Docetaxel Injection (Non-Alcohol Formula) and EryPed

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.

Erythromycin may significantly increase the blood levels of DOCEtaxel. This may increase the risk of side effects such as nausea, vomiting, diarrhea, mouth sores, fluid retention, nerve pain, numbness, tingling, muscle pain or weakness, and impaired bone marrow function resulting in low numbers of different types of blood cells. You may also be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should contact your doctor if you develop paleness, fatigue, dizziness, fainting, unusual bruising or bleeding, fever, chills, diarrhea, sore throat, muscle aches, shortness of breath, blood in phlegm, weight loss, red or inflamed skin, body sores, and pain or burning during urination. 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.

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 or dual CYP450 3A4 and P-glycoprotein (P-gp) inhibitors may significantly increase the plasma concentrations of docetaxel, which is a substrate of both CYP450 3A4 and P-gp. In a pharmacokinetic study consisting of 7 cancer patients, mean dose-normalized docetaxel systemic exposure (AUC) increased by 2.2-fold and clearance decreased by 49% when intravenous docetaxel was given at a reduced dosage of 10 mg/m2 in combination with the potent CYP450 3A4 inhibitor ketoconazole (200 mg orally once daily for 3 days) compared to docetaxel administered alone at 100 mg/m2. In addition, a suspected interaction with amiodarone was described in a case report involving a 77-year-old woman with HER2-positive invasive ductal breast cancer on long-term amiodarone therapy who developed increasing abdominal discomfort and skin lesions during 4 cycles of paclitaxel (80 mg/m2 weekly) and trastuzumab. A subsequent switch to docetaxel (100 mg or 75 mg/m2 weekly) led to the development of severe skin and mucosal toxicity, requiring hospitalization 8 days after the first docetaxel dose was administered. Analysis of two blood samples taken 9 and 10 days after docetaxel administration showed an approximately fivefold increase in its AUC as well as the presence of paclitaxel in unquantifiable levels, 20 and 21 days after it was last administered. In another case report, a 79-year-old man was hospitalized with fever, diarrhea, and grade 4 stomatitis and neutropenia after receiving a third cycle of docetaxel (35 mg/m2 on days 1 and 8 every 21 days) for metastatic androgen-independent prostate cancer while on dronedarone therapy (400 mg twice daily), which had been commenced 24 days earlier due to recurrence of atrial fibrillation. Docetaxel was still detectable in a plasma sample taken 24 days after it was last administered, at a concentration of approximately 2.4 ng/mL, even though its terminal half-life is about 12 hours. Unfortunately, the patient died after deterioration of his condition and multiple infectious complications. The authors of these case reports propose that, in addition to CYP450 3A4 inhibition, P-gp inhibition due to amiodarone and dronedarone may also have contributed to the interaction.

MANAGEMENT: Concomitant use of docetaxel with CYP450 3A4 inhibitors, particularly potent inhibitors or dual CYP450 3A4 and P-gp inhibitors such as itraconazole, ketoconazole, posaconazole, conivaptan, ceritinib, idelalisib, nefazodone, cobicistat, delavirdine, protease inhibitors, and ketolide and certain macrolide antibiotics, should generally be avoided. If concomitant use is required, a reduced dosage of docetaxel should be considered. Based on extrapolation from the pharmacokinetic study in 7 cancer patients, a 50% reduction in the docetaxel dose may be reasonable. Patients should be closely monitored for the development of docetaxel toxicity such as myelosuppression, stomatitis, neurotoxicity (e.g., paraesthesia, dysesthesia, pain), myalgia, asthenia, fluid retention, nausea, vomiting, and diarrhea.

Docetaxel Injection (Non-Alcohol Formula)

Generic Name: docetaxel

Brand name: Taxotere, Docefrez

Synonyms: Docetaxel, DOCEtaxel

What is Docetaxel Injection (Non-Alcohol Formula)?

EryPed

Generic Name: erythromycin

Brand name: E. E. S, EryPed, EES. Granules, EES-400 Filmtab, EryPed 200, EryPed 400, Ery-Tab, Erythrocin Lactobionate, Erythrocin Stearate Filmtab, PCE Dispertab, Erythrocin, Erythromycin Filmtabs, Erythromycin Lactobionate - IV

Synonyms: n.a.

What is EryPed?