Drug interactions
Lomustine + Trastuzumab deruxtecan
Severity: Major
Lomustine and Trastuzumab deruxtecan: major interaction.
Last updated
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
Trastuzumab deruxtecan commonly causes neutropenia and lomustine is strongly myelosuppressive. Together they can increase the incidence and severity of neutropenia, including febrile neutropenia and infection.
What this interaction means in plain words
Lomustine and Trastuzumab deruxtecan 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; Trastuzumab deruxtecan belongs to Oncology.
Why it happens
Additive myelosuppression from the cytotoxic topoisomerase I inhibitor payload and the nitrosourea alkylating agent.
What to do
Check blood counts before each dose and at the expected nadir, and hold or reduce doses according to labeled neutropenia criteria. Educate patients to report fever promptly.
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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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
Other interactions of Trastuzumab deruxtecan
Frequently asked questions
Can I take Lomustine with Trastuzumab deruxtecan?
MediHelp rates the interaction as major. Lomustine and Trastuzumab deruxtecan 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. Trastuzumab deruxtecan commonly causes neutropenia and lomustine is strongly myelosuppressive. Together they can increase the incidence and severity of neutropenia, including febrile neutropenia and infection.
How serious is the interaction between Lomustine and Trastuzumab deruxtecan?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check blood counts before each dose and at the expected nadir, and hold or reduce doses according to labeled neutropenia criteria. Educate patients to report fever promptly.
What other medicines interact with Lomustine?
MediHelp also lists interactions of Lomustine with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Lomustine page.
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