Drug General Information (ID: DDIN7KOA3Q)
Drug Name			Bivalirudin		Drug Info		Tositumomab (I-131)		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antithrombotic Agents				Therapeutic Radiopharmaceuticals

Mechanism of Bivalirudin-Tositumomab (I-131) Interaction (Severity Level: Major)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Bivalirudin				Tositumomab (I-131)
Mechanism		Risk of bleeding Anticoagulant				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 Bivalirudin and Tositumomab (I-131)

Recommended Action
Management		Due to the frequent occurrence of severe and prolonged thrombocytopenia associated with tositumomab and iodine I 131 tositumomab, concomitant use of other medications that interfere with platelet function or coagulation should be considered cautiously. Close clinical and laboratory observation for bleeding complications is recommended during and after the therapeutic regimen.

References
1	Product Information. Bexxar I 131 Therapeutic (iodine I 131 tositumomab). GlaxoSmithKline, Research Triangle Park, NC.
2	Product Information. BexxarTherapy (tositumomab). GlaxoSmithKline Inc, Oakville, IA.