Drug General Information (ID: DDISX95IE3)
Drug Name			Anistreplase		Drug Info		Defibrotide		Drug Info
Drug Type		Protein/peptide				Small molecule
Therapeutic Class		Thrombolytics				Antiviral Agents

Mechanism of Anistreplase-Defibrotide Interaction (Severity Level: Major)
Increased risk of bleeding Click to Show/Hide Mechanism Graph
Drug Name		Anistreplase				Defibrotide
Mechanism		Risk of bleeding Thrombolytic agent				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 Anistreplase and Defibrotide

Recommended Action
Management		Concomitant use of defibrotide with fibrinolytic therapy is considered contraindicated. Fibrinolytic agents should be discontinued prior to initiation of defibrotide. Preferably, defibrotide administration should be delayed until the effects of fibrinolytic therapy have subsided. Patients should be monitored for signs of bleeding during defibrotide therapy. If bleeding develops, defibrotide should be discontinued and treatment/supportive care provided until the bleeding stops.

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2	Product Information. Defitelio (defibrotide). Jazz Pharmaceuticals, Palo Alto, CA.