PDR.net is to be used only as a reference aid. trastuzumab deruxtecan, teniposide. 0000019863 00000 n Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Copyright(c) 2021 First Databank, Inc. View the formulary and any restrictions for each plan. teniposide will increase the level or effect of conjugated estrogens, vaginal by P-glycoprotein (MDR1) efflux transporter. Contact the applicable plan Salicylates also displace protein-bound teniposide in fresh human serum to a small but significant extent. Naproxen; Pseudoephedrine: (Major) Dose-limiting bone marrow suppression is the most significant toxicity associated with teniposide, and may include thrombocytopenia. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs. fosphenytoin will decrease the level or effect of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Mitotane: (Moderate) Monitor patients for reduced efficacy of teniposide if coadministration with mitotane is necessary. Teniposide is a substrate of the drug transporter P-glycoprotein (P-gp); ledipasvir is a P-gp inhibitor. Use Caution/Monitor. Teniposide is a CYP3A4 substrate and primidone is metabolized to phenobarbital, a strong CYP3A4 inducer. Minor (1)choline magnesium trisalicylate increases levels of teniposide by unspecified interaction mechanism. Inhibits topoisomerase II to cause DNA strand breaks, preventing mitosis, Vd: 8-44 L/m² (adults); 3-11 L/m² (children), Must be diluted with either D5W or NS to a final concentration of 0.1, 0.2, 0.4 or 1 mg/mL, To prevent extraction of the plasticizer DEHP, prepare solutions in non-DEHP-containing containers such as glass or polyolefin, Administer 1 mg/mL solutions within 4 hr of preparation to reduce potential for precipitation, Precipitation may occur at any concentration, Rapid infusion may cause hypotension or incr nausea & vomiting, Flush thoroughly before & after administration, Do not use in-line filter during IV infusion, WARNING: This medication may cause certain severe blood and bone marrow problems (low red blood cells/white blood cells/platelets). The mean steady-state Vd of teniposide ranges from 8 to 44 L/m2 in adults. Adjust dose according to prescribing information if needed. Use Caution/Monitor. aspirin increases levels of teniposide by unspecified interaction mechanism. This drug is available at a higher level co-pay. Use Caution/Monitor. The depressant effects of the antiemetic agents and the alcohol content of the teniposide formulation may place patients receiving higher than recommended doses of teniposide at risk for central nervous system depression. The teniposide dosage has not been established for the treatment of advanced bladder cancer. Teniposide is usually given after other cancer medications have been tried without successful treatment. Isoniazid, INH; Pyrazinamide, PZA; Rifampin: (Moderate) Monitor patients for reduced efficacy of teniposide if coadministration with rifampin is necessary. Mefenamic Acid: (Major) Dose-limiting bone marrow suppression is the most significant toxicity associated with teniposide, and may include thrombocytopenia. An additive risk of bleeding may be seen in patients receiving concomitant NSAIDs. Monitor Closely (1)ofatumumab SC, teniposide. teniposide will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. The blood-brain barrier may limit diffusion of teniposide into the cerebral spinal fluid (CSF). teniposide will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration with other strong CYP3A4 inducers reduced plasma concentrations of teniposide. Oritavancin: (Moderate) Teniposide is metabolized by CYP3A4; oritavancin is a weak CYP3A4 inducer. It does not intercalate into nor bind strongly to DNA. Monitor Closely (1)atorvastatin will increase the level or effect of teniposide by P-glycoprotein (MDR1) efflux transporter. An additive risk of bleeding may be seen in patients receiving concomitant NSAIDs. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Use Caution/Monitor. This complex induces breaks in double stranded DNA and prevents repair by topoisomerase II binding. Either increases effects of the other by immunosuppressive effects; risk of infection. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates. Use Caution/Monitor. DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. ritonavir will increase the level or effect of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Consult your doctor before breast-feeding. Tell your doctor right away if you feel pain or irritation at the injection site.If this medication touches your skin, immediately wash the area well with soap and water. Use Caution/Monitor. An additive risk of bleeding may be seen in patients receiving concomitant NSAIDs. Teniposide inhibits DNA synthesis by forming a complex with topoisomerase II and DNA. S or early G2 phase. Minor (1)diflunisal increases levels of teniposide by unspecified interaction mechanism. Vumon (teniposide injection), in combination with other approved anticancer agents, is indicated for induction therapy in patients with Grade 3 and 4 hematologic toxicity (including neutropenia, thrombocytopenia, and anemia), febrile neutropenia, and infection were reported significantly more often with teniposide plus cisplatin compared with paclitaxel plus cisplatin; additionally, there were 6 toxic deaths (3.6%) in the teniposide plus cisplatin arm and 3 toxic deaths (1.9%) in the paclitaxel plus cisplatin arm. In addition, large doses of salicylates (>= 3-4 g/day) can cause hypoprothrombinemia, an additional risk factor for bleeding. Monitor Closely (1)atazanavir increases levels of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consider increasing CYP3A substrate dose if needed. An additive risk of bleeding may be seen in patients receiving concomitant NSAIDs. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate. Avoid or Use Alternate Drug. Teniposide delays transit of cells through the S phase and arrests cells in late S or early G2phase, preventing cells from entering mitosis. Lonafarnib is a weak P-gp inhibitor. tucatinib will increase the level or effect of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. In a study, therapeutically relevant concentrations of tolbutamide displaced protein-bound teniposide in fresh human serum to a small but significant extent. Darunavir: (Major) The plasma concentrations of teniposide may be significantly elevated when administered concurrently with darunavir. Avoid or Use Alternate Drug. Found inside – Page 812Designated Indication : Date Designated : 10/5/1998 Market Approval Date : 8/11/1999 Generic Name : Teniposide Trade Name : Vumon for Injection Designated ... Valdecoxib: (Major) Dose-limiting bone marrow suppression is the most significant toxicity associated with teniposide, and may include thrombocytopenia. Not a Member? Found inside – Page 79Indications . Colorectal cancer , lung cancer 2. ... D. Teniposide ( VM - 26 , Vumon ) 1 ... Anticonvulsants increase clearance of teniposide . lasmiditan increases levels of teniposide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. This section has been translated automatically. Salicylates also displace protein-bound teniposide in fresh human serum to a small but significant extent. DNA strand breaks develop, causing cell death.Although fluoroquinolone antibiotics also interact with topoisomerase enzymes, bactericidal concentrations do not affect the human enzyme. H�t����0��z�����I��)��!��O����Y�c�.a�M���>� �pk��F�������� ����>͡;Ǧ�U%��eq��w��������xm�0���o}g������>KQ|}�x�W��g���0� Use Caution/Monitor. Because of the extremely high binding of teniposide to plasma proteins, these small decreases in binding could cause substantial increases in plasma free drug concentrations that could result in potentiation of teniposide toxicity, including bone marrow suppression. In addition, large doses of salicylates (>= 3-4 g/day) can cause hypoprothrombinemia, an additional risk factor for bleeding. Comment: Combination may increase risk of myelosuppression. 0 Either increases toxicity of the other by pharmacodynamic synergism. The depressant effects of the antiemetic agents and the alcohol content of the teniposide formulation may place patients receiving higher than recommended doses of teniposide at risk for central nervous system depression. Teniposide Injection is a cytotoxic drug which should be administered under the supervision of a qualified physician experienced in the use of cancer chemotherapeutic agents. Use Caution/Monitor. In addition, large doses of salicylates (>= 3-4 g/day) can cause hypoprothrombinemia, an additional risk factor for bleeding. [60884], Topoisomerase II inhibitorUsed with other chemotherapy for induction therapy in patients with refractory acute lymphocytic leukemiaSevere myelosuppression and hypersensitivity reactions have occurred, Teniposide/Vumon Intravenous Inj Sol: 1mL, 10mg, 165 mg/m2 IV in combination with cytarabine 300 mg/m2 IV twice weekly for 8 to 9 doses was evaluated in a clinical study. Use Caution/Monitor. Found inside – Page 251ADULT - Chemotherapy doses vary by indication . ... TENIPOSIDE ( Vumon , VM - 26 ) K CD - $ varies by therapy WARNING - Bone marrow suppression ... stiripentol will increase the level or effect of teniposide by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown. Vemurafenib: (Major) Concomitant use of vemurafenib and teniposide may result in altered concentrations of teniposide. Teniposide. ketoconazole will increase the level or effect of teniposide by P-glycoprotein (MDR1) efflux transporter. Monitor Closely (1)nafcillin will decrease the level or effect of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Teniposide injection must be given in a hospital or medical facility under the supervision of a doctor who is experienced in giving chemotherapy medications for cancer. idelalisib will increase the level or effect of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. In addition, large doses of salicylates (>= 3-4 g/day) can cause hypoprothrombinemia, an additional risk factor for bleeding. dose-dependent single- and double-stranded breaks in DNA and DNA-protein cross-links. Use Caution/Monitor. An additive risk of bleeding may be seen in patients receiving concomitant NSAIDs. Serious - Use Alternative (1)voxelotor will increase the level or effect of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. choline magnesium trisalicylate increases levels of teniposide by unspecified interaction mechanism. 60 or 80 mg/m2 IV for 5 days every 3 weeks or 60 mg/m2 IV on days 2 to 4 in combination with CAV have been studied. Teniposide is a substrate for CYP3A4 and P-glycoprotein (P-gp); ritonavir inhibits both CYP3A44 and P-gp. Salicylates also displace protein-bound teniposide in fresh human serum to a small but significant extent. An additive risk of bleeding may be seen in patients receiving concomitant NSAIDs. Teniposide is a Pgp substrate, and concomitant use of ixabepilone with a Pgp substrate may cause an increase in teniposide concentrations. 0000004828 00000 n Telithromycin: (Major) Concentrations of teniposide may be increased with concomitant use of telithromycin. ALL is a type of cancer of the white blood cells. Nausea and vomiting can be severe. Monitor Closely (1)vemurafenib increases levels of teniposide by P-glycoprotein (MDR1) efflux transporter. Use caution when switching patients from long-acting therapies with immune effects. Do not use in … 1,3. quinidine will increase the level or effect of teniposide by P-glycoprotein (MDR1) efflux transporter. x�bb2e`b``Ń3� ��� Use Caution/Monitor. amiodarone will increase the level or effect of teniposide by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Salicylates also displace protein-bound teniposide in fresh human serum to a small but significant extent. %%EOF This book, now in its second edition, provides a comprehensive overview of current re-irradiation strategies, with detailed discussion of re-irradiation methods, technical aspects, the role of combined therapy with anticancer drugs and ... Monitor Closely (1)fostamatinib will increase the level or effect of teniposide by P-glycoprotein (MDR1) efflux transporter. There was no drug accumulation in these patients after 3 days of teniposide administration. The depressant effects of the antiemetic agents and the alcohol content of the teniposide formulation may place patients receiving higher than recommended doses of teniposide at risk for central nervous system depression. Naproxen: (Major) Dose-limiting bone marrow suppression is the most significant toxicity associated with teniposide, and may include thrombocytopenia. This medication may cause low blood pressure. Lansoprazole; Naproxen: (Major) Dose-limiting bone marrow suppression is the most significant toxicity associated with teniposide, and may include thrombocytopenia. Teniposide is a CYP3A4 substrate and apalutamide is a strong CYP3A4 inducer. If concomitant use unavoidable, reduce the P-gp substrate dosage if recommended in its approved product labeling. Use Caution/Monitor. Steady-state volume of distribution (Vd) increases with a decrease in plasma albumin levels. Teniposide is a substrate of the drug efflux transporter P-glycoprotein (PGP) and of the hepatic isoenzyme CYP3A4; boceprevir is an inhibitor of both the efflux protein and the isoenzyme. Minor (1)teniposide will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Comment: Caution should be taken in patients on concomitant immunosuppressants or with impaired immune systems because of increased risk for serious infections. Found inside – Page 1113The only indication for teniposide is refractory acute lymphoblastic leukemia of childhood . Administration is by slow IV infusion . This complex induces breaks in double stranded DNA and prevents repair by topoisomerase II binding. Individuals with altered immunocompetence may have reduced immune responses to the vaccine. Use Caution/Monitor. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Because of the extremely high binding of teniposide to plasma proteins, these small decreases in binding could cause substantial increases in plasma free drug concentrations that could result in potentiation of teniposide toxicity, including bone marrow suppression. vemurafenib increases levels of teniposide by P-glycoprotein (MDR1) efflux transporter. Conivaptan: (Major) Avoid coadministration of conivaptan, a CYP3A4/P-glycoprotein (P-gp) inhibitor and teniposide, a CYP3A4/P-gp substrate. Ask your doctor or pharmacist about using this product safely.This medication can affect fertility in males. Use Caution/Monitor. Serious - Use Alternative (1)apalutamide will decrease the level or effect of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 100 mg/m2 IV plus cisplatin repeated every 3 weeks has been studied. For induction therapy in patients with refractory ALL, in combination with other approved anticancer agents. Minor/Significance Unknown. excessive tiredness. Tolmetin: (Major) Dose-limiting bone marrow suppression is the most significant toxicity associated with teniposide, and may include thrombocytopenia. Diphenhydramine; Naproxen: (Major) Dose-limiting bone marrow suppression is the most significant toxicity associated with teniposide, and may include thrombocytopenia. Send the page "" Serious - Use Alternative (1)teniposide decreases effects of adenovirus types 4 and 7 live, oral by pharmacodynamic antagonism. In addition, large doses of salicylates (>= 3-4 g/day) can cause hypoprothrombinemia, an additional risk factor for bleeding. The depressant effects of the antiemetic agents and the alcohol content of the teniposide formulation may place patients receiving higher than recommended doses of teniposide at risk for central nervous system depression. In some cases, your doctor may prescribe medication to prevent or relieve nausea and vomiting. Use caution when administering these drugs concomitantly. Found inside – Page 743... found in milk at 28 days 39 hours 27 hours Lactation 7 43 Compound Indication Peak plasma time Half-life Recommendation Pentostatin Tamoxifen Teniposide. . endstream endobj 342 0 obj <. Salicylates also displace protein-bound teniposide in fresh human serum to a small but significant extent. Because of the extremely high binding of teniposide to plasma proteins, these small decreases in binding could cause substantial increases in plasma free drug concentrations that could result in potentiation of teniposide toxicity, including bone marrow suppression. 0000010556 00000 n An additive risk of bleeding may be seen in patients receiving concomitant NSAIDs. Diphenhydramine; Ibuprofen: (Major) Dose-limiting bone marrow suppression is the most significant toxicity associated with teniposide, and may include thrombocytopenia. In a 3-arm, randomized study in 135 patients with ED-SCLC, the overall response rate (ORR) was significantly lower with single-agent teniposide (60 mg/m2/day IV on days 1 to 5 repeated every 3 weeks) compared with cyclophosphamide, etoposide, and cisplatin (43% vs 56%; p = 0.02). acalabrutinib, teniposide. Live-attenuated vaccines should be avoided for at least 3mo after cessation of immunosuppressive therapy. Use Caution/Monitor. Serious - Use Alternative (1)primidone will decrease the level or effect of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)siponimod and teniposide both increase immunosuppressive effects; risk of infection. provider for the most current information. But the application in clinic was limited because of its poor solubility. Paritaprevir also inhibits P-gp. This document does not contain all possible drug interactions. The ORR was 51% when teniposide 100 mg/m2 IV over 30 min on days 1 and 2 plus cisplatin repeated every 3 weeks was given as first-line systemic chemotherapy in 41 patients with metastatic TCC of the bladder in a phase II study. Monitor Closely (1)berotralstat will increase the level or effect of teniposide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Coadministration of teniposide and enzyme-inducing antiepileptic drugs resulted in teniposide clearance values that were 2- to 3-times higher than values with teniposide alone. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling. bosentan will decrease the level or effect of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Salicylates also displace protein-bound teniposide in fresh human serum to a small but significant extent. Tell your doctor or other health care professional if you feel dizzy. Due to a risk of male-mediated teratogenicity, men should avoid fathering a child during teniposide therapy. Modify Therapy/Monitor Closely. Use Caution/Monitor. aspirin/citric acid/sodium bicarbonate increases levels of teniposide by unspecified interaction mechanism. Eating several small meals, not eating before treatment, or limiting activity may help lessen some of these effects. Serious - Use Alternative (1)idelalisib will increase the level or effect of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Salicylates also displace protein-bound teniposide in fresh human serum to a small but significant extent. Caution and close monitoring are advised if these drugs are administered together. Minor (1)aspirin rectal increases levels of teniposide by unspecified interaction mechanism. Females of reproductive potential should avoid becoming pregnant during teniposide therapy. Coadministration may result in elevated teniposide plasma concentrations. Serious - Use Alternative (1)posaconazole will increase the level or effect of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. deferiprone, teniposide. Alternatively, teniposide 250 mg/m2 IV once weekly and vincristine 1.5 mg/m2 IV once weekly for 4 to 8 weeks plus prednisone 40 mg daily for 28 days was studied in another clinical trial. commonly, these are "non-preferred" brand drugs. Found inside – Page 1529These investigators studied the effect teniposide is more potent than ... or inhibition of DNA synthesis ( 40 ) An indication that some nuclear enzyme may ... Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: live vaccines (e.g., flu vaccine inhaled through the nose, typhoid/polio vaccine taken by mouth), "blood thinners" (e.g., warfarin, enoxaparin), salicylates/NSAIDs (e.g., aspirin, ibuprofen, naproxen, sodium salicylate), drugs that may interact with alcohol (e.g., disulfiram, metronidazole), methotrexate, sulfonamide antibiotics (e.g., sulfamethizole).Tell your doctor or pharmacist if you are using other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. 2. Clinical monitoring for adverse effects, such as myelosuppression, is recommended during coadministration. Found inside – Page 10When the indication is based on adult data supplemented by other information ... would be considered misbranded . teniposide has greater cellular uptake ... Modify Therapy/Monitor Closely. Use Caution/Monitor. Use Caution/Monitor. phenytoin will decrease the level or effect of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. rucaparib will increase the level or effect of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Found inside – Page 3470Teniposide is more extensively bound to plasma proteins and its cellular ... Indications : Etoposide : Refractory testicular tumors in combination with ... Teniposide forms a ternary complex with the enzyme topoisomerase II and DNA, resulting in dose-dependent single- and double-stranded breaks in DNA, DNA: protein cross-links, inhibition of DNA strand religation, and cytotoxicity. rifapentine will decrease the level or effect of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. A dosage reduction or therapy discontinuation may be necessary in patients who develop severe toxicity.[60884]. In this paper, teniposide nanosuspensions drug delivery system (TEN-NSDDS) for intravenous administration was developed for the first time. Use Caution/Monitor. Methotrexate: (Moderate) Use methotrexate and teniposide together with caution; increased methotrexate levels and increased methotrexate toxicity may occur. Teniposide is a substrate of the hepatic isoenzyme CYP3A4 and drug transporter P-glycoprotein (P-gp); isavuconazole, the active moiety of isavuconazonium, is an inhibitor of CYP3A4 and P-gp. Monitor Closely (1)iloperidone increases levels of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)rucaparib will increase the level or effect of teniposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Indications (3) and toxicity (2) of etoposide. Severe myelosuppression occurred in 27% of ACTVP-treated patients and in 22% of ACTP-treated patients but only in 8% of ACVP-treated patients (P = 0.02), indicating an increased risk of myelosuppression for the combinations including teniposide. Clinical monitoring for adverse effects, such as myelosuppression, is recommended during coadministration. If metabolic acidosis occurs or persists, consider reducing the dose or discontinuing dichlorphenamide therapy. It appears to produce its cytotoxic effects by damaging DNA, thereby preventing or altering DNA synthesis. Use Caution/Monitor. Evaluate for loss of therapeutic effect if medication must be coadministered. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis. Avoid coadministration with sensitive CYP3A substrates. Find patient medical information for teniposide intravenous on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Monitor Closely (1)nelfinavir will increase the level or effect of teniposide by P-glycoprotein (MDR1) efflux transporter. affecting hepatic/intestinal enzyme CYP3A4 metabolism. If you become pregnant or think you may be pregnant, tell your doctor right away. lomitapide increases levels of teniposide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. St. John's Wort, Hypericum perforatum: (Moderate) Monitor patients for reduced efficacy of teniposide if coadministration with St. John's Wort is necessary. This website also contains material copyrighted by 3rd parties. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate. teniposide increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Palifermin: (Moderate) Palifermin should not be administered within 24 hours before, during infusion of, or within 24 hours after administration of antineoplastic agents. cyclosporine will increase the level or effect of teniposide by P-glycoprotein (MDR1) efflux transporter. erdafitinib will increase the level or effect of teniposide by P-glycoprotein (MDR1) efflux transporter. Vincristine: (Moderate) Use teniposide and vincristine together with caution; neurotoxicity including cases of severe neuropathy have been reported. Avoid or Use Alternate Drug. Salicylates also displace protein-bound teniposide in fresh human serum to a small but significant extent. Monitor Closely (1)teniposide will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Warnings. Dose-limiting bone marrow suppression is the most significant toxicity associated with teniposide therapy. Therefore, the following studies should be obtained at the start of therapy and prior to each subsequent dose of teniposide: hemoglobin, white blood cell count and differential, and platelet count. Monitor Closely (1)darunavir will increase the level or effect of teniposide by P-glycoprotein (MDR1) efflux transporter. affecting hepatic/intestinal enzyme CYP3A4 metabolism. teniposide will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. elagolix will increase the level or effect of teniposide by P-glycoprotein (MDR1) efflux transporter. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments. Monitor Closely (1)itraconazole will increase the level or effect of teniposide by P-glycoprotein (MDR1) efflux transporter. Compare formulary status to other drugs in the same class. Teniposide and vincristine together with caution ; neurotoxicity including cases of severe neuropathy have been tried without treatment... 26, Vumon ) 1... Anticonvulsants increase clearance of teniposide by unspecified interaction mechanism Page 251ADULT - doses! Significant extent idelalisib is a type of cancer of the drug transporter P-glycoprotein MDR1. Teniposide clearance values that were 2- to 3-times higher than values with teniposide, and include! Metabolic acidosis occurs or persists, consider reducing the dose or discontinuing dichlorphenamide therapy vemurafenib teniposide... Immunocompetence may have reduced immune responses to the vaccine increase your risk for serious infections also interact topoisomerase... With refractory all, in combination with other approved anticancer agents is a P-gp inhibitor does intercalate... Indication is based on adult data supplemented by other information... would considered... 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