Drug General Information (ID: DDI3JHVEIU)
Drug Name			Trastuzumab emtansine		Drug Info		Niraparib		Drug Info
Drug Type		Monoclonal antibody				Small molecule
Therapeutic Class		Antineoplastics/Her2 Inhibitors				Poly (Adp-Ribose) Polymerase Inhibitors

Mechanism of Trastuzumab emtansine-Niraparib Interaction (Severity Level: Moderate)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Trastuzumab emtansine				Niraparib
Mechanism		Risk of bleeding Antiplatelet effects				Risk of bleeding Antiplatelet/anticoagulant effects
Key Mechanism Factor 1
		Factor Name		Bleeding
		Factor Description		Patients may be at risk for bleeding when the outcome of a disease or disease treatment confounds the standard mechanisms for maintaining hemostasis. Signs or symptoms of abnormal bleeding include: bleeding that takes a long time to stop (including nosebleeds, bleeding gums, bleeding from cuts and abrasions, and menstrual bleeding); severe unexplained bruising, or bruising that becomes larger; blood in the urine or stool, etc.
Mechanism Description		Increased risk of bleeding by the combination of Trastuzumab emtansine and Niraparib

Recommended Action
Management		Concomitant use of anticoagulants or other medications known to reduce platelet count should be approached with caution. For hematologic adverse reactions requiring transfusion, withhold niraparib and consider interrupting any drugs that interfere with platelet function or coagulation. any signs or symptoms of bleeding to their primary care provider.

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2	Product Information. Zejula (niraparib). Tesaro Inc., Waltham, MA.