Drug interactions
Lomustine + Natalizumab
Severity: Major
Lomustine and Natalizumab: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Lomustine is a myelosuppressive nitrosourea that causes delayed, prolonged cytopenias. Adding natalizumab further impairs immune defence and raises the risk of serious infections including PML.
What this interaction means in plain words
Lomustine and Natalizumab can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Lomustine belongs to Oncology; Natalizumab belongs to Gastrointestinal Tract.
Why it happens
Additive immunosuppression from cytotoxic myelosuppression and impaired lymphocyte trafficking.
What to do
Avoid combination where possible. If needed, monitor blood counts frequently, including delayed nadirs, and watch for infection and neurological symptoms.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Natalizumab
- Natalizumab + Vedolizumab Contraindicated
- Axicabtagene ciloleucel + Natalizumab Major
- Baricitinib + Natalizumab Major
- Belatacept + Natalizumab Major
- Brexucabtagene autoleucel + Natalizumab Major
- Cabazitaxel + Natalizumab Major
Other interactions of Lomustine
- Adenovirus types 4 and 7 live + Lomustine Contraindicated
- Bcg vaccine live + Lomustine Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Lomustine Contraindicated
- Lomustine + Measles mumps and rubella vaccine Contraindicated
- Lomustine + Measles mumps and rubella vaccine live Contraindicated
- Lomustine + Measles mumps rubella and varicella vaccine live Contraindicated
Frequently asked questions
Can I take Lomustine with Natalizumab?
MediHelp rates the interaction as major. Lomustine and Natalizumab can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Lomustine is a myelosuppressive nitrosourea that causes delayed, prolonged cytopenias. Adding natalizumab further impairs immune defence and raises the risk of serious infections including PML.
How serious is the interaction between Lomustine and Natalizumab?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combination where possible. If needed, monitor blood counts frequently, including delayed nadirs, and watch for infection and neurological symptoms.
What other medicines interact with Natalizumab?
MediHelp also lists interactions of Natalizumab with, for example, Vedolizumab, Axicabtagene ciloleucel, Baricitinib. The full list is on the Natalizumab page.
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