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Blinatumomab is an antineoplastic antibody used to treat Philadelphia chromosome-negative relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL). Blinatumomab is a BiTE-class (bi-specific T-cell engagers) constructed monoclonal antibody indicated for the treatment of Philadelphia chromosome-negative relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL). Blinatumomab is manufactured by Amgen Inc. and marketed under the brand Blincyto™. A full treatment regimen consisting of two cycles of four weeks each is priced at $178 000 USD. Blinatumomab was approved in December 2014 under the FDA’s accelerated approval program, which allows approval of a drug to treat a serious or life-threatening disease based on clinical data showing the drug has an effect on a surrogate endpoint reasonably likely to predict clinical benefit to patients.
Blinatumomab (Blincyto, Amgen), a bi-specific antibody, is a first-in-class, targeted immunotherapy agent for the treatment of B-cell malignancies with a novel mechanism of action which involves in-vivo engagement of the patient’s T cells with CD19-expressing tumor cells. Clinical trials have demonstrated its efficacy in relapsed B-cell Acute Lymphoblastic Leukaemia (B-ALL) and B-cell Non-Hodgkin’s Lymphoma including in patients who are refractory to chemotherapy. This review summarises the development and design of Blinatumomab, the outcome of clinical studies demonstrating its efficacy, and how to manage the administration, practically, including relevant toxicities. We compare and contrast it to other emerging agents for the treatment of B-cell malignancies.
Blinatumomab is a 55-kilodalton fusion protein consisting of two recombinantly expressed single-chain variable fragments (murine anti-CD19 and anti-CD3) joined by a flexible glycine-serine linker. CD19 is a cell surface antigen expressed ubiquitously on precursor B-cells and has been implicated in the self-renewal capacity of leukemia cells
Mechanism of action
Blinatumomab is a bispecific CD19-directed CD3 T-cell engager that binds to CD19 expressed on the surface of cells of B-lineage origin and CD3 expressed on the surface of T cells. It activates endogenous T cells by connecting CD3 in the T-cell receptor (TCR) complex with CD19 on benign and malignant B cells. Blinatumomab mediates the formation of a synapse between the T cell and the tumor cell, upregulation of cell adhesion molecules, production of cytolytic proteins, release of inflammatory cytokines, and proliferation of T cells, which result in redirected lysis of CD19+ cells.
Indications
- Indicated for the treatment of Philadelphia chromosome-negative relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).
- B-cell Precursor Acute Lymphoblastic Leukemia (ALL)
- Refractory B-cell precursor acute lymphoblastic leukemia
- Relapsed B cell precursor Acute lymphoblastic leukemia
- MRD-positive B-cell Precursor ALL: For B-cell precursor acute lymphoblastic leukemia (ALL) in first or second complete remission with minimal residual disease (MRD) greater than or equal to 0.1%
- Relapsed or Refractory B-cell Precursor ALL: For relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL)
Use in Cancer
Blinatumomab is approved to treat:
- B-cell acute lymphoblastic leukemia in adults and children. It is used:
- In patients whose cancer has recurred (come back) or is refractory (does not respond to treatment).
- In some patients whose cancer is in complete remission. This use is approved under FDA’s Accelerated Approval Program. As a condition of approval, a confirmatory trial(s) must show that blinatumomab provides a clinical benefit in these patients.
Blinatumomab is also being studied in the treatment of other types of cancer.
Contraindication
- a bad infection
- low levels of a type of white blood cell called neutrophils
- leukoencephalopathy is a disease of the white matter of the brain
- seizures
- pregnancy
- pancreatitis
Dosage
Acute Lymphoblastic Leukemia
MRD-POSITIVE B-CELL PRECURSOR ALL:
- A therapy course consists of 1 cycle of this drug for induction followed by up to 3 additional cycles for consolidation.
- A single cycle of therapy of induction or consolidation consists of 28 days of continuous IV infusion followed by a 14-day treatment-free interval (a total of 42 days).
LESS THAN 45 KG:
- Induction Cycle 1: 15 mcg/m2 IV daily (not to exceed 28 mcg/day) on Days 1 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Consolidation Cycles 2 through 4: 15 mcg/m2 IV daily (not to exceed 28 mcg/day) on Days 1 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
45 KG OR GREATER:
- Induction Cycle 1: 28 mcg IV daily on Days 1 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Consolidation Cycles 2 through 4: 28 mcg/day on Days 1 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Hospitalization is recommended for the first 3 days of the first cycle and the first 2 days of the second cycle. For all subsequent cycle starts and reinitiation (e.g., if treatment is interrupted for 4 or more hours), supervision by a healthcare professional or hospitalization is recommended.
- For adult patients, premedication with prednisone 100 mg IV or equivalent (e.g., dexamethasone 16 mg) 1 hour before the first dose in each cycle.
RELAPSED OR REFRACTORY B-CELL PRECURSOR ALL:
- A therapy course consists of up to 2 cycles for induction followed by up to 3 additional cycles for consolidation and up to 4 cycles of continued therapy.
- A single cycle of therapy of induction or consolidation consists of 28 days of continuous IV infusion followed by a 14-day treatment-free interval (a total of 42 days).
- A single cycle of continued therapy consists of 28 days of continuous IV infusion followed by a 56-day treatment-free interval (a total of 84 days).
LESS THAN 45 KG:
- Induction Cycle 1: 5 mcg/m2 IV daily (not to exceed 9 mcg/day) on Days 1 through 7 followed by 15 mcg/m2 IV daily (not to exceed 28 mcg/day) on Days 8 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Induction Cycle 2: 15 mcg/m2 IV daily (not to exceed 28 mcg/day) on Days 1 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Consolidation Cycles 3 Through 5: 15 mcg/m2 IV daily (not to exceed 28 mcg/day) on Days 1 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Continued Therapy Cycles 6 Through 9: 15 mcg/m2 IV daily (not to exceed 28 mcg/day) on Days 1 through 28 followed by a 56-day treatment-free interval (Days 29 through 84)
45 KG OR GREATER:
- Induction Cycle 1: 9 mcg IV daily on Days 1 through 7 followed by a 28 mcg IV daily on Days 8 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Induction Cycle 2: 28 mcg IV daily on Days 1 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Consolidation Cycles 3 Through 5: 28 mcg IV daily on Days 1 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Continued Therapy Cycles 6 Through 9: 28 mcg IV daily on Days 1 through 28 followed by a 56-day treatment-free interval (Days 29 through 84)
- Hospitalization is recommended for the first 9 days of the first cycle and the first 2 days of the second cycle. For all subsequent cycle starts and reinitiation (e.g., if treatment is interrupted for 4 or more hours), supervision by a healthcare professional or hospitalization is recommended.
- For adult patients, premedication with 20 mg dexamethasone 1 hour before the first dose in each cycle, before a step dose (such as Cycle 1 Day 8), and when restarting an infusion after an interruption of 4 or more hours.
Usual Pediatric Dose for Acute Lymphoblastic Leukemia
MRD-POSITIVE B-CELL PRECURSOR ALL:
- A therapy course consists of 1 cycle of this drug for induction followed by up to 3 additional cycles for consolidation.
- A single cycle of therapy of induction or consolidation consists of 28 days of continuous IV infusion followed by a 14-day treatment-free interval (a total of 42 days).
1 MONTH AND OLDER/LESS THAN 45 KG:
- Induction Cycle 1: 15 mcg/m2 IV daily (not to exceed 28 mcg/day) on Days 1 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Consolidation Cycles 2 through 4: 15 mcg/m2 IV daily (not to exceed 28 mcg/day) on Days 1 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
1 MONTH AND OLDER/45 KG OR GREATER:
- Induction Cycle 1: 28 mcg IV daily on Days 1 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Consolidation Cycles 2 through 4: 28 mcg/day on Days 1 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Hospitalization is recommended for the first 3 days of the first cycle and the first 2 days of the second cycle. For all subsequent cycle starts and reinitiation (e.g., if treatment is interrupted for 4 or more hours), supervision by a healthcare professional or hospitalization is recommended.
- For pediatric patients, premedication with 5 mg/m2 of dexamethasone, to a maximum dose of 20 mg before the first dose of this drug in the first cycle and when restarting an infusion after an interruption of 4 or more hours in the first cycle.
RELAPSED OR REFRACTORY B-CELL PRECURSOR ALL:
- A therapy course consists of up to 2 cycles for induction followed by up to 3 additional cycles for consolidation and up to 4 cycles of continued therapy.
- A single cycle of therapy of induction or consolidation consists of 28 days of continuous IV infusion followed by a 14-day treatment-free interval (a total of 42 days).
- A single cycle of continued therapy consists of 28 days of continuous IV infusion followed by a 56-day treatment-free interval (a total of 84 days).
LESS THAN 45 KG:
- Induction Cycle 1: 5 mcg/m2 IV daily (not to exceed 9 mcg/day) on Days 1 through 7 followed by 15 mcg/m2 IV daily (not to exceed 28 mcg/day) on Days 8 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Induction Cycle 2: 15 mcg/m2 IV daily (not to exceed 28 mcg/day) on Days 1 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Consolidation Cycles 3 Through 5: 15 mcg/m2 IV daily (not to exceed 28 mcg/day) on Days 1 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Continued Therapy Cycles 6 Through 9: 15 mcg/m2 IV daily (not to exceed 28 mcg/day) on Days 1 through 28 followed by a 56-day treatment-free interval (Days 29 through 84)
45 KG OR GREATER:
- Induction Cycle 1: 9 mcg IV daily on Days 1 through 7 followed by a 28 mcg IV daily on Days 8 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Induction Cycle 2: 28 mcg IV daily on Days 1 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Consolidation Cycles 3 Through 5: 28 mcg IV daily on Days 1 through 28 followed by a 14-day treatment-free interval (Days 29 through 42)
- Continued Therapy Cycles 6 Through 9: 28 mcg IV daily on Days 1 through 28 followed by a 56-day treatment-free interval (Days 29 through 84)
- Hospitalization is recommended for the first 9 days of the first cycle and the first 2 days of the second cycle. For all subsequent cycle starts and reinitiation (e.g., if treatment is interrupted for 4 or more hours), supervision by a healthcare professional or hospitalization is recommended.
- For pediatric patients, premedication with 5 mg/m2 of dexamethasone, to a maximum dose of 20 mg before the first dose of this drug in the first cycle, before a step dose (such as Cycle 1 Day 8), and when restarting an infusion after an interruption of 4 or more hours in the first cycle.
- MRD-positive B-cell Precursor ALL: For B-cell precursor acute lymphoblastic leukemia (ALL) in first or second complete remission with minimal residual disease (MRD) greater than or equal to 0.1%
- Relapsed or Refractory B-cell Precursor ALL: For relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL)
Dose Adjustments
DOSE MODIFICATION GUIDELINES FOR ADVERSE EVENTS:
- If the interruption after an adverse event is no longer than 7 days, continue the same cycle to a total of 28 days of infusion inclusive of days before and after the interruption in that cycle.
- If an interruption due to an adverse event is longer than 7 days, start a new cycle.
Cytokine Release Syndrome (CRS) Toxicity:
LESS THAN 45 KG:
- Grade 3: Withhold therapy until resolved, and then restart at 5 mcg/m2/day. Escalate to 15 mcg/m2/day after 7 days if the toxicity does not recur.
- Grade 4: Discontinue therapy permanently.
45 KG OR GREATER:
- Grade 3: Withhold therapy until resolved, and then restart at 9 mcg/day. Escalate to 28 mcg/ day after 7 days if the toxicity does not recur.
- Grade 4: Discontinue therapy permanently.
Neurological Toxicity:
LESS THAN 45 KG:
- Seizure: Discontinue therapy permanently if more than one seizure occurs.
- Grade 3: Withhold therapy until no more than Grade 1 and for at least 3 days, then restart therapy at 5 mcg/m2/day. Escalate to 15 mcg/m2/day after 7 days if the toxicity does not recur. If the toxicity occurred at 5 mcg/m2/day, or if the toxicity takes more than 7 days to resolve, discontinue therapy permanently.
- Grade 4: Discontinue therapy permanently.
45 KG OR GREATER:
- Seizure: Discontinue therapy permanently if more than one seizure occurs.
- Grade 3: Withhold therapy until no more than Grade 1 and for at least 3 days, then restart therapy at 9 mcg/day. Escalate to 28 mcg/day after 7 days if the toxicity does not recur. If the toxicity occurred at 9 mcg/day, or if the toxicity takes more than 7 days to resolve, discontinue therapy permanently.
- Grade 4: Discontinue therapy permanently.
Other Clinically Relevant Adverse Reactions:
LESS THAN 45 KG:
- Grade 3: Withhold therapy until no more than Grade 1, then restart therapy at 5 mcg/m2/day. Escalate to 15 mcg/m2/day after 7 days if the toxicity does not recur. If the toxicity takes more than 14 days to resolve, discontinue therapy permanently.
- Grade 4: Discontinue therapy permanently.
45 KG OR GREATER:
- Grade 3: Withhold therapy until no more than Grade 1, and then restart therapy at 9 mcg/day. Escalate to 28 mcg/day after 7 days if the toxicity does not recur. If the toxicity takes more than 14 days to resolve, discontinue therapy permanently. -Grade 4: Consider discontinuing therapy permanently.
Side Effects
The Most Common
- constipation
- diarrhea
- weight gain
- back, joint, or muscle pain
- swelling of the arms, hands, feet, ankles, or lower legs
- pain at the injection site
- chest pain
- numbness or tingling in the arms, legs, hands, or feet
- shortness of breath
- ongoing pain that begins in the stomach area but may spread to the back that may occur with or without nausea and vomiting
- fever, sore throat, cough, and other signs of infection
More Common
- fever
- headache
- swelling of the extremities
- nausea
- tremor
- rash
- constipation
- fever accompanying low levels of white blood cells (febrile neutropenia), and
- low levels of potassium in the blood (hypokalemia)
- anemia
- low platelet levels in the blood
- low white blood cell count
- irregular heartbeats (arrhythmia)
- diarrhea
- abdominal pain
- vomiting
- fatigue
- chills
- chest pain
- infections
- weight gain
- decreased appetite
- back pain
- pain in extremities
- bone pain
- joint pain
- dizziness
- insomnia
- cough
- shortness of breath
- nosebleeds
- high or low blood pressure (hypertension or hypotension)
Rare
- Infections. blinatumomab may cause life-threatening infections that may lead to death. Tell your healthcare provider right away if you develop any signs or symptoms of an infection.
- Low white blood cell counts (neutropenia). Neutropenia is common with blinatumomab treatment and may sometimes be life-threatening. Low white blood cell counts can increase your risk of infection. Your healthcare provider will do blood tests to check your white blood cell count during treatment with this medicine. Tell your healthcare provider right away if you get a fever.
- Abnormal liver blood tests. Your healthcare provider will do blood tests to check your liver before you start this medicine and during treatment.
- Inflammation of the pancreas (pancreatitis). Pancreatitis may happen in people treated with blinatumomab and corticosteroids. It may be severe and lead to death. Tell your healthcare provider right away if you have severe stomach-area pain that does not go away. The pain may happen with or without nausea and vomiting.
- infections
- low platelet count (thrombocytopenia)
- fever
- reactions related to the infusion of the medicine such as face swelling, low blood pressure, and high blood pressure (infusion-related reactions)
- headache
- low red blood cell count (anemia)
Drug Interaction
| DRUG | INTERACTION |
|---|---|
| Abatacept | The risk or severity of adverse effects can be increased when Abatacept is combined with Blinatumomab. |
| Abciximab | The risk or severity of bleeding can be increased when Abciximab is combined with Blinatumomab. |
| Acenocoumarol | The risk or severity of bleeding can be increased when Acenocoumarol is combined with Blinatumomab. |
| Acetylsalicylic acid | The risk or severity of bleeding can be increased when Acetylsalicylic acid is combined with Blinatumomab. |
| Adalimumab | The risk or severity of adverse effects can be increased when Adalimumab is combined with Blinatumomab. |
| Adenovirus type | The risk or severity of infection can be increased when the Adenovirus type 7 vaccine live is combined with Blinatumomab. |
| Aducanumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Aducanumab. |
| Aldesleukin | The risk or severity of adverse effects can be increased when Aldesleukin is combined with Blinatumomab. |
| Alefacept | The risk or severity of adverse effects can be increased when Alefacept is combined with Blinatumomab. |
| Alemtuzumab | The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Blinatumomab. |
| Alirocumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Alirocumab. |
| Allogeneic | The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Blinatumomab. |
| Allopurinol | The risk or severity of adverse effects can be increased when Allopurinol is combined with Blinatumomab. |
| Alteplase | The risk or severity of bleeding can be increased when Alteplase is combined with Blinatumomab. |
| Altretamine | The risk or severity of adverse effects can be increased when Altretamine is combined with Blinatumomab. |
| Amivantamab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Amivantamab. |
| Amsacrine | The risk or severity of adverse effects can be increased when Amsacrine is combined with Blinatumomab. |
| Anagrelide | The risk or severity of bleeding can be increased when Anagrelide is combined with Blinatumomab. |
| Anakinra | The risk or severity of adverse effects can be increased when Anakinra is combined with Blinatumomab. |
| Ancrod | The risk or severity of bleeding can be increased when Ancrod is combined with Blinatumomab. |
| Anifrolumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Anifrolumab. |
| Anistreplase | The risk or severity of bleeding can be increased when Anistreplase is combined with Blinatumomab. |
| Ansuvimab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Ansuvimab. |
| Anthrax immune | The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Blinatumomab. |
| Anthrax vaccine | The risk or severity of infection can be increased when Anthrax vaccine is combined with Blinatumomab. |
| Antilymphocyte | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Antilymphocyte immunoglobulin (horse). |
| Antithrombin Alfa | The risk or severity of bleeding can be increased when Antithrombin Alfa is combined with Blinatumomab. |
| Antithrombin III human | The risk or severity of bleeding can be increased when Antithrombin III human is combined with Blinatumomab. |
| Antithymocyte (rabbit) | The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Blinatumomab. |
| Apixaban | The risk or severity of bleeding can be increased when Apixaban is combined with Blinatumomab. |
| Apremilast | The risk or severity of adverse effects can be increased when Apremilast is combined with Blinatumomab. |
| Ardeparin | The risk or severity of bleeding can be increased when Ardeparin is combined with Blinatumomab. |
| Argatroban | The risk or severity of bleeding can be increased when Argatroban is combined with Blinatumomab. |
| Arsenic trioxide | The risk or severity of adverse effects can be increased when Arsenic trioxide is combined with Blinatumomab. |
| Articaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Articaine. |
| Asfotase alfa | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Asfotase alfa. |
| COVID-19 Vaccine | The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Blinatumomab. |
| Atezolizumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Atezolizumab. |
| Atoltivimab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Atoltivimab. |
| Avelumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Avelumab. |
| Azacitidine | The risk or severity of adverse effects can be increased when Azacitidine is combined with Blinatumomab. |
| Azathioprine | The risk or severity of adverse effects can be increased when Azathioprine is combined with Blinatumomab. |
| Bacillus calmette- | The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Blinatumomab. |
| Bacillus calmette- | The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Blinatumomab. |
| Bacillus calmette- | The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Blinatumomab. |
| Bamlanivimab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Bamlanivimab. |
| Baricitinib | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Baricitinib. |
| Basiliximab | The risk or severity of adverse effects can be increased when Basiliximab is combined with Blinatumomab. |
| BCG vaccine | The risk or severity of infection can be increased when BCG vaccine is combined with Blinatumomab. |
| Bebtelovimab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Bebtelovimab. |
| Beclomethasone | The risk or severity of adverse effects can be increased when Beclomethasone dipropionate is combined with Blinatumomab. |
| Belantamab mafodotin | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Belantamab mafodotin. |
| Belatacept | The risk or severity of adverse effects can be increased when Belatacept is combined with Blinatumomab. |
| Belimumab | The risk or severity of adverse effects can be increased when Belimumab is combined with Blinatumomab. |
| Belinostat | The risk or severity of adverse effects can be increased when Belinostat is combined with Blinatumomab. |
| Belumosudil | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Belumosudil. |
| Bemiparin | The risk or severity of bleeding can be increased when Bemiparin is combined with Blinatumomab. |
| Bendamustine | The risk or severity of adverse effects can be increased when Bendamustine is combined with Blinatumomab. |
| Bendroflumethiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Bendroflumethiazide is combined with Blinatumomab. |
| Benralizumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Benralizumab. |
| Benzocaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Benzocaine. |
| Benzthiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Benzthiazide is combined with Blinatumomab. |
| Benzyl alcohol | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Benzyl alcohol. |
| Besilesomab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Besilesomab. |
| Betamethasone | The risk or severity of adverse effects can be increased when Betamethasone is combined with Blinatumomab. |
| Betrixaban | The risk or severity of bleeding can be increased when Betrixaban is combined with Blinatumomab. |
| Bevacizumab | The risk or severity of adverse effects can be increased when Bevacizumab is combined with Blinatumomab. |
| Bexarotene | The risk or severity of adverse effects can be increased when Bexarotene is combined with Blinatumomab. |
| Bezlotoxumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Bezlotoxumab. |
| Bimekizumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Bimekizumab. |
| Bivalirudin | The risk or severity of bleeding can be increased when Bivalirudin is combined with Blinatumomab. |
| Bleomycin | The risk or severity of adverse effects can be increased when Bleomycin is combined with Blinatumomab. |
| Bordetella pertussis | The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Blinatumomab. |
| Bortezomib | The risk or severity of adverse effects can be increased when Bortezomib is combined with Blinatumomab. |
| Bosutinib | The risk or severity of adverse effects can be increased when Bosutinib is combined with Blinatumomab. |
| Brentuximab vedotin | The risk or severity of adverse effects can be increased when Brentuximab vedotin is combined with Blinatumomab. |
| Brodalumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Brodalumab. |
| Brolucizumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Brolucizumab. |
| Budesonide | The risk or severity of adverse effects can be increased when Budesonide is combined with Blinatumomab. |
| Bupivacaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Bupivacaine. |
| Burosumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Burosumab. |
| Busulfan | The risk or severity of adverse effects can be increased when Busulfan is combined with Blinatumomab. |
| Butacaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Butacaine. |
| Butamben | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Butamben. |
| Cabazitaxel | The risk or severity of adverse effects can be increased when Cabazitaxel is combined with Blinatumomab. |
| Canakinumab | The risk or severity of adverse effects can be increased when Canakinumab is combined with Blinatumomab. |
| Cangrelor | The risk or severity of bleeding can be increased when Cangrelor is combined with Blinatumomab. |
| Capecitabine | The risk or severity of adverse effects can be increased when Capecitabine is combined with Blinatumomab. |
| Caplacizumab | The risk or severity of bleeding can be increased when Caplacizumab is combined with Blinatumomab. |
| Capromab pendetide | The risk or severity of adverse effects can be increased when Capromab pendetide is combined with Blinatumomab. |
| Capsaicin | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Capsaicin. |
| Carbamazepine | The risk or severity of adverse effects can be increased when Carbamazepine is combined with Blinatumomab. |
| Carboplatin | The risk or severity of adverse effects can be increased when Carboplatin is combined with Blinatumomab. |
| Carfilzomib | The risk or severity of adverse effects can be increased when Carfilzomib is combined with Blinatumomab. |
| Carmustine | The risk or severity of adverse effects can be increased when Carmustine is combined with Blinatumomab. |
| Casirivimab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Casirivimab. |
| Catumaxomab | The risk or severity of adverse effects can be increased when Catumaxomab is combined with Blinatumomab. |
| Cemiplimab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Cemiplimab. |
| Certolizumab pegol | The risk or severity of adverse effects can be increased when Certolizumab pegol is combined with Blinatumomab. |
| Cetuximab | The risk or severity of adverse effects can be increased when Cetuximab is combined with Blinatumomab. |
| Cilostazol | The risk or severity of bleeding can be increased when Cilostazol is combined with Blinatumomab. |
| Cinchocaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Cinchocaine. |
| Cisplatin | The risk or severity of adverse effects can be increased when Cisplatin is combined with Blinatumomab. |
| Cladribine | The risk or severity of adverse effects can be increased when Cladribine is combined with Blinatumomab. |
| Clobetasol propionate | The risk or severity of adverse effects can be increased when Clobetasol propionate is combined with Blinatumomab. |
| Clofarabine | The risk or severity of adverse effects can be increased when Clofarabine is combined with Blinatumomab. |
| Clopidogrel | The risk or severity of bleeding can be increased when Clopidogrel is combined with Blinatumomab. |
| Clostridium tetani | The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Blinatumomab. |
| Clozapine | The risk or severity of neutropenia can be increased when Blinatumomab is combined with Clozapine. |
| Cocaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Cocaine. |
| Conjugated estrogens | Conjugated estrogens may increase the thrombogenic activities of Blinatumomab. |
| Corticotropin | The risk or severity of adverse effects can be increased when Corticotropin is combined with Blinatumomab. |
| Cortisone acetate | The risk or severity of adverse effects can be increased when Cortisone acetate is combined with Blinatumomab. |
| Corynebacterium | The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Blinatumomab. |
| Cyanocobalamin | The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Blinatumomab. |
| Cyclopenthiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclopenthiazide is combined with Blinatumomab. |
| Cyclophosphamide | The risk or severity of adverse effects can be increased when Cyclophosphamide is combined with Blinatumomab. |
| Cyclosporine | Blinatumomab may increase the immunosuppressive activities of Cyclosporine. |
| Cyclothiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclothiazide is combined with Blinatumomab. |
| Cytarabine | The risk or severity of adverse effects can be increased when Cytarabine is combined with Blinatumomab. |
| Dabigatran | The risk or severity of bleeding can be increased when Dabigatran is combined with Blinatumomab. |
| Dabigatran etexilate | The risk or severity of bleeding can be increased when Dabigatran etexilate is combined with Blinatumomab. |
| Dacarbazine | The risk or severity of adverse effects can be increased when Dacarbazine is combined with Blinatumomab. |
| Dactinomycin | The risk or severity of adverse effects can be increased when Dactinomycin is combined with Blinatumomab. |
| Dalteparin | The risk or severity of bleeding can be increased when Dalteparin is combined with Blinatumomab. |
| Danaparoid | The risk or severity of bleeding can be increased when Danaparoid is combined with Blinatumomab. |
| Daratumumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Daratumumab. |
| Darbepoetin alfa | The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Blinatumomab. |
| Dasatinib | The risk or severity of adverse effects can be increased when Dasatinib is combined with Blinatumomab. |
| Daunorubicin | The risk or severity of adverse effects can be increased when Daunorubicin is combined with Blinatumomab. |
| Decitabine | The risk or severity of adverse effects can be increased when Decitabine is combined with Blinatumomab. |
| Defibrotide | The risk or severity of bleeding can be increased when Defibrotide is combined with Blinatumomab. |
| Deflazacort | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Deflazacort. |
| Denosumab | The risk or severity of adverse effects can be increased when Denosumab is combined with Blinatumomab. |
| Desirudin | The risk or severity of bleeding can be increased when Desirudin is combined with Blinatumomab. |
| Desoximetasone | The risk or severity of adverse effects can be increased when Desoximetasone is combined with Blinatumomab. |
| Deucravacitinib | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Deucravacitinib. |
| Dexamethasone | The risk or severity of adverse effects can be increased when Dexamethasone is combined with Blinatumomab. |
| Dexrazoxane | The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Blinatumomab. |
| Dextran | The risk or severity of bleeding can be increased when Dextran is combined with Blinatumomab. |
| Dicoumarol | The risk or severity of bleeding can be increased when Dicoumarol is combined with Blinatumomab. |
| Dienestrol | Dienestrol may increase the thrombogenic activities of Blinatumomab. |
| Diethylstilbestrol | Diethylstilbestrol may increase the thrombogenic activities of Blinatumomab. |
| Difluocortolone | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Difluocortolone. |
| Digoxin Immune Fab | The risk or severity of adverse effects can be increased when Digoxin Immune Fab (Ovine) is combined with Blinatumomab. |
| Dimethyl fumarate | The risk or severity of adverse effects can be increased when Dimethyl fumarate is combined with Blinatumomab. |
| Dinutuximab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Dinutuximab. |
| Diphenhydramine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Diphenhydramine. |
| Dipyridamole | The risk or severity of bleeding can be increased when Dipyridamole is combined with Blinatumomab. |
| Diroximel fumarate | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Diroximel fumarate. |
| Docetaxel | The risk or severity of adverse effects can be increased when Docetaxel is combined with Blinatumomab. |
| Dostarlimab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Dostarlimab. |
| Doxorubicin | The risk or severity of adverse effects can be increased when Doxorubicin is combined with Blinatumomab. |
| Drotrecogin alfa | The risk or severity of bleeding can be increased when Drotrecogin alfa is combined with Blinatumomab. |
| Dulaglutide | The risk or severity of adverse effects can be increased when Dulaglutide is combined with Blinatumomab. |
| Dupilumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Dupilumab. |
| Durvalumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Durvalumab. |
| Dyclonine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Dyclonine. |
| Ebola Zaire vaccine | The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Blinatumomab. |
| Eculizumab | The risk or severity of adverse effects can be increased when Eculizumab is combined with Blinatumomab. |
| Edetic acid | The risk or severity of bleeding can be increased when Edetic acid is combined with Blinatumomab. |
| Edoxaban | The risk or severity of bleeding can be increased when Edoxaban is combined with Blinatumomab. |
| Efalizumab | The risk or severity of adverse effects can be increased when Efalizumab is combined with Blinatumomab. |
| Eflapegrastim | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Eflapegrastim. |
| Eftrenonacog alfa | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Eftrenonacog alfa. |
| Elotuzumab | The risk or severity of adverse effects can be increased when Elotuzumab is combined with Blinatumomab. |
| Emapalumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Emapalumab. |
| Emicizumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Emicizumab. |
| Enoxaparin | The risk or severity of bleeding can be increased when Enoxaparin is combined with Blinatumomab. |
| Epirubicin | The risk or severity of adverse effects can be increased when Epirubicin is combined with Blinatumomab. |
| Epoprostenol | The risk or severity of bleeding can be increased when Epoprostenol is combined with Blinatumomab. |
| Eptifibatide | The risk or severity of bleeding can be increased when Eptifibatide is combined with Blinatumomab. |
| Eptinezumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Eptinezumab. |
| Erenumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Erenumab. |
| Eribulin | The risk or severity of adverse effects can be increased when Eribulin is combined with Blinatumomab. |
| Erythropoietin | The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Blinatumomab. |
| Esterified estrogens | Esterified estrogens may increase the thrombogenic activities of Blinatumomab. |
| Estetrol | Estetrol may increase the thrombogenic activities of Blinatumomab. |
| Estradiol | Estradiol may increase the thrombogenic activities of Blinatumomab. |
| Estradiol acetate | Estradiol acetate may increase the thrombogenic activities of Blinatumomab. |
| Estradiol benzoate | Estradiol benzoate may increase the thrombogenic activities of Blinatumomab. |
| Estradiol cypionate | Estradiol cypionate may increase the thrombogenic activities of Blinatumomab. |
| Estradiol valerate | Estradiol valerate may increase the thrombogenic activities of Blinatumomab. |
| Estramustine | The risk or severity of adverse effects can be increased when Estramustine is combined with Blinatumomab. |
| Estriol | Estriol may increase the thrombogenic activities of Blinatumomab. |
| Estrone | Estrone may increase the thrombogenic activities of Blinatumomab. |
| Estrone sulfate | Estrone sulfate may increase the thrombogenic activities of Blinatumomab. |
| Etanercept | The risk or severity of adverse effects can be increased when Etanercept is combined with Blinatumomab. |
| Ethinylestradiol | Ethinylestradiol may increase the thrombogenic activities of Blinatumomab. |
| Ethyl chloride | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Ethyl chloride. |
| Etidocaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Etidocaine. |
| Etoposide | The risk or severity of adverse effects can be increased when Etoposide is combined with Blinatumomab. |
| Everolimus | The risk or severity of adverse effects can be increased when Everolimus is combined with Blinatumomab. |
| Evolocumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Evolocumab. |
| Filgotinib | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Filgotinib. |
| Fingolimod | Blinatumomab may increase the immunosuppressive activities of Fingolimod. |
| Floxuridine | The risk or severity of adverse effects can be increased when Floxuridine is combined with Blinatumomab. |
| Flucytosine | The risk or severity of adverse effects can be increased when Flucytosine is combined with Blinatumomab. |
| Fludarabine | The risk or severity of adverse effects can be increased when Fludarabine is combined with Blinatumomab. |
| Fludrocortisone | The risk or severity of adverse effects can be increased when Fludrocortisone is combined with Blinatumomab. |
| Fluindione | The risk or severity of bleeding can be increased when Fluindione is combined with Blinatumomab. |
| Flunisolide | The risk or severity of adverse effects can be increased when Flunisolide is combined with Blinatumomab. |
| Fluocinolone acetonide | The risk or severity of adverse effects can be increased when Fluocinolone acetonide is combined with Blinatumomab. |
| Fluocinonide | The risk or severity of adverse effects can be increased when Fluocinonide is combined with Blinatumomab. |
| Fluocortolone | The risk or severity of adverse effects can be increased when Fluocortolone is combined with Blinatumomab. |
| Fluorometholone | The risk or severity of adverse effects can be increased when Fluorometholone is combined with Blinatumomab. |
| Fluorouracil | The risk or severity of adverse effects can be increased when Fluorouracil is combined with Blinatumomab. |
| Flupentixol | The risk or severity of myelosuppression can be increased when Flupentixol is combined with Blinatumomab. |
| Fluprednisolone | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Fluprednisolone. |
| Fluticasone | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Fluticasone. |
| Fluticasone furoate | The risk or severity of adverse effects can be increased when Fluticasone furoate is combined with Blinatumomab. |
| Fluticasone propionate | The risk or severity of adverse effects can be increased when Fluticasone propionate is combined with Blinatumomab. |
| Fondaparinux | The risk or severity of bleeding can be increased when Fondaparinux is combined with Blinatumomab. |
| Fremanezumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Fremanezumab. |
| Galcanezumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Galcanezumab. |
| Gallium nitrate | The risk or severity of adverse effects can be increased when Gallium nitrate is combined with Blinatumomab. |
| Gemcitabine | The risk or severity of adverse effects can be increased when Gemcitabine is combined with Blinatumomab. |
| Gemtuzumab ozogamicin | The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Blinatumomab. |
| Glatiramer | The risk or severity of adverse effects can be increased when Glatiramer is combined with Blinatumomab. |
| Golimumab | The risk or severity of adverse effects can be increased when Golimumab is combined with Blinatumomab. |
| Guselkumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Guselkumab. |
| Haemophilus influenzae | The therapeutic efficacy of Haemophilus influenzae type B strain 20752 capsular polysaccharide tetanus toxoid conjugate antigen can be decreased when used in combination with Blinatumomab. |
| Heparin | The risk or severity of bleeding can be increased when Heparin is combined with Blinatumomab. |
| Hepatitis A Vaccine | The therapeutic efficacy of Hepatitis A Vaccine can be decreased when used in combination with Blinatumomab. |
| Hepatitis B immune | The risk or severity of adverse effects can be increased when Hepatitis B immune globulin is combined with Blinatumomab. |
| Hepatitis B Vaccine | The therapeutic efficacy of Hepatitis B Vaccine (Recombinant) can be decreased when used in combination with Blinatumomab. |
| Human adenovirus | The risk or severity of infection can be increased when Human adenovirus e serotype 4 strain cl-68578 antigen is combined with Blinatumomab. |
| cytomegalovirus | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Human cytomegalovirus immune globulin. |
| immunoglobulin G | The risk or severity of adverse effects can be increased when Human immunoglobulin G is combined with Blinatumomab. |
| immune globulin | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Human Rho(D) immune globulin. |
| Human varicella-zoster | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Human varicella-zoster immune globulin. |
| Hydrochlorothiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Hydrochlorothiazide is combined with Blinatumomab. |
| Hydrocortisone acetate | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Hydrocortisone acetate. |
| Hydrocortisone butyrate | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Hydrocortisone butyrate. |
| Hydrocortisone succinate | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Hydrocortisone succinate. |
| Hydroflumethiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Hydroflumethiazide is combined with Blinatumomab. |
| Hydroxychloroquine | The risk or severity of adverse effects can be increased when Hydroxychloroquine is combined with Blinatumomab. |
| Hydroxyurea | The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Blinatumomab. |
| Ibalizumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Ibalizumab. |
| Ibritumomab tiuxetan | The risk or severity of adverse effects can be increased when Ibritumomab tiuxetan is combined with Blinatumomab. |
| Ibrutinib | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Ibrutinib. |
| Icosapent ethyl | The risk or severity of bleeding can be increased when Icosapent ethyl is combined with Blinatumomab. |
| Idarubicin | The risk or severity of adverse effects can be increased when Idarubicin is combined with Blinatumomab. |
| Idarucizumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Idarucizumab. |
| Idelalisib | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Idelalisib. |
| Ifosfamide | The risk or severity of adverse effects can be increased when Ifosfamide is combined with Blinatumomab. |
| Iloprost | The risk or severity of bleeding can be increased when Iloprost is combined with Blinatumomab. |
| Imatinib | The risk or severity of adverse effects can be increased when Imatinib is combined with Blinatumomab. |
| Imdevimab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Imdevimab. |
| Imlifidase | The therapeutic efficacy of Blinatumomab can be decreased when used in combination with Imlifidase. |
| Indomethacin | The risk or severity of adverse effects can be increased when Indomethacin is combined with Blinatumomab. |
| Inebilizumab | The risk or severity of infection can be increased when Blinatumomab is combined with Inebilizumab. |
| Infliximab | The risk or severity of adverse effects can be increased when Infliximab is combined with Blinatumomab. |
| Influenza A virus A | The therapeutic efficacy of Influenza A virus A/Brisbane/59/2007(H1N1) antigen (propiolactone inactivated) can be decreased when used in combination with Blinatumomab. |
| Influenza A virus A | The therapeutic efficacy of Influenza A virus A/Brisbane/59/2007(H1N1) hemagglutinin antigen (propiolactone inactivated) can be decreased when used in combination with Blinatumomab. |
| Influenza A virus | The therapeutic efficacy of Influenza A virus A/California/7/2009 (H1N1) live (attenuated) antigen can be decreased when used in combination with Blinatumomab. |
| Influenza A virus A | The therapeutic efficacy of Influenza A virus A/California/7/2009 X-181 (H1N1) antigen (propiolactone inactivated) can be decreased when used in combination with Blinatumomab. |
| Influenza A virus A | The therapeutic efficacy of Influenza A virus A/California/7/2009 X-181 (H1N1) hemagglutinin antigen (propiolactone inactivated) can be decreased when used in combination with Blinatumomab. |
| Influenza A virus | The therapeutic efficacy of Influenza A virus A/Perth/16/2009 (H3N2) live (attenuated) antigen can be decreased when used in combination with Blinatumomab. |
| Influenza A virus A | The therapeutic efficacy of Influenza A virus A/Uruguay/716/2007(H3N2) antigen (propiolactone inactivated) can be decreased when used in combination with Blinatumomab. |
| Influenza A virus A/ | The therapeutic efficacy of Influenza A virus A/Victoria/210/2009 X-187 (H3N2) antigen (formaldehyde inactivated) can be decreased when used in combination with Blinatumomab. |
| Influenza A virus A | The therapeutic efficacy of Influenza A virus A/Victoria/210/2009 X-187 (H3N2) hemagglutinin antigen (formaldehyde inactivated) can be decreased when used in combination with Blinatumomab. |
| Influenza B virus B | The therapeutic efficacy of Influenza B virus B/Brisbane/60/2008 antigen (formaldehyde inactivated) can be decreased when used in combination with Blinatumomab. |
| Influenza B virus B | The therapeutic efficacy of Influenza B virus B/Brisbane/60/2008 antigen (propiolactone inactivated) can be decreased when used in combination with Blinatumomab. |
| Influenza B virus B/ | The therapeutic efficacy of Influenza B virus B/Brisbane/60/2008 hemagglutinin antigen (formaldehyde inactivated) can be decreased when used in combination with Blinatumomab. |
| Influenza B virus B | The therapeutic efficacy of Influenza B virus B/Brisbane/60/2008 hemagglutinin antigen (propiolactone inactivated) can be decreased when used in combination with Blinatumomab. |
| Inotuzumab ozogamicin | The risk or severity of adverse effects can be increased when Inotuzumab ozogamicin is combined with Blinatumomab. |
| Interferon alfa-2a | The risk or severity of adverse effects can be increased when Interferon alfa-2a is combined with Blinatumomab. |
| Interferon alfa-2b | The risk or severity of adverse effects can be increased when Interferon alfa-2b is combined with Blinatumomab. |
| Interferon alfa-n1 | The risk or severity of adverse effects can be increased when Interferon alfa-n1 is combined with Blinatumomab. |
| Interferon alfa-n3 | The risk or severity of adverse effects can be increased when Interferon alfa-n3 is combined with Blinatumomab. |
| Interferon alfacon-1 | The risk or severity of adverse effects can be increased when Interferon alfacon-1 is combined with Blinatumomab. |
| Interferon beta-1b | The risk or severity of adverse effects can be increased when Interferon beta-1b is combined with Blinatumomab. |
| Interferon gamma-1b | The risk or severity of adverse effects can be increased when Interferon gamma-1b is combined with Blinatumomab. |
| Ipilimumab | The risk or severity of adverse effects can be increased when Ipilimumab is combined with Blinatumomab. |
| Irinotecan | The risk or severity of adverse effects can be increased when Irinotecan is combined with Blinatumomab. |
| Isatuximab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Isatuximab. |
| Ixabepilone | The risk or severity of adverse effects can be increased when Ixabepilone is combined with Blinatumomab. |
| Ixekizumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Ixekizumab. |
| COVID-19 Vaccine | The therapeutic efficacy of Janssen COVID-19 Vaccine can be decreased when used in combination with Blinatumomab. |
| Japanese encephalitis | The therapeutic efficacy of Japanese encephalitis virus strain sa 14-14-2 antigen (formaldehyde inactivated) can be decreased when used in combination with Blinatumomab. |
| Lanadelumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Lanadelumab. |
| Leflunomide | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Leflunomide. |
| Lenalidomide | The risk or severity of adverse effects can be increased when Lenalidomide is combined with Blinatumomab. |
| Lepirudin | The risk or severity of bleeding can be increased when Lepirudin is combined with Blinatumomab. |
| Levobupivacaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Levobupivacaine. |
| Lidocaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Lidocaine. |
| Linezolid | The risk or severity of adverse effects can be increased when Linezolid is combined with Blinatumomab. |
| Lipegfilgrastim | Blinatumomab may increase the myelosuppressive activities of Lipegfilgrastim. |
| Lomustine | The risk or severity of adverse effects can be increased when Lomustine is combined with Blinatumomab. |
| Loncastuximab tesirine | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Loncastuximab tesirine. |
| Lopinavir | The serum concentration of Blinatumomab can be increased when it is combined with Lopinavir. |
| Maftivimab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Maftivimab. |
| Magnesium | The serum concentration of Magnesium can be decreased when it is combined with Blinatumomab. |
| Margetuximab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Margetuximab. |
| Measles virus vaccine | The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Blinatumomab. |
| Mechlorethamine | The risk or severity of adverse effects can be increased when Mechlorethamine is combined with Blinatumomab. |
| Meloxicam | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Meloxicam. |
| Melphalan | The risk or severity of adverse effects can be increased when Melphalan is combined with Blinatumomab. |
| Meningococcal | The therapeutic efficacy of Meningococcal (groups A, C, Y and W-135) oligosaccharide diphtheria CRM197 conjugate vaccine can be decreased when used in combination with Blinatumomab. |
| Mepivacaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Mepivacaine. |
| Mepolizumab | The risk or severity of adverse effects can be increased when Mepolizumab is combined with Blinatumomab. |
| Meprednisone | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Meprednisone. |
| Mercaptopurine | The risk or severity of adverse effects can be increased when Mercaptopurine is combined with Blinatumomab. |
| Mestranol | Mestranol may increase the thrombogenic activities of Blinatumomab. |
| Methimazole | The risk or severity of adverse effects can be increased when Methimazole is combined with Blinatumomab. |
| Methotrexate | The risk or severity of adverse effects can be increased when Methotrexate is combined with Blinatumomab. |
| Methoxy polyethylene | The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Blinatumomab. |
| Methylprednisolone | The risk or severity of adverse effects can be increased when Methylprednisolone is combined with Blinatumomab. |
| Mitomycin | The risk or severity of adverse effects can be increased when Mitomycin is combined with Blinatumomab. |
| Mitoxantrone | The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Blinatumomab. |
| COVID-19 Vaccine | The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Blinatumomab. |
| Modified vaccinia ankara | The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Blinatumomab. |
| Mogamulizumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Mogamulizumab. |
| Mometasone furoate | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Mometasone furoate. |
| Monomethyl fumarate | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Monomethyl fumarate. |
| Mosunetuzumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Mosunetuzumab. |
| Mumps virus strain | The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Blinatumomab. |
| Muromonab | The risk or severity of adverse effects can be increased when Muromonab is combined with Blinatumomab. |
| Mycophenolate mofetil | The risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Blinatumomab. |
| Mycophenolic acid | The risk or severity of adverse effects can be increased when Mycophenolic acid is combined with Blinatumomab. |
| Nadroparin | The risk or severity of bleeding can be increased when Nadroparin is combined with Blinatumomab. |
| Natalizumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Natalizumab. |
| Necitumumab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Necitumumab. |
| Nelarabine | The risk or severity of adverse effects can be increased when Nelarabine is combined with Blinatumomab. |
| Nilotinib | The risk or severity of adverse effects can be increased when Nilotinib is combined with Blinatumomab. |
| Nimesulide | The risk or severity of bleeding can be increased when Nimesulide is combined with Blinatumomab. |
| Nivolumab | The risk or severity of adverse effects can be increased when Nivolumab is combined with Blinatumomab. |
| Nuvaxovid | The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Blinatumomab. |
| Obiltoxaximab | The risk or severity of adverse effects can be increased when Obiltoxaximab is combined with Blinatumomab. |
| Obinutuzumab | The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Blinatumomab. |
| Ocrelizumab | Ocrelizumab may increase the immunosuppressive activities of Blinatumomab. |
| Odesivimab | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Odesivimab. |
| Ofatumumab | The risk or severity of adverse effects can be increased when Ofatumumab is combined with Blinatumomab. |
| Olaparib | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Olaparib. |
| Olaratumab | The risk or severity of adverse effects can be increased when Olaratumab is combined with Blinatumomab. |
| Omalizumab | The risk or severity of adverse effects can be increased when Omalizumab is combined with Blinatumomab. |
| Oxaliplatin | The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Blinatumomab. |
| Oxetacaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Oxetacaine. |
| Oxybuprocaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Oxybuprocaine. |
| Ozanimod | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Ozanimod. |
| Paclitaxel | The risk or severity of adverse effects can be increased when Paclitaxel is combined with Blinatumomab. |
| Palbociclib | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Palbociclib. |
| Palifermin | The therapeutic efficacy of Palifermin can be decreased when used in combination with Blinatumomab. |
| Palivizumab | The risk or severity of adverse effects can be increased when Palivizumab is combined with Blinatumomab. |
| Panitumumab | The risk or severity of adverse effects can be increased when Panitumumab is combined with Blinatumomab. |
| Panobinostat | The risk or severity of adverse effects can be increased when Panobinostat is combined with Blinatumomab. |
| Parnaparin | The risk or severity of bleeding can be increased when Parnaparin is combined with Blinatumomab. |
| Pazopanib | The risk or severity of adverse effects can be increased when Pazopanib is combined with Blinatumomab. |
| Pegaspargase | The risk or severity of adverse effects can be increased when Pegaspargase is combined with Blinatumomab. |
| Pegcetacoplan | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Pegcetacoplan. |
| Peginesatide | The risk or severity of Thrombosis can be increased when Peginesatide is combined with Blinatumomab. |
| Peginterferon alfa-2a | The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Blinatumomab. |
| Peginterferon alfa-2b | The risk or severity of adverse effects can be increased when Peginterferon alfa-2b is combined with Blinatumomab. |
| Peginterferon beta-1a | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Peginterferon beta-1a. |
| Pembrolizumab | The risk or severity of adverse effects can be increased when Pembrolizumab is combined with Blinatumomab. |
| Pemetrexed | The risk or severity of adverse effects can be increased when Pemetrexed is combined with Blinatumomab. |
| Penicillamine | The risk or severity of adverse effects can be increased when Penicillamine is combined with Blinatumomab. |
| Pentosan polysulfate | The risk or severity of bleeding can be increased when Pentosan polysulfate is combined with Blinatumomab. |
| Pentostatin | The risk or severity of adverse effects can be increased when Pentostatin is combined with Blinatumomab. |
| Pentoxifylline | The risk or severity of bleeding can be increased when Pentoxifylline is combined with Blinatumomab. |
| Pertussis vaccine | The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Blinatumomab. |
| Pertuzumab | The risk or severity of adverse effects can be increased when Pertuzumab is combined with Blinatumomab. |
| Phenindione | The risk or severity of bleeding can be increased when Phenindione is combined with Blinatumomab. |
| Phenol | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Phenol. |
| Phenprocoumon | The risk or severity of bleeding can be increased when Phenprocoumon is combined with Blinatumomab. |
| Phenylalanine | The risk or severity of adverse effects can be increased when Phenylalanine is combined with Blinatumomab. |
| Pimecrolimus | The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Blinatumomab. |
| Pirfenidone | The risk or severity of adverse effects can be increased when Pirfenidone is combined with Blinatumomab. |
| Polatuzumab vedotin | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Polatuzumab vedotin. |
| Polyestradiol phosphate | Polyestradiol phosphate may increase the thrombogenic activities of Blinatumomab. |
| Polythiazide | The risk or severity of neutropenia and thrombocytopenia can be increased when Polythiazide is combined with Blinatumomab. |
| Pomalidomide | The risk or severity of adverse effects can be increased when Pomalidomide is combined with Blinatumomab. |
| Ponatinib | The risk or severity of adverse effects can be increased when Ponatinib is combined with Blinatumomab. |
| Ponesimod | The risk or severity of adverse effects can be increased when Blinatumomab is combined with Ponesimod. |
| Pralatrexate | The risk or severity of adverse effects can be increased when Pralatrexate is combined with Blinatumomab. |
| Pramocaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Pramocaine. |
| Prasugrel | The risk or severity of bleeding can be increased when Prasugrel is combined with Blinatumomab. |
| Prednisolone | The risk or severity of adverse effects can be increased when Prednisolone is combined with Blinatumomab. |
| Prednisone | The risk or severity of adverse effects can be increased when Prednisone is combined with Blinatumomab. |
| Prilocaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Prilocaine. |
| Procaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Procaine. |
| Procarbazine | The risk or severity of adverse effects can be increased when Procarbazine is combined with Blinatumomab. |
| Proparacaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Proparacaine. |
| Propoxycaine | The risk or severity of methemoglobinemia can be increased when Blinatumomab is combined with Propoxycaine. |
| Propylthiouracil | The risk or severity of adverse effects can be increased when Propylthiouracil is combined with Blinatumomab. |
| Protein C | The risk or severity of bleeding can be increased when Protein C is combined with Blinatumomab. |
| Protein S human | The risk or severity of bleeding can be increased when Protein S human is combined with Blinatumomab. |
| Quinestrol | Quinestrol may increase the thrombogenic activities of Blinatumomab. |
| Rabies immune | The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Blinatumomab. |
| Rabies virus | The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Blinatumomab. |
| Rabies virus | The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Blinatumomab. |
| Raltitrexed | The risk or severity of adverse effects can be increased when Raltitrexed is combined with Blinatumomab. |
Pregnancy and Lactation
US FDA pregnancy category: Not assigned
Pregnancy
If you are pregnant or are planning to become pregnant, blinatumomab may harm your unborn baby. Tell your healthcare provider if you become pregnant during treatment with blinatumomab.
- If you are able to become pregnant, your healthcare provider should do a pregnancy test before you start treatment with blinatumomab.
- Females who are able to become pregnant should use an effective form of birth control during treatment with blinatumomab, and for 48 hours after the last dose of blinatumomab.
Lactation
If you are breastfeeding or plan to breastfeed, it is not known if blinatumomab passes into your breast milk.
- You should not breastfeed during treatment with blinatumomab and for 48 hours after your last treatment.
How should this medicine be used?
Blinatumomab comes as a powder to be mixed with liquid to be slowly injected intravenously (into a vein) by a doctor or nurse in a hospital or medical facility and sometimes at home. This medication is given continuously for 4 weeks followed by 2 to 8 weeks when the medication is not given. This treatment period is called a cycle, and the cycle may be repeated as necessary. The length of treatment depends on how you respond to the medication.
Your doctor may need to delay your treatment, change your dose, or stop your treatment if you experience certain side effects. It is important for you to tell your doctor how you are feeling during your treatment with blinatumomab injection.
Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before receiving blinatumomab injection,
- tell your doctor and pharmacist if you are allergic to blinatumomab, any other medications, benzyl alcohol. or any other ingredients in blinatumomab injection. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: cyclosporine (Gengraf, Neoral, Sandimmune) or warfarin (Coumadin, Jantoven). Many other medications may also interact with blinatumomab, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have an infection or if you have or have ever had an infection that keeps coming back. Also, tell your doctor if you have ever had radiation therapy to the brain or have received chemotherapy or have or have ever had liver disease.
- tell your doctor if you are pregnant or plan to become pregnant. You will need to have a pregnancy test before you receive this medication. You should not become pregnant during your treatment with blinatumomab and for at least 2 days after your final dose. Talk to your doctor about types of birth control that will work for you. If you become pregnant while using blinatumomab, call your doctor. Blinatumomab may harm the fetus.
- tell your doctor if you are breastfeeding. Do not breastfeed while receiving blinatumomab and for at least 2 days after your final dose.
- you should know that blinatumomab injection may make you drowsy. Do not drive a car or operate machinery while you are receiving this medication.
- do not have any vaccinations without talking to your doctor. Tell your doctor if you have received a vaccine within the past 2 weeks. After your final dose, your doctor will tell you when it is safe to receive a vaccine.
References
- https://pubchem.ncbi.nlm.nih.gov/substance/178103956
- https://www.cancer.gov/about-cancer/treatment/drugs/blinatumomab
- https://go.drugbank.com/drugs/DB09052
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6605719/
- https://en.wikipedia.org/wiki/Blinatumomab
- https://www.drugs.com/blinatumomab.html
- https://medlineplus.gov/druginfo/meds/a614061.html
