Drug General Information (ID: DDI7S96UGN)
Drug Name			Tositumomab (I-131)		Drug Info		Diclofenac (topical)		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Therapeutic Radiopharmaceuticals				Nsaids/Analgesics

Mechanism of Tositumomab (I-131)-Diclofenac (topical) Interaction (Severity Level: Moderate)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Tositumomab (I-131)				Diclofenac (topical)
Mechanism		Risk of bleeding Antiplatelet effects				Risk of bleeding Antiplatelet 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 Tositumomab (I-131) and Diclofenac (topical)

Recommended Action
Management		Caution is advised if NSAIDs are used in combination with other drugs that affect hemostasis. Close clinical and laboratory observation for hematologic complications is recommended. Patients should be advised to promptly report any signs of bleeding to their doctor, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.

References
1	Product Information. Acular (ketorolac). Allergan Inc, Irvine, CA.
2	Product Information. Nevanac (nepafenac ophthalmic). Alcon Laboratories Inc, Fort Worth, TX.
3	Product Information. Xibrom (bromfenac ophthalmic). ISTA Pharmaceuticals, Irvine, CA.