, nausea, vomiting, fatigue, malaise, right upper quadrant pain, dark urine, pale stools, and jaundice.

References
  • "Product Information. Clolar (clofarabine)." sanofi-aventis, Bridgewater, NJ.
Clofarabine

Generic Name: clofarabine

Brand name: Clolar

Synonyms: n.a.

Theraflu Warming Relief Nighttime Severe Cold

Generic Name: acetaminophen / diphenhydramine / phenylephrine

Brand name: Theraflu Warming Relief Nighttime Severe Cold, Benadryl Allergy & Sinus Headache, Delsym Cough Plus Cold Night Time, Mucinex Fast-Max Night Time Cold and Flu, Robitussin Nighttime Multi-Symptom Cold, Sudafed PE Severe Cold, Theraflu Severe Cold & Cough Nighttime, Theraflu Warming Flu & Sore Throat, Theraflu Warming Sinus & Cold, Theraflu Warming Severe Cold Nighttime, Benadryl Allergy & Cold, Sudafed PE Nighttime Cold, Tylenol Allergy Multi-Symptom Nighttime, Theraflu Nighttime Severe Cough & Cold, Children's Delsym Cough Plus Cold Night Time, Children's Mucinex Night Multi-Symp Cold, Children's Dimetapp Multi-Symptom Cold & Flu, Theraflu ExpressMax Nighttime Severe C&C, Theraflu PowerPods Nighttime Severe Cold, Benadryl Allergy/Cold, Tylenol Allergy Multi-Symptom

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.