11
Contraindications and Cautions
AZA is contraindicated in patients who have shown hypersensitivity to the
drug. Patients with rheumatoid arthritis previously treated with alkylating agents
(cyclophosphamide, chlorambucil, melphalan, or others) may have a prohibitive risk of
malignancy if treated with AZA.
Warning that patients receiving immunosuppressants, including AZA, are at increased
risk of developing lymphoma and other malignancies, particularly of the skin. Physicians
should inform patients of the risk of malignancy with AZA. As usual for patients
with increased risk for skin cancer, exposure to sunlight and ultraviolet light should be
limited.
Contraindications include hypersensitivity to cyclophosphamide and urinary outflow
obstruction.
Warnings include urinary tract and renal toxicity. Cardiotoxicity, which may be fatal,
has been reported. Monitor patients, especially those with risk factors for cardiotoxicity
or pre-existing cardiac disease. Pulmonary toxicity leading to respiratory failure may
also occur. Monitor patients for signs and symptoms of pulmonary toxicity. Secondary
malignancies, veno-occlusive liver disease, and embryo-fetal toxicity can occur. Advise
female patients of reproductive potential to avoid pregnancy.
Contraindicated in patients with a hypersensitivity to cyclosporine and/or
polyoxyethylated castor oil.
Only physicians experienced in immunosuppressive therapy and management of organ
transplant patients should prescribe cyclosporine. Patients receiving the drug should
be managed in facilities equipped and staffed with adequate laboratory and supportive
medical resources. Cyclosporine should be administered with adrenal corticosteroids
but not with other immunosuppressive agents. Increased susceptibility to infection
and the possible development of lymphoma may result from immunosuppression.
Cyclosporine, when used in high doses, can cause hepatotoxicity and nephrotoxicity.
No contraindications.
Warnings that eltrombopag may cause hepatotoxicity, increase the risk for development
or progression of reticulin fiber deposition within the bone marrow, and may increase
the risk for hematological malignancies.
Contraindicated in patients with a hypersensitivity to etoposide products.
Warnings that etoposide may cause
Myelosuppression, secondary leukemias with long-term use, hypersensitivity reactions,
and embryo-fetal toxicity.
Use of hydroxychloroquine is contraindicated in patients with known hypersensitivity
to 4 aminoquinoline compounds. Use with caution in patients with gastrointestinal,
neurologic, or blood disorders.
Prolonged used requires ophthalmologic monitoring for retinal toxicity.
