Drug General Information (ID: DDIDWA5Y23)
Drug Name			Ipilimumab		Drug Info		Brentuximab vedotin		Drug Info
Drug Type		Monoclonal antibody				Monoclonal antibody
Therapeutic Class		Antineoplastics				Antineoplastics

Mechanism of Ipilimumab-Brentuximab vedotin Interaction (Severity Level: Moderate)
Increased risk of hepatotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Ipilimumab				Brentuximab vedotin
Mechanism 1		Hepatotoxicity				Hepatotoxicity
Key Mechanism Factor 1
		Factor Name		Hepatotoxicity
		Factor Description		Combination of drugs that can induce hepatotoxicity may increase the risk of liver injury. Symptoms vary depending on the level of exposure and the total extent of liver damage, and may cause few symptoms if the damage is mild, and eventually lead to liver failure in patients with severe damage.
Mechanism Description		Increased risk of hepatotoxicity by the combination of Ipilimumab and Brentuximab vedotin
Increased risk of peripheral neuropathy Click to Show/Hide Mechanism Graph
Drug Name		Ipilimumab				Brentuximab vedotin
Mechanism 2		Peripheral neuropathy				Peripheral neuropathy
Key Mechanism Factor 2
		Factor Name		Peripheral neuropathy
		Factor Description		Peripheral neuropathy is a disorder of the peripheral nerves that can cause sensory and motor symptoms, and even paralysis in severe cases. Signs and symptoms of peripheral neuropathy may include: gradual numbness, tingling or prickling in the feet or hands that can spread up the legs and arms; sharp, stinging, pricking or burning sensations; extreme sensitivity to touch; pain during activities that should not cause pain; lack of coordination and falls; muscle weakness; and paralysis if the motor nerves are affected.
Mechanism Description		Increased risk of peripheral neuropathy by the combination of Ipilimumab and Brentuximab vedotin

Recommended Action
Management		The potential for increased risk and/or severity of peripheral neuropathy and hepatotoxicity should be considered when brentuximab vedotin is used with other drugs that are also associated with these adverse effects. Patients should be closely monitored for symptoms of neuropathy such as burning, tingling, pain, numbness, or weakness. Liver enzymes and bilirubin should be measured before and during treatment, especially in patients with underlying hepatic disease or marked baseline transaminase elevations. Patients experiencing new, worsening, or recurrent neuropathy or hepatotoxicity may require a delay, change in dosage, or discontinuation of brentuximab vedotin in accordance with the product labeling. Patients should be advised to seek medical attention if they experience potential signs and symptoms of hepatotoxicity such as fever, rash, itching, anorexia, nausea, vomiting, fatigue, malaise, right upper quadrant pain, dark urine, pale stools, and jaundice.

References
1	Product Information. Accolate (zafirlukast). Zeneca Pharmaceuticals, Wilmington, DE.
2	Product Information. Adcetris (brentuximab vedotin). Seattle Genetics Inc, Bothell, WA.