Drug General Information (ID: DDIPRX5TQ3)
Drug Name			Trastuzumab emtansine		Drug Info		Acalabrutinib		Drug Info
Drug Type		Monoclonal antibody				Small molecule
Therapeutic Class		Antineoplastics/Her2 Inhibitors				Antineoplastics/Bruton Tyrosine Kinase Inhibitor

Mechanism of Trastuzumab emtansine-Acalabrutinib Interaction (Severity Level: Major)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Trastuzumab emtansine				Acalabrutinib
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 Trastuzumab emtansine and Acalabrutinib

Recommended Action
Management		Concomitant use of acalabrutinib in patients receiving other medications that interfere with platelet function or coagulation should be approached with caution. Close clinical and laboratory monitoring for bleeding complications is recommended during therapy. Patients should be advised to promptly report any signs and symptoms of bleeding to their physician.

References
1	Product Information. Brukinsa (zanubrutinib). BeiGene USA, Inc, San Mateo, CA.
2	Product Information. Calquence (acalabrutinib). Astra-Zeneca Pharmaceuticals, Wilmington, DE.