Drug General Information (ID: DDI8XY2RFN)
Drug Name			Sunitinib		Drug Info		Dalteparin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antineoplastics				Anticoagulants
Structure

Mechanism of Sunitinib-Dalteparin Interaction (Severity Level: Moderate)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Sunitinib				Dalteparin
Mechanism		Risk of bleeding Antiplatelet/anticoagulant effects				Risk of bleeding Anticoagulant
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 Sunitinib and Dalteparin

Recommended Action
Management		Monitoring for clinical and laboratory signs of bleeding is recommended during concomitant therapy, including INR/PT and complete blood counts. Patients should be advised to promptly report any potential signs of bleeding to their doctor, including nosebleeds, pain, swelling, or headache.

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2	EMEA. European Medicines Agency "EPARs. European Union Public Assessment Reports.".
3	Product Information. Sutent (sunitinib). Pfizer U.S. Pharmaceuticals Group, New York, NY.