Interactions : אינטראקציות

4.5   Interaction with other medicinal products and other forms of interaction

Hydroxycarbamide should be given with caution to patients with previous or concomitant radiotherapy or cytotoxic therapy. In these cases the patients have an increased risk to develop bone marrow depression, gastric irritation and mucositis (more severe, higher frequency). Furthermore, an exacerbation of erythema caused by previous or simultaneous irradiation may occur.
In-vitro studies have demonstrated hydroxycarbamide’s ability to enhance the cytotoxicity of both ara-C and fluoropyrimidines.

Hydroxycarbamide may enhance the antiretroviral activity of nucleoside reverse transcriptase inhibitors like didanosine and stavudine. Hydroxycarbamide inhibits HIV DNA synthesis and HIV replication by decreasing the amount of intracellular deoxynucleotides. Patients treated with hydroxycarbamide in combination with didanosine, stavudine, and indinavir in study ACTG 5025 showed a median decline in CD4 cells of approximately 100/mm3. Hydroxycarbamide may also enhance potential side effects of nucleoside reverse transcriptase inhibitors such as hepatotoxicity, pancreatitis and peripheral neuropathy (see section 4.8).

Vaccinations

There is an increased risk of severe or fatal infections with the concomitant use of live vaccines. Live vaccines are not recommended in immunosuppressed patients (see section 4.4).