Please wait while the formulary information is being retrieved.
Drug overview for HICON (sodium iodide-131):
Generic name: SODIUM IODIDE-131
Drug class:
Therapeutic class: Antineoplastics
No enhanced Introduction information available for this drug.
No enhanced Uses information available for this drug.
Generic name: SODIUM IODIDE-131
Drug class:
Therapeutic class: Antineoplastics
No enhanced Introduction information available for this drug.
No enhanced Uses information available for this drug.
DRUG IMAGES
No Image Available
The following indications for HICON (sodium iodide-131) have been approved by the FDA:
Indications:
Hyperthyroidism
Thyroid carcinoma
Professional Synonyms:
Malignant epithelial neoplasm of thyroid
Malignant epithelial tumor of thyroid
Indications:
Hyperthyroidism
Thyroid carcinoma
Professional Synonyms:
Malignant epithelial neoplasm of thyroid
Malignant epithelial tumor of thyroid
The following dosing information is available for HICON (sodium iodide-131):
No enhanced Dosing information available for this drug.
No enhanced Administration information available for this drug.
No dosing information available.
No generic dosing information available.
The following drug interaction information is available for HICON (sodium iodide-131):
There are 1 contraindications.
These drug combinations generally should not be dispensed or administered to the same patient. A manufacturer label warning that indicates the contraindication warrants inclusion of a drug combination in this category, regardless of clinical evidence or lack of clinical evidence to support the contraindication.
| Drug Interaction | Drug Names |
|---|---|
| Live Vaccines; Live BCG/Selected Immunosuppressive Agents SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient. MECHANISM OF ACTION: A variety of disease modifying agents suppress the immune system. Immunocompromised patients may be at increased risk for uninhibited replication after administration of live, attenuated vaccines or intravesicular BCG. Immune response to vaccines may be decreased during periods of immunocompromise.(1) CLINICAL EFFECTS: The expected serum antibody response may not be obtained and/or the vaccine may result in illness.(1) After instillation of intravesicular BCG, immunosuppression may interfere with local immune response, or increase the severity of mycobacterial infection following inadvertent systemic exposure.(2) PREDISPOSING FACTORS: Immunosuppressive diseases (e.g. hematologic malignancies, HIV disease), treatments (e.g. radiation) and drugs may all increase the magnitude of immunodeficiency. PATIENT MANAGEMENT: The Centers for Disease Control(CDC) Advisory Committee on Immunization Practices (ACIP) states that live-virus and live, attenuated vaccines should not be administered to patients who are immunocompromised. The magnitude of immunocompromise and associated risks should be determined by a physician.(1) For patients scheduled to receive chemotherapy, vaccination should ideally precede the initiation of chemotherapy by 14 days. Patients vaccinated while on immunosuppressive therapy or in the 2 weeks prior to starting therapy should be considered unimmunized and should be revaccinated at least 3 months after discontinuation of therapy.(1) Patients who receive anti-B cell therapies should not receive live vaccines for at least 6 months after such therapies due to a prolonged duration of immunosuppression. An exception is the Zoster vaccine, which can be given at least 1 month after receipt of anti-B cell therapies.(1) The US manufacturer of abatacept states live vaccines should not be given during or for up to 3 months after discontinuation of abatacept.(2) The US manufacturer of live BCG for intravesicular treatment of bladder cancer states use is contraindicated in immunosuppressed patients.(3) The US manufacturer of daclizumab states live vaccines are not recommended during and for up to 4 months after discontinuation of treatment.(4) The US manufacturer of guselkumab states that live vaccines should be avoided during treatment with guselkumab.(5) The US manufacturer of inebilizumab-cdon states that live vaccines are not recommended during treatment and after discontinuation until B-cell repletion. Administer all live vaccinations at least 4 weeks prior to initiation of inebilizumab-cdon.(6) The US manufacturer of ocrelizumab states that live vaccines are not recommended during treatment and until B-cell repletion occurs after discontinuation of therapy. Administer all live vaccines at least 4 weeks prior to initiation of ocrelizumab.(7) The US manufacturer of ozanimod states that live vaccines should be avoided during and for up to 3 months after discontinuation of ozanimod.(8) The US manufacturer of siponimod states that live vaccines are not recommended during treatment and for up to 4 weeks after discontinuation of treatment.(9) The US manufacturer of ustekinumab states BCG vaccines should not be given in the year prior to, during, or the year after ustekinumab therapy.(10) The US manufacturer of satralizumab-mwge states that live vaccines are not recommended during treatment and should be administered at least four weeks prior to initiation of satralizumab-mwge.(11) The US manufacturer of ublituximab-xiiy states that live vaccines are not recommended during treatment and until B-cell recovery. Live vaccines should be administered at least 4 weeks prior to initiation of ublituximab-xiiy.(12) The US manufacturer of etrasimod states that live vaccines should be avoided during and for 5 weeks after treatment. Live vaccines should be administered at least 4 weeks prior to initiation of etrasimod.(13) The US manufacturer of emapalumab-lzsg states that live vaccines should not be administered to patients receiving emapalumab-lzsg and for at least 4 weeks after the last dose of emapalumab-lzsg. The safety of immunization with live vaccines during or following emapalumab-lzsg therapy has not been studied.(14) The US manufacturer of sibeprenlimab-szsi states live vaccines should not be given within 30 days prior to initiation or during treatment with sibeprenlimab-szsi.(15) DISCUSSION: Killed or inactivated vaccines do not pose a danger to immunocompromised patients.(1) Patients with a history of leukemia who are in remission and have not received chemotherapy for at least 3 months are not considered to be immunocompromised.(1) |
ACAM2000 (NATIONAL STOCKPILE), ADENOVIRUS TYPE 4, ADENOVIRUS TYPE 4 AND TYPE 7, ADENOVIRUS TYPE 7, BCG (TICE STRAIN), BCG VACCINE (TICE STRAIN), DENGVAXIA, ERVEBO (NATIONAL STOCKPILE), M-M-R II VACCINE, PRIORIX, PROQUAD, ROTARIX, ROTATEQ, STAMARIL, VARIVAX VACCINE, VAXCHORA ACTIVE COMPONENT, VAXCHORA VACCINE, VIVOTIF, YF-VAX |
There are 8 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Ponesimod/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Ponesimod in combination with immunosuppressives and immune-modulators all suppress the immune system.(1) CLINICAL EFFECTS: Concurrent use of ponesimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection, cryptococcal infection, or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1) PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications. PATIENT MANAGEMENT: The ponesimod US prescribing information states ponesimod has not been studied in combination with anti-neoplastic, immune-modulating, or immunosuppressive therapies. Caution should be used during concomitant administration because of the risk of additive immune effects during therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive immunosuppressive effects. Initiating treatment with ponesimod after alemtuzumab is not recommended. However, ponesimod can generally be started immediately after discontinuation of beta interferon or glatiramer acetate.(1) DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections, cryptococcal meningitis, disseminated cryptococcal infections, and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1) |
PONVORY |
| Sodium Iodide I 131/Myelosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Sodium iodide I 131 can cause depression of the hematopoetic system. Myelosuppressives and immunomodulators also suppress the immune system.(1) CLINICAL EFFECTS: Concurrent use of sodium iodide I 131 with agents that cause bone marrow depression, including myelosuppressives or immunomodulators, may result in an enhanced risk of hematologic disorders, including anemia, blood dyscrasias, bone marrow depression, leukopenia, and thrombocytopenia. Bone marrow depression may increase the risk of serious infections and bleeding.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of sodium iodide I 131 states that concurrent use with bone marrow depressants may enhance the depression of the hematopoetic system caused by large doses of sodium iodide I 131.(1) Sodium iodide I 131 causes a dose-dependent bone marrow suppression, including neutropenia or thrombocytopenia, in the 3 to 5 weeks following administration. Patients may be at increased risk of infections or bleeding during this time. Monitor complete blood counts within one month of therapy. If results indicate leukopenia or thrombocytopenia, dosimetry should be used to determine a safe sodium iodide I 131 activity.(1) DISCUSSION: Hematologic disorders including death have been reported with sodium iodide I 131. The most common hematologic disorders reported include anemia, blood dyscrasias, bone marrow depression, leukopenia, and thrombocytopenia.(1) |
2,3-DIMERCAPTOSUCCINIC ACID, ABECMA, ABRAXANE, ACTEMRA, ACTEMRA ACTPEN, ACTIMMUNE, ADCETRIS, ADRIAMYCIN, ADRUCIL, AFINITOR, AFINITOR DISPERZ, AGRYLIN, AKEEGA, ALDURAZYME, ALFERON N, ALKERAN, ALLOPURINOL, ALLOPURINOL SODIUM, ALOPRIM, ALUNBRIG, ALYMSYS, AMBISOME, AMPHOTERICIN B, AMPHOTERICIN B LIPOSOME, AMTAGVI, ANAGRELIDE HCL, ANCOBON, APONVIE, APREPITANT, APTIVUS, ARAVA, ARCALYST, ARRANON, ARSENIC TRIOXIDE, ARTESUNATE, ARZERRA, ASPARLAS, ASTAGRAF XL, ATGAM, AUBAGIO, AUCATZYL, AUGTYRO, AURANOFIN, AVASTIN, AVGEMSI, AVLAYAH, AVONEX, AVONEX (4 PACK), AVONEX PEN, AVONEX PEN (4 PACK), AVOPEF, AVTOZMA, AVTOZMA AUTOINJECTOR, AXTLE, AYVAKIT, AZACITIDINE, AZASAN, AZATHIOPRINE, AZATHIOPRINE SODIUM, AZELAIC ACID, AZSTARYS, BAFIERTAM, BALVERSA, BAVENCIO, BEIZRAY, BEIZRAY-ALBUMIN, BELEODAQ, BELRAPZO, BENDAMUSTINE HCL, BENDEKA, BENZNIDAZOLE, BESPONSA, BESREMI, BESREMI PEN, BETASERON, BEXAROTENE, BICNU, BIMZELX, BIMZELX AUTOINJECTOR, BIZENGRI, BLENREP, BLEOMYCIN SULFATE, BLINCYTO, BORTEZOMIB, BORUZU, BOSULIF, BOSUTINIB, BRAFTOVI, BREYANZI, BREYANZI CD4 COMPONENT, BREYANZI CD8 COMPONENT, BRIUMVI, BRUKINSA, BUPHENYL, BUSULFAN, BUSULFEX, CABOMETYX, CAELYX, CALQUENCE, CAMPTOSAR, CAPECITABINE, CAPRELSA, CARBAMAZEPINE, CARBAMAZEPINE ER, CARBATROL, CARBOPLATIN, CARMUSTINE, CARVEDILOL, CARVEDILOL ER, CARVYKTI, CASPOFUNGIN ACETATE, CAVHANZA, CEFOXITIN, CEFOXITIN SODIUM, CEFTRIAXONE, CEFTRIAXONE SODIUM, CELLCEPT, CHEMET, CHLORAMPHENICOL, CHLORAMPHENICOL PALMITATE, CHLORAMPHENICOL SOD SUCCINATE, CIBINQO, CIDOFOVIR, CINVANTI, CISPLATIN, CLADRIBINE, CLOFARABINE, CLOZAPINE, CLOZAPINE ODT, CLOZARIL, COLCHICINE, COLCRYS, COLUMVI, COMETRIQ, CONCERTA, COPAXONE, COPIKTRA, COREG, COREG CR, COSENTYX, COSENTYX (2 SYRINGES), COSENTYX SENSOREADY (2 PENS), COSENTYX SENSOREADY PEN, COSENTYX SYRINGE, COSENTYX UNOREADY PEN, COTEMPLA XR-ODT, CUPRIMINE, CYCLOPHOSPHAMIDE, CYCLOSPORINE, CYCLOSPORINE MODIFIED, CYRAMZA, CYTARABINE, DACARBAZINE, DACTINOMYCIN, DALBAVANCIN HCL, DALVANCE, DANYELZA, DANZITEN, DARAPRIM, DARZALEX, DARZALEX FASPRO, DASATINIB, DAUNORUBICIN HCL, DAURISMO, DAYTRANA, DECITABINE, DECNUPAZ, DEFERIPRONE, DEFERIPRONE (3 TIMES A DAY), DEFEROXAMINE MESYLATE, DEPEN, DESFERAL MESYLATE, DEXMETHYLPHENIDATE HCL, DEXMETHYLPHENIDATE HCL ER, DEXRAZOXANE, DIACOMIT, DIFICID, DIMETHYL FUMARATE, DMSA, DOCETAXEL, DOCIVYX, DOXIL, DOXORUBICIN HCL, DOXORUBICIN HCL LIPOSOME, DROXIA, DUVYZAT, EFLORNITHINE HCL, ELAHERE, ELLENCE, ELREXFIO, ELZONRIS, EMEND, EMPLICITI, ENHERTU, ENSPRYNG, ENTYVIO, ENTYVIO PEN, ENVARSUS XR, EPIRUBICIN HCL, EPKINLY, EPOPROSTENOL SODIUM, EQUETRO, ERBITUX, ERIBULIN MESYLATE, ERLOTINIB HCL, ERTAPENEM, ETOPOPHOS, ETOPOSIDE, EULEXIN, EVDI, EVEROLIMUS, EVOMELA, FAMCICLOVIR, FAVLYXA, FEBUXOSTAT, FELBAMATE, FELBATOL, FERRIPROX, FERRIPROX (2 TIMES A DAY), FERRIPROX (3 TIMES A DAY), FIDAXOMICIN, FIRVANQ, FLOLAN, FLOXURIDINE, FLUCYTOSINE, FLUDARABINE PHOSPHATE, FLUOROURACIL, FOCALIN, FOCALIN XR, FOCINVEZ, FOLOTYN, FOSAPREPITANT DIMEGLUMINE, FOSCARNET SODIUM, FOSCAVIR, FOTIVDA, FRINDOVYX, FYARRO, GAMIFANT, GANCICLOVIR SODIUM, GAVRETO, GAZYVA, GEFITINIB, GEMCITABINE HCL, GENGRAF, GIAPREZA, GLATIRAMER ACETATE, GLATOPA, GLEEVEC, GLEOSTINE, GLIADEL, GLOPERBA, GRAFAPEX, HALAVEN, HARLIKU, HEPZATO, HERCEPTIN, HERCEPTIN HYLECTA, HERCESSI, HERZUMA, HYCAMTIN, HYDREA, HYDROXYUREA, IBRANCE, ICLUSIG, IDAMYCIN PFS, IDARUBICIN HCL, IFEX, IFOSFAMIDE, ILARIS, IMATINIB MESYLATE, IMBRUVICA, IMDELLTRA, IMFINZI, IMIPENEM-CILASTATIN SODIUM, IMIQUIMOD, IMKELDI, IMLYGIC, IMPAVIDO, IMULDOSA, IMURAN, INDOCIN, INDOMETHACIN, INDOMETHACIN ER, INFUGEM, INLYTA, INQOVI, INREBIC, IRESSA, IRINOTECAN HCL, ISTODAX, ITVISMA, IVRA, IWILFIN, IXEMPRA, JAKAFI, JAKAFI XR, JAYPIRCA, JEMPERLI, JEVTANA, JOBEVNE, JOENJA, JORNAY PM, JYLAMVO, KADCYLA, KANJINTI, KEMOPLAT, KESIMPTA PEN, KEVZARA, KEYTRUDA, KEYTRUDA QLEX, KINERET, KISQALI, KOMZIFTI, KOSELUGO, KRAZATI, KYMRIAH, KYPROLIS, KYXATA, LAMIVUDINE-ZIDOVUDINE, LAPATINIB, LAZCLUZE, LEFLUNICLO, LEFLUNOMIDE, LEMTRADA, LENALIDOMIDE, LENVIMA, LEQSELVI, LEUKERAN, LINCOCIN, LINCOMYCIN HCL, LINEZOLID, LINEZOLID-0.9% NACL, LINEZOLID-D5W, LISINOPRIL, LISINOPRIL-HYDROCHLOROTHIAZIDE, LODOCO, LOMUSTINE, LONSURF, LOQTORZI, LUNSUMIO, LUNSUMIO VELO, LUTATHERA, LYMPHIR, LYNOZYFIC, LYNPARZA, LYRICA, LYRICA CR, MARAVIROC, MATULANE, MAVENCLAD, MEKINIST, MEKTOVI, MELPHALAN HCL, MERCAPTOPURINE, MESNA, MESNEX, METADATE CD, METHOTREXATE, METHOTREXATE SODIUM, METHOTREXATE-NACL, METHYLIN, METHYLPHENIDATE, METHYLPHENIDATE ER, METHYLPHENIDATE ER (LA), METHYLPHENIDATE ER ODT, METHYLPHENIDATE HCL, METHYLPHENIDATE HCL CD, METHYLPHENIDATE HCL ER (CD), METOPIRONE, MICAFUNGIN, MICAFUNGIN-0.9% NACL, MITIGARE, MITOMYCIN, MITOXANTRONE HCL, MONJUVI, MUTAMYCIN, MVASI, MYCOPHENOLATE MOFETIL, MYCOPHENOLIC ACID, MYFORTIC, MYHIBBIN, MYLERAN, NAVITRUX, NEBUPENT, NELARABINE, NEORAL, NEPHROSCAN, NEXAVAR, NILOTINIB D-TARTRATE, NILOTINIB HCL, NINLARO, NIPENT, NITISINONE, NITYR, NOXAFIL, NUBEQA, NULOJIX, OCREVUS, OCREVUS ZUNOVO, OGIVRI, OJJAARA, OLPRUVA, OLUMIANT, ONCASPAR, ONIVYDE, ONTRUZANT, ONUREG, OPDIVO, OPDIVO QVANTIG, OPDUALAG, ORENCIA, ORENCIA CLICKJECT, ORFADIN, OTULFI, OXALIPLATIN, PACLITAXEL, PACLITAXEL PROTEIN-BOUND, PADCEV, PAROXETINE CR, PAROXETINE ER, PAROXETINE HCL, PAROXETINE MESYLATE, PAXIL, PAXIL CR, PAZOPANIB HCL, PEGASYS, PEMETREXED, PEMETREXED DISODIUM, PEMFEXY, PEMRYDI RTU, PENICILLAMINE, PENICILLAMINE(D-), PENTAM 300, PENTAMIDINE ISETHIONATE, PERJETA, PHEBURANE, PHESGO, PHOTOFRIN, PHYRAGO, PLEGRIDY, PLEGRIDY PEN, PLUVICTO, POLIVY, POMALIDOMIDE, POMALYST, POSACONAZOLE, POTELIGEO, PRALATREXATE, PREGABALIN, PREGABALIN ER, PRIFTIN, PRIMAXIN, PROBENECID-COLCHICINE, PROCARBAZINE HCL, PROGRAF, PROLEUKIN, PROTRIPTYLINE HCL, PROVENGE, PURIXAN, PYRIMETHAMINE, PYZCHIVA, PYZCHIVA AUTOINJECTOR, QBRELIS, QINLOCK, QUILLICHEW ER, QUILLIVANT XR, RAPIVAB, RASUVO, REBIF, REBIF REBIDOSE, RECARBRIO, RECLAST, RELEXXII, RETEVMO, RETHYMIC, RETROVIR, REVLIMID, REVUFORJ, REZUROCK, RIABNI, RIBAVIRIN, RIDAURA, RINVOQ, RINVOQ LQ, RITALIN, RITUXAN, RITUXAN HYCELA, ROMIDEPSIN, ROTOP-DMSA, ROZLYTREK, RUBRACA, RUXIENCE, RYDAPT, RYLAZE, RYONCIL, RYTELO, SANDIMMUNE, SARCLISA, SARCLISA ESCENA, SCEMBLIX, SELARSDI, SELZENTRY, SIKLOS, SILIQ, SIMULECT, SIROLIMUS, SIVEXTRO, SODIUM IODIDE I-123, SODIUM PHENYLBUTYRATE, SODIUM VALPROATE, SORAFENIB, SOTYKTU, SPINRAZA, SPRYCEL, STARJEMZA, STELARA, STEQEYMA, STIVARGA, STRONTIUM-89 CHLORIDE, SUCCIMER DMSA, SUNITINIB MALATE, SUTENT, SYLVANT, TABLOID, TACROLIMUS, TACROLIMUS XL, TAGRISSO, TALTZ AUTOINJECTOR, TALTZ AUTOINJECTOR (2 PACK), TALTZ AUTOINJECTOR (3 PACK), TALTZ SYRINGE, TALVEY, TALZENNA, TARGRETIN, TASIGNA, TAVALISSE, TECARTUS, TECELRA, TECENTRIQ, TECENTRIQ HYBREZA, TECFIDERA, TECVAYLI, TEGRETOL, TEGRETOL XR, TEMODAR, TEMOZOLOMIDE, TEMSIROLIMUS, TEPADINA, TEPYLUTE, TERIFLUNOMIDE, TEVIMBRA, THIOTEPA, TIGECYCLINE, TOFIDENCE, TOLAZOLINE HCL, TOPOTECAN HCL, TORISEL, TORPENZ, TRAMETINIB, TRAZIMERA, TREANDA, TRETINOIN, TREXALL, TRISENOX, TRODELVY, TROGARZO, TRUQAP, TRUXIMA, TURALIO, TYENNE, TYENNE AUTOINJECTOR, TYGACIL, TYKERB, TYRUKO, TYSABRI, TYZAVAN, TZIELD, ULORIC, UNITUXIN, UNLOXCYT, UPLIZNA, USTEKINUMAB, USTEKINUMAB-AAUZ, USTEKINUMAB-AEKN, USTEKINUMAB-TTWE, UVADEX, VALCYTE, VALGANCICLOVIR HCL, VALPROATE SODIUM, VALPROIC ACID, VANCOCIN HCL, VANCOMYCIN, VANCOMYCIN HCL, VANCOMYCIN HCL-0.9% NACL, VANCOMYCIN HCL-D5W, VANFLYTA, VARUBI, VECTIBIX, VEGZELMA, VELCADE, VELETRI, VENCLEXTA, VENCLEXTA STARTING PACK, VEPPANU, VERSACLOZ, VERZENIO, VIDAZA, VINBLASTINE SULFATE, VINCASAR PFS, VINCRISTINE SULFATE, VINORELBINE TARTRATE, VITRAKVI, VIVIMUSTA, VONJO, VOTRIENT, VOYXACT, VRAYLAR, VUMERITY, WAYRILZ, WEZLANA, WINREVAIR, WINREVAIR (2 PACK), XALKORI, XATMEP, XOFIGO, XPOVIO, XROMI, YESCARTA, YESINTEK, YONDELIS, YULITHIRA, ZALTRAP, ZANOSAR, ZEJULA, ZEPZELCA, ZESTORETIC, ZESTRIL, ZEVALIN, ZIDOVUDINE, ZIRABEV, ZOKINVY, ZOLEDRONIC ACID, ZOLGENSMA, ZOLINZA, ZORTRESS, ZYDELIG, ZYLOPRIM, ZYNLONTA, ZYNYZ, ZYVOX |
| Fingolimod/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Fingolimod in combination with immunosuppressives and immune-modulators all suppress the immune system.(1-3) CLINICAL EFFECTS: Concurrent use of fingolimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1-3) PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications. PATIENT MANAGEMENT: Recommendations for fingolimod regarding this interaction differ between regulatory approving agencies. The fingolimod US prescribing information states: - Antineoplastic, immune-modulating, or immunosuppressive therapies, (including corticosteroids) are expected to increase the risk of immunosuppression, and the risk of additive immune system effects must be considered if these therapies are coadministered with fingolimod. When switching from drugs with prolonged immune effects, such as natalizumab, teriflunomide or mitoxantrone, the duration and mode of action of these drugs must be considered to avoid unintended additive immunosuppressive effects when initiating fingolimod.(1) The fingolimod Canadian prescribing information states: - Concurrent use with immunosuppressive or immunomodulatory agents is contraindicated due to the risk of additive immune system effects. However, co-administration of a short course of corticosteroids (up to 5 days) did not increase the overall rate of infection in patients participating Phase III clinical trials.(2) The fingolimod UK specific product characteristics states: - Fingolimod is contraindicated in patients currently receiving immunosuppressive therapies or those immunocompromised by prior therapies. When switching patients from another disease modifying therapy to Gilenya, the half-life and mode of action of the other therapy must be considered in order to avoid an additive immune effect whilst at the same time minimizing the risk of disease activation.(3) DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1-3) |
FINGOLIMOD, GILENYA, TASCENSO ODT |
| Ozanimod/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Ozanimod in combination with immunosuppressives and immune-modulators all suppress the immune system.(1) CLINICAL EFFECTS: Concurrent use of ozanimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1) PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications. PATIENT MANAGEMENT: The ozanimod US prescribing information state this information regarding this interaction: -Ozanimod has not been studied in combination with anti-neoplastic, immune-modulating, or immunosuppressive therapies. Caution should be used during concomitant administration because of the risk of additive immune effects during therapy and in the week following administration. When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive immunosuppressive effects. Initiating treatment with ozanimod after alemtuzumab is not recommended. However, ozanimod can generally be started immediately after discontinuation of beta interferon or glatiramer acetate.(1) DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1) |
ZEPOSIA |
| Siponimod/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Siponimod in combination with immunosuppressives and immune-modulators all suppress the immune system.(1) CLINICAL EFFECTS: Concurrent use of siponimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1) PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications. PATIENT MANAGEMENT: The siponimod US prescribing information state this information regarding this interaction: -Siponimod has not been studied in combination with anti-neoplastic, immune-modulating, or immunosuppressive therapies. Caution should be used during concomitant administration because of the risk of additive immune effects during therapy and in the week following administration. When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive immunosuppressive effects. Initiating treatment with siponimod after alemtuzumab is not recommended. However, siponimod can generally be started immediately after discontinuation of beta interferon or glatiramer acetate.(1) DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1) |
MAYZENT |
| Etrasimod/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Etrasimod causes reversible sequestration of lymphocytes in lymphoid tissues, resulting in a mean 55% decrease in peripheral blood lymphocyte count at 52 weeks.(1) Other immunosuppressives and immune-modulators also suppress the immune system. CLINICAL EFFECTS: Concurrent use of etrasimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious and fatal infections, such as disseminated herpetic infection, cryptococcal infection, or progressive multifocal leukoencephalopathy (PML).(1) PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications increases the risk of adverse effects. PATIENT MANAGEMENT: The etrasimod US prescribing information states etrasimod has not been studied in combination with anti-neoplastic, immune-modulating, or immunosuppressive therapies. Concomitant administration of these therapies with etrasimod should be avoided because of the risk of additive immune effects during therapy and in the weeks following administration. Etrasimod's effect on peripheral lymphocytes may persist for up to 5 weeks after discontinuation.(1) When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive immunosuppressive effects.(1) DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections, cryptococcal meningitis, disseminated cryptococcal infections, and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients treated with other sphingosine-1 phosphate receptor modulators.(1) |
VELSIPITY |
| Sodium Iodide I 131/Myelosuppressives that affect Iodide SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Sodium iodide I 131 can cause depression of the hematopoetic system. Myelosuppressives and immunomodulators also suppress the immune system.(1) Many compounds can affect iodide protein binding and alter iodide pharmacokinetics and pharmacodynamics. CLINICAL EFFECTS: Concurrent use of sodium iodide I 131 with agents that cause bone marrow depression, including myelosuppressives or immunomodulators, may result in an enhanced risk of hematologic disorders, including anemia, blood dyscrasias, bone marrow depression, leukopenia, and thrombocytopenia. Bone marrow depression may increase the risk of serious infections and bleeding.(1) Compounds that affect iodide pharmacokinetics and pharmacodynamics may impact the effectiveness of radioactive iodide.(1,2) PREDISPOSING FACTORS: Compounds that affect iodide pharmacokinetics and pharmacodynamics are expected to have the most impact during therapy using radioactive iodide. Diagnostic procedures would be expected to be impacted less. PATIENT MANAGEMENT: The US manufacturer of sodium iodide I 131 states that concurrent use with bone marrow depressants may enhance the depression of the hematopoetic system caused by large doses of sodium iodide I 131.(1) Sodium iodide I 131 causes a dose-dependent bone marrow suppression, including neutropenia or thrombocytopenia, in the 3 to 5 weeks following administration. Patients may be at increased risk of infections or bleeding during this time. Monitor complete blood counts within one month of therapy. If results indicate leukopenia or thrombocytopenia, dosimetry should be used to determine a safe sodium iodide I 131 activity.(1) Discuss the use of agents that affect iodide pharmacokinetics and pharmacodynamics with the patient's oncologist.(1,2) DISCUSSION: Hematologic disorders including death have been reported with sodium iodide I 131. The most common hematologic disorders reported include anemia, blood dyscrasias, bone marrow depression, leukopenia, and thrombocytopenia.(1) Many agents interact with radioactive iodine. The average duration of effect is: anticoagulants - 1 week antihistamines - 1 week anti-thyroid drugs, e.g: carbimazole, methimazole, propylthiouracil - 3-5 days corticosteroids - 1 week iodide-containing medications, e.g: amiodarone - 1-6 months expectorants - 2 weeks Lugol solution - 3 weeks saturated solution of potassium iodine - 3 weeks vitamins - 10-14 days iodide-containing X-ray contrast agents - up to 1 year lithium - 4 weeks phenylbutazone - 1-2 weeks sulfonamides - 1 week thyroid hormones (natural or synthetic), e.g.: thyroxine - 4 weeks tri-iodothyronine - 2 weeks tolbutamide - 1 week topical iodide - 1-9 months (1,2) |
AGAMREE, ALKINDI SPRINKLE, ANUCORT-HC, ANUSOL-HC, AZULFIDINE, BECLOMETHASONE DIPROPIONATE, BETALOAN SUIK, BETAMETHASONE ACETATE MICRO, BETAMETHASONE ACETATE-SOD PHOS, BETAMETHASONE DIPROPIONATE, BETAMETHASONE SOD PHOS-ACETATE, BETAMETHASONE SOD PHOS-WATER, BETAMETHASONE SODIUM PHOSPHATE, BETAMETHASONE VALERATE, BUDESONIDE, BUDESONIDE DR, BUDESONIDE EC, BUDESONIDE ER, BUDESONIDE MICRONIZED, BUPIVACAINE-DEXAMETH-EPINEPHRN, CELESTONE, CLOBETASOL PROPIONATE MICRO, CORTEF, CORTENEMA, CORTIFOAM, CORTISONE ACETATE, DEFLAZACORT, DEPO-MEDROL, DESONIDE MICRONIZED, DESOXIMETASONE, DEXABLISS, DEXAMETHASONE, DEXAMETHASONE ACETATE, DEXAMETHASONE ACETATE MICRO, DEXAMETHASONE INTENSOL, DEXAMETHASONE ISONICOTINATE, DEXAMETHASONE MICRONIZED, DEXAMETHASONE SOD PHOS-WATER, DEXAMETHASONE SODIUM PHOSPHATE, DEXAMETHASONE-0.9% NACL, DEXLYT, DMT SUIK, DOUBLEDEX, EMFLAZA, EOHILIA, FLUNISOLIDE, FLUOCINOLONE ACETONIDE, FLUOCINOLONE ACETONIDE MICRO, FLUOCINONIDE MICRONIZED, FLUTICASONE PROPIONATE, FLUTICASONE PROPIONATE MICRO, HEMADY, HEMMOREX-HC, HEXATRIONE, HYDROCORTISONE, HYDROCORTISONE ACETATE, HYDROCORTISONE SOD SUCCINATE, HYDROCORTISONE-PRAMOXINE, JAYTHARI, KENALOG-10, KENALOG-40, KENALOG-80, KHINDIVI, KYMBEE, LIDOCIDEX-I, MAS CARE-PAK, MEDROL, MEDROLOAN II SUIK, MEDROLOAN SUIK, METHIMAZOLE, METHYLPREDNISOLONE, METHYLPREDNISOLONE AC MICRO, METHYLPREDNISOLONE ACETATE, METHYLPREDNISOLONE SODIUM SUCC, MILLIPRED, MILLIPRED DP, MOMETASONE FUROATE, ORAPRED ODT, P-PACK PREDNISONE, PREDNISOLONE, PREDNISOLONE ACETATE MICRONIZE, PREDNISOLONE MICRONIZED, PREDNISOLONE SODIUM PHOS ODT, PREDNISOLONE SODIUM PHOSPHATE, PREDNISONE, PREDNISONE INTENSOL, PREDNISONE MICRONIZED, PROCTOCORT, PYQUVI, QUALAQUIN, QUININE HCL, QUININE SULFATE, SOLU-CORTEF, SOLU-MEDROL, SULFASALAZINE, SULFASALAZINE DR, TAPERDEX, TARPEYO, TRIAMCINOLONE, TRIAMCINOLONE ACETONIDE, TRIAMCINOLONE DIACETATE, TRIAMCINOLONE DIACETATE MICRO, TRILOAN II SUIK, TRILOAN SUIK, UCERIS, VERIPRED 20, ZCORT, ZILRETTA |
| Sodium Iodide I 131/Agents that Affect Iodide SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Many compounds can affect iodide protein binding and alter iodide pharmacokinetics and pharmacodynamics.(1,2) CLINICAL EFFECTS: Compounds that affect iodide pharmacokinetics and pharmacodynamics may impact the effectiveness of radioactive iodide.(1,2) PREDISPOSING FACTORS: Compounds that affect iodide pharmacokinetics and pharmacodynamics are expected to have the most impact during therapy using radioactive iodide. Diagnostic procedures would be expected to be impacted less. PATIENT MANAGEMENT: Discuss the use of agents that affect iodide pharmacokinetics and pharmacodynamics with the patient's oncologist.(1,2) Because indocyanine green contains sodium iodide, the iodine-binding capacity of thyroid tissue may be reduced for at least one week following administration. Do not perform radioactive iodine uptake studies for at least one week following administration of indocyanine green.(3) The manufacturer of iopamidol states administration may interfere with thyroid uptake of radioactive iodine and decrease therapeutic and diagnostic efficacy. Avoid thyroid therapy or testing for up to 6 weeks post administration of iopamidol.(4) DISCUSSION: Many agents interact with radioactive iodine. The average duration of effect is: anticoagulants - 1 week antihistamines - 1 week anti-thyroid drugs, e.g: carbimazole, methimazole, propylthiouracil - 3-5 days corticosteroids - 1 week iodide-containing medications, e.g: amiodarone - 1-6 months expectorants - 2 weeks Lugol solution - 3 weeks saturated solution of potassium iodine - 3 weeks vitamins - 10-14 days iodide-containing X-ray contrast agents - up to 1 year lithium - 4 weeks phenylbutazone - 1-2 weeks sulfonamides - 1 week thyroid hormones (natural or synthetic), e.g.: thyroxine - 4 weeks tri-iodothyronine - 2 weeks tolbutamide - 1 week topical iodide - 1-9 months (1,2) |
ADDAMEL N, ADTHYZA, ADVAIR DISKUS, ADVAIR HFA, AIRDUO DIGIHALER, AIRSUPRA, ALVESCO, AMERITHROID, AMIODARONE HCL, AMIODARONE HCL-D5W, ARMONAIR DIGIHALER, ARMOUR THYROID, ARNUITY ELLIPTA, ASMANEX, ASMANEX HFA, AZELASTINE HCL, AZELASTINE-FLUTICASONE, BACTRIM, BACTRIM DS, BECLOMETHASONE DIPROPIONATE, BREO ELLIPTA, BREYNA, BREZTRI AEROSPHERE, BROMFED DM, BROMPHENIRAMINE MALEATE, BROMPHENIRAMINE-PSEUDOEPHED-DM, BUDESONIDE, BUDESONIDE-FORMOTEROL FUMARATE, CARBIMAZOLE, CARBINOXAMINE MALEATE, CARBINOXAMINE MALEATE ER, CARBZAH, CETIRIZINE HCL, CHLORPHENIRAMINE MALEATE, CLARINEX, CLARINEX-D 12 HOUR, CLEMASTINE FUMARATE, CLEMSZA, CLIOQUINOL, CONRAY, CONRAY-30, CONRAY-43, CORPHENA, CYPROHEPTADINE HCL, CYTOMEL, DATSCAN, DESLORATADINE, DEXCHLORPHENIRAMINE MALEATE, DIATRIZOATE MEGLUMINE-SODIUM, DIPHEN, DIPHENHYDRAMINE HCL, DIPHENHYDRAMINE-0.9% NACL, DULERA, DYMISTA, EVEXITHROID, FEXOFENADINE HCL, FLUNISOLIDE, FLUTICASONE FUROATE, FLUTICASONE PROPIONATE, FLUTICASONE PROPIONATE HFA, FLUTICASONE-SALMETEROL, FLUTICASONE-SALMETEROL HFA, FLUTICASONE-VILANTEROL, GASTROGRAFIN, HYDROCODONE-CHLORPHENIRAMNE ER, HYDROXYZINE HCL, HYDROXYZINE PAMOATE, IBUPROFEN-FAMOTIDINE, IC GREEN, IDOXURIDINE, INDOCYANINE GREEN, IODINE, IODIXANOL, IODOFORM, IODOPEN, IODOQUINOL, IOFLUPANE I-123, IOHEXOL, IOMERON 350, IOPAMIDOL, IOPANOIC ACID, ISOPROPAMIDE IODIDE, ISOVUE-200, ISOVUE-250, ISOVUE-300, ISOVUE-370, KARBINAL ER, LEVO-T, LEVOCETIRIZINE DIHYDROCHLORIDE, LEVOTHYROXINE SODIUM, LEVOXYL, LIOMNY, LIOTHYRONINE SODIUM, LIPIODOL, LITHIUM CARBONATE, LITHIUM CARBONATE ER, LITHIUM CITRATE, LITHIUM CITRATE TETRAHYDRATE, LITHOBID, LORATADINE, LORATADINE MICRONIZED, LUGOL'S, MD-GASTROVIEW, MOMETASONE FUROATE, NEXTERONE, NIVA THYROID, NP THYROID, OLOPATADINE HCL, OMNARIS, OMNIPAQUE, OPTIRAY 240, OPTIRAY 300, OPTIRAY 320, OPTIRAY 350, OXILAN-350, PACERONE, PEDITRACE, PHENERGAN, PHENYLBUTAZONE, POTASSIUM IODIDE, POVIDONE IODINE, PROMETHAZINE HCL, PROMETHAZINE HCL-0.9% NACL, PROMETHAZINE VC, PROMETHAZINE-CODEINE, PROMETHAZINE-DM, PROMETHAZINE-PHENYLEPHRINE HCL, PROPYLTHIOURACIL, PULMICORT, PULMICORT FLEXHALER, PYRILAMINE MALEATE, QNASL, QNASL CHILDREN, QUZYTTIR, QVAR REDIHALER, RENTHYROID, RESPA A.R., RYALTRIS, RYCLORA, RYVENT, SINOGRAFIN, SINUVA, SPY AGENT GREEN, SPY-MIS, SSKI, STRONG IODINE, SULFADIAZINE, SULFAMETHOXAZOLE-TRIMETHOPRIM, SULFATRIM, SYMBICORT, SYNTHROID, THYMOL IODIDE, THYQUIDITY, THYROID, TICANASE, TIROSINT, TIROSINT-SOL, TRELEGY ELLIPTA, TUXARIN ER, ULTRAVIST, UNITHROID, VISIPAQUE, WARFARIN SODIUM, WIXELA INHUB, XHANCE |
There are 0 moderate interactions.
The following contraindication information is available for HICON (sodium iodide-131):
Drug contraindication overview.
No enhanced Contraindications information available for this drug.
No enhanced Contraindications information available for this drug.
There are 2 contraindications.
Absolute contraindication.
| Contraindication List |
|---|
| Lactation |
| Pregnancy |
There are 1 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Kidney disease with reduction in glomerular filtration rate (GFr) |
There are 1 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Dehydration |
The following adverse reaction information is available for HICON (sodium iodide-131):
Adverse reaction overview.
No enhanced Common Adverse Effects information available for this drug.
No enhanced Common Adverse Effects information available for this drug.
There are 20 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Hyperthyroidism Hypothyroidism Nasolacrimal duct stenosis Radiation sickness Thyrotoxicosis crisis |
Bone marrow depression |
| Rare/Very Rare |
|---|
|
Anaphylaxis Anemia Cerebral edema Hypoparathyroidism Infertility Leukemia Leukopenia Malignancy Oligospermia Pulmonary fibrosis Radiation pneumonitis Secondary ovarian failure Thrombocytopenic disorder Thyroiditis |
There are 21 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Pharyngeal edema Sialoadenitis |
Chest pain Dry eye Eye tearing Injection site sequelae Nausea Pruritus of skin Skin rash Tachycardia Urticaria Vomiting |
| Rare/Very Rare |
|---|
|
Conjunctivitis Cough Dacryocystitis Fever Headache disorder Iododerma Neck pain Sore throat Xerostomia |
The following precautions are available for HICON (sodium iodide-131):
No enhanced Pediatric Use information available for this drug.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
No enhanced Pregnancy information available for this drug.
No enhanced Lactation information available for this drug.
No enhanced Geriatric Use information available for this drug.
The following prioritized warning is available for HICON (sodium iodide-131):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for HICON (sodium iodide-131)'s list of indications:
| Hyperthyroidism | |
| E05 | Thyrotoxicosis [hyperthyroidism] |
| E05.0 | Thyrotoxicosis with diffuse goiter |
| E05.00 | Thyrotoxicosis with diffuse goiter without thyrotoxic crisis or storm |
| E05.01 | Thyrotoxicosis with diffuse goiter with thyrotoxic crisis or storm |
| E05.1 | Thyrotoxicosis with toxic single thyroid nodule |
| E05.10 | Thyrotoxicosis with toxic single thyroid nodule without thyrotoxic crisis or storm |
| E05.11 | Thyrotoxicosis with toxic single thyroid nodule with thyrotoxic crisis or storm |
| E05.2 | Thyrotoxicosis with toxic multinodular goiter |
| E05.20 | Thyrotoxicosis with toxic multinodular goiter without thyrotoxic crisis or storm |
| E05.21 | Thyrotoxicosis with toxic multinodular goiter with thyrotoxic crisis or storm |
| E05.3 | Thyrotoxicosis from ectopic thyroid tissue |
| E05.30 | Thyrotoxicosis from ectopic thyroid tissue without thyrotoxic crisis or storm |
| E05.31 | Thyrotoxicosis from ectopic thyroid tissue with thyrotoxic crisis or storm |
| E05.4 | Thyrotoxicosis factitia |
| E05.40 | Thyrotoxicosis factitia without thyrotoxic crisis or storm |
| E05.41 | Thyrotoxicosis factitia with thyrotoxic crisis or storm |
| E05.8 | Other thyrotoxicosis |
| E05.80 | Other thyrotoxicosis without thyrotoxic crisis or storm |
| E05.81 | Other thyrotoxicosis with thyrotoxic crisis or storm |
| E05.9 | Thyrotoxicosis, unspecified |
| E05.90 | Thyrotoxicosis, unspecified without thyrotoxic crisis or storm |
| E05.91 | Thyrotoxicosis, unspecified with thyrotoxic crisis or storm |
| Thyroid carcinoma | |
| C73 | Malignant neoplasm of thyroid gland |
Formulary Reference Tool