Marqibo Drug Interactions

Marqibo Drug Interactions Explained

The following sections explain in detail the potentially negative reactions that can occur when Marqibo is combined with any of the drugs listed above.
 
Amphotericin B
Combining amphotericin B with chemotherapy drugs, such as Marqibo, may increase the risk for amphotericin B side effects, such as kidney damage, low blood pressure (hypotension), and lung problems. Your healthcare provider may choose to monitor you more closely for side effects if you use these medicines together. 
 
Aripiprazole
Marqibo may increase blood levels of aripiprazole, which could increase your risk for aripiprazole side effects. If you use these medicines together, talk to your healthcare provider if you think you may be experiencing more side effects from aripiprazole. Your healthcare provider may choose to adjust your dose.  
 
Certain Biologic and Immunologic Medications
Using Marqibo with certain biologic and immunologic medications could increase your risk for low blood cell counts, thereby increasing your risk for problems such as infections, anemia, and bleeding. It is recommended that Marqibo not be used in combination with some biologic and immunologic medicines, while other combinations will require careful monitoring or dosage adjustments.
 
Clozapine
Taking clozapine with Marqibo may increase the risk for dangerously low white blood cells, and potentially serious infections. It is generally recommended that these medicines not be taken together if at all possible. However, it is important that you not stop taking clozapine unless your healthcare provider specifically tells you to do so.
 
CYP 3A4 Inducer Medications
The liver breaks down Marqibo using enzymes known as CYP 3A4 enzymes, and certain medications known as CYP 3A4 inducers can increase the activity of these enzymes. Thus, combining Marqibo with one of these drugs may decrease the level of Marqibo in your body, potentially making it less effective. These medicines should generally not be used together. 
 
CYP 3A4 Inhibitor Medications
The liver breaks down Marqibo using enzymes known as CYP 3A4 enzymes, and certain medications known as CYP 3A4 inhibitors can decrease the activity of these enzymes. Thus, combining Marqibo with one of these drugs may increase the level of Marqibo in your body, increasing your risk for side effects. Some of these medicines should generally not be used in combination with Marqibo, while others may require more careful monitoring.
 
Digoxin
Marqibo may decrease the amount of digoxin absorbed into your body from your gastrointestinal (GI) tract, which could decrease your digoxin blood levels. This interaction is thought to only be a potential problem with digoxin tablets, as opposed to other forms of digoxin, such as digoxin solution (liquid). Your healthcare provider may choose to monitor your response to digoxin more closely if you use these medicines together, and adjust your dose if needed.
 
Echinacea
Marqibo may be less effective if used with echinacea. Talk to your healthcare provider prior to taking echinacea during Marqibo treatment.
 
Live Vaccinations
Live vaccines are vaccines that contain live viruses or bacteria. If you receive a live vaccine during Marqibo treatment, you might become infected with the virus or bacteria from the vaccine. Also, live vaccines may be less effective in people using Marqibo.
 
In general, people on chemotherapy are advised to not receive a live vaccination. Talk to your healthcare provider before receiving a vaccination or immunization during Marqibo treatment, and for three months after your last dose.
 
Mitomycin
Breathing problems have been reported in people using vinca alkaloid anticancer medicines, such as Marqibo, in combination with mitomycin. Your healthcare provider may need to monitor you for lung problems if you use these medicines together. Let your healthcare provider know if you have shortness of breath or any difficulty breathing.
 
MAOIs
Both MAOIs and Marqibo can cause orthostatic hypotension (low blood pressure that occurs when you stand up from sitting or lying down). Using these medicines together can further increase your risk for this side effect. Orthostatic hypotension can cause you to feel dizzy, faint, or fall down. If you use these medicines together, make sure to sit or stand slowly, and let your healthcare provider know if you feel particularly dizzy or faint.
 
Nifedipine
Nifedipine has been reported to increase blood levels of Marqibo; however, the significance of this interaction is unknown. If you use these medicines together, your healthcare provider may choose to monitor you more closely for Marqibo side effects.
 
P-glycoprotein (Pgp) Inducers
P-glycoprotein is a protein found in the body. One of its roles is to help remove substances, such as medications, from the tissues in the body so they can be removed through the urine or feces. Pgp helps remove Marqibo from the body.
 
Certain other medications (known as Pgp inducers) increase the activity of Pgp. Using Marqibo with one of these Pgp inducers causes Marqibo to be removed from the body too quickly, potentially making it less effective. The manufacturer of Marqibo recommends that these medicines not be used together.
 
P-glycoprotein (Pgp) Inhibitors
P-glycoprotein is a protein found in the body. One of its roles is to help remove substances, such as medications, from the tissues in the body so they can be excreted through the urine or feces. Pgp helps remove Marqibo from the body.
 
Certain other medications (known as Pgp inhibitors) can decrease the activity of Pgp. Using Marqibo with one of these Pgp inhibitors causes Marqibo to be removed more slowly, potentially increasing the amount of Marqibo in your body and your risk for side effects. The manufacturer of Marqibo recommends that these medicines not be used together.
 
Pimozide
Marqibo may increase blood levels of pimozide, potentially increasing your risk for pimozide side effects. In general, these medicines should not be used together if at all possible. Talk to your healthcare provider about this potential interaction before using Marqibo with pimozide.
 
Roflumilast
Combining roflumilast with Marqibo may further increase your risk for developing infections. Talk to your healthcare provider about this potential interaction before using these medicines together.
 
Sipuleucel-T
Marqibo could decrease the effectiveness of sipuleucel-T. This is because sipuleucel-T is thought to work by stimulating the body's immune system, while Marqibo decreases the activity of the immune system. Talk to your healthcare provider about this possible interaction before using these medicines together.
 
Warfarin
Marqibo may increase or decrease the effects of warfarin. If you use these medicines together, your healthcare provider may need to test your prothrombin time ("protime" or PT) and international normalized ratio (INR) more closely than usual, and adjust your warfarin dose if needed.
 
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