Dinutuximab – Uses, Dosage, Side Effects, Interaction

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 58 min read
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Dinutuximab - Uses, Dosage, Side Effects, Interaction
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Dinutuximab is an immunotherapeutic agent used in combination with other immunomodulating agents to treat high-risk neuroblastoma in pediatric patients who achieve at least a partial response to prior first-line multiagent, multimodality therapy. Dinutuximab is an IgG1 monoclonal human/mouse chimeric antibody against GD2, a disialoganglioside expressed on...

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Article Summary

Dinutuximab is an immunotherapeutic agent used in combination with other immunomodulating agents to treat high-risk neuroblastoma in pediatric patients who achieve at least a partial response to prior first-line multiagent, multimodality therapy. Dinutuximab is an IgG1 monoclonal human/mouse chimeric antibody against GD2, a disialoganglioside expressed on tumors of neuroectodermal origin, including human neuroblastoma and melanoma, with a highly restricted expression on normal tissues. It is composed...

Key Takeaways

  • This article explains Mechanism of action in simple medical language.
  • This article explains Indications in simple medical language.
  • This article explains Contraindications in simple medical language.
  • This article explains Dosage in simple medical language.
Educational health guideWritten for patient understanding and clinical awareness.
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Definition

Dinutuximab is an immunotherapeutic agent used in combination with other immunomodulating agents to treat high-risk neuroblastoma in pediatric patients who achieve at least a partial response to prior first-line multiagent, multimodality therapy.

Dinutuximab is an IgG1 monoclonal human/mouse chimeric antibody against GD2, a disialoganglioside expressed on tumors of neuroectodermal origin, including human neuroblastoma and melanoma, with a highly restricted expression on normal tissues. It is composed of the variable heavy- and light chain regions of the murine anti-GD2 mAb 14.18 and the constant regions of human IgG1 heavy-chain and kappa light-chain. By binding to GD2, dinutiximab induces antibody-dependent cell-mediated cytotoxicity and complement-dependent cytotoxicity of tumor cells thereby leading to apoptosis and inhibiting the proliferation of the tumor. It is indicated, in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-2 (IL-2), and 13-cis-retinoic acid (RA), for the treatment of pediatric patients with high-risk neuroblastoma who achieve at least a partial response to prior first-line multiagent, multimodality therapy. Despite a high clinical response seen after first-line treatment, the complete eradication of neuroblastoma is rarely achieved and the majority of patients with the advanced disease suffer a relapse. Current strategies for treatment include immunotherapy with drugs such as dinutuximab to target surviving neuroblastoma cells and prevent relapse.

Mechanism of action

Dinutuximab is an IgG1 monoclonal human/mouse chimeric antibody against GD2, a disialoganglioside expressed on tumors of neuroectodermal origin, including human neuroblastoma and melanoma, with a highly restricted expression on normal tissues. It is composed of the variable heavy- and light chain regions of the murine anti-GD2 mAb 14.18 and the constant regions of human IgG1 heavy-chain and kappa light-chain. By binding to GD2, infliximab induces antibody-dependent cell-mediated cytotoxicity and complement-dependent cytotoxicity of tumor cells thereby leading to apoptosis and inhibiting the proliferation of the tumor.

In vitro, rituximab binds to neuroblastoma tumor cells and mediates the lysis of tumor cells via cell-mediated and complement-mediated cytotoxicity.

Indications

  • Dinutuximab is indicated, in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-2 (IL-2), and 13-cis-retinoic acid (RA), for the treatment of pediatric patients with high-risk neuroblastoma who achieve at least a partial response to prior first-line multiagent, multimodality therapy. Despite a high clinical response seen after first-line treatment, the complete eradication of neuroblastoma is rarely achieved and the majority of patients with the advanced disease suffer a relapse. Current strategies for treatment include immunotherapy with drugs such as dinutuximab to target surviving neuroblastoma cells and prevent relapse.
  • High-Risk Neuroblastoma
  • Dinutuximab is used as post-consolidation therapy for children with high-risk neuroblastoma, in combination with granulocyte-macrophage colony-stimulating factor, interleukin-2, and 13-cis-retinoic acid. It is given in patients who have completed induction therapy and consolidation therapy (autologous bone marrow transplant and external beam radiation therapy), as part of standard-of-care therapy for newly-diagnosed high-risk neuroblastoma. It is given by intravenous infusion, over ten to twenty hours, four days in a row.[rx] It is also used second-line for relapsed/refractory neuroblastoma in combination with chemotherapy and GM-CSF.
  • Dinutuximab beta is also used as a second-line treatment for children with high-risk neuroblastoma; it was tested and is used with a longer and slower dosing regime, and is given on its own, although it may be combined with IL-2 if a stronger immune response is needed.[rx]
  • Morphine is administered prior to, during, and for two hours after infusion of dinutuximab and dinutuximab beta to manage the severe pain that this drug causes. An antihistamine and an infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation, pain, or swelling. সহজ বাংলা: প্রদাহ/ফোলা/ব্যথা কমায়।" data-rx-term="anti-inflammatory" data-rx-definition="Anti-inflammatory means reducing inflammation, pain, or swelling. সহজ বাংলা: প্রদাহ/ফোলা/ব্যথা কমায়।">anti-inflammatory are also given before, during, and after to manage the infusion reaction
  • In combination with granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-2 (IL-2) and 13-cis-retinoic acid (RA), for the treatment of pediatric patients with high-risk neuroblastoma who achieve at least a partial response to prior first-line multiagent, multimodality therapy

Use in Cancer

Dinutuximab is approved to be used with granulocyte-macrophage colony-stimulating factor (GM-CSF), aldesleukin (IL-2), and 13-cis retinoic acid to treat:

Contraindications

  • a bad infection
  • a disorder with excess antidiuretic hormone called syndrome of inappropriate antidiuretic hormone
  • hemolytic uremic syndrome, a condition that affects the kidney and the blood
  • anemia
  • decreased blood platelets
  • low levels of a type of white blood cell called neutrophils
  • infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation of the spinal cord
  • a painful condition that affects the nerves in the legs and arms called peripheral pain, numbness, tingling, or weakness. সহজ বাংলা: স্নায়ুর ক্ষতি/সমস্যা।" data-rx-term="neuropathy" data-rx-definition="Neuropathy means nerve damage or irritation causing pain, numbness, tingling, or weakness. সহজ বাংলা: স্নায়ুর ক্ষতি/সমস্যা।">neuropathy
  • low blood pressure
  • an inability to completely empty the bladder
  • pregnancy
  • a patient who is producing milk and breastfeeding
  • a type of brain disorder called posterior reversible encephalopathy syndrome

Dosage

Strengths: 17.5 mg/5 mL

Neuroblastoma

17.5 mg/m2/day IV over 10 to 20 hours for 4 consecutive days for a maximum of 5 cycles:

  • Infuse on days 4, 5, 6, and 7 during cycles 1, 3, and 5 (cycles 1, 3, and 5 are 24 days in duration).
  • Infuse on days 8, 9, 10, and 11 during cycles 2 and 4 (cycles 2 and 4 are 32 days in duration).

Rate of Infusion:

  • Initiate at 0.875 mg/m2/hour for 30 minutes. Gradually increase as tolerated to a maximum rate of 1.75 mg/m2/hour.

REQUIRED PRE-TREATMENT AND GUIDELINES FOR PAIN MANAGEMENT IV HYDRATION:
1) Hydration:

  • Administer 0.9% sodium chloride 10 mL/kg IV over one hour just prior to initiating each infusion.

2) Analgesics:

  • Administer morphine 50 mcg/kg IV immediately prior to infusion and then continue as a morphine drip at an infusion rate of 20 to 50 mcg/kg/hour during and for 2 hours following completion of therapy.
  • Administer an additional 25 mcg/kg to 50 mcg/kg IV doses of morphine as needed for pain up to once every 2 hours followed by an increase in the morphine infusion rate in stable patients.
  • Consider using fentanyl or hydromorphone if morphine is not tolerated.
  • If pain is inadequately managed with opioids, consider use of gabapentin or lidocaine in conjunction with IV morphine.

3) Antihistamines and Antipyretics:

  • Administer an antihistamine such as diphenhydramine (0.5 to 1 mg/kg; maximum dose 50 mg) IV over 10 to 15 minutes starting 20 minutes prior to initiation of therapy and as tolerated every 4 to 6 hours during therapy.
  • Administer acetaminophen (10 to 15 mg/kg; maximum dose 650 mg) 20 minutes prior to each infusion and every 4 to 6 hours as needed for fever or pain. -Administer ibuprofen (5 to 10 mg/kg) every 6 hours as needed for control of persistent fever or pain.

Dose Adjustments

Permanently discontinue therapy for:

  • Grade 3 or 4 anaphylaxis
  • Grade 3 or 4 serum sickness
  • Grade 3 pain unresponsive to maximum supportive measures
  • Grade 4 sensory pain, numbness, tingling, or weakness. সহজ বাংলা: স্নায়ুর ক্ষতি/সমস্যা।" data-rx-term="neuropathy" data-rx-definition="Neuropathy means nerve damage or irritation causing pain, numbness, tingling, or weakness. সহজ বাংলা: স্নায়ুর ক্ষতি/সমস্যা।">neuropathy or Grade 3 sensory neuropathy that interferes with daily activities for more than 2 weeks
  • Grade 2 or greater peripheral motor pain, numbness, tingling, or weakness. সহজ বাংলা: স্নায়ুর ক্ষতি/সমস্যা।" data-rx-term="neuropathy" data-rx-definition="Neuropathy means nerve damage or irritation causing pain, numbness, tingling, or weakness. সহজ বাংলা: স্নায়ুর ক্ষতি/সমস্যা।">neuropathy
  • Urinary retention that persists following discontinuation of opioids
  • Transverse myelitis
  • Reversible posterior leukoencephalopathy syndrome (RPLS)
  • Subtotal or total vision loss
  • Grade 4 hyponatremia despite appropriate fluid management

Infusion-related reactions:

  • Mild to moderate reaction (e.g., transient rash, fever, rigors, and localized urticaria that respond promptly to symptomatic treatment): Reduce infusion rate by 50%; monitor closely. Upon resolution, gradually increase the infusion rate up to a maximum of 1.75 mg/m2/hour.
  • Severe or prolonged reaction (e.g., mild bronchospasm without other symptoms, angioedema that does not affect the airway): Interrupt infusion; if symptoms resolve rapidly, resume infusion at 50% of the previous rate and monitor closely. If the reaction recurs, discontinue therapy until the following day. If symptoms resolve and further treatment is warranted, premedicated with IV hydrocortisone 1 mg/kg (maximum 50 mg) and infuse at a rate of 0.875 mg/m2/hour in an intensive care unit. If the reaction recurs a second time, permanently discontinue therapy.

Neurological Disorders of the Eye:

  • The onset of reaction: Discontinue the infusion until resolved; upon resolution, reduce the dose by 50%.
  • First recurrence or if accompanied by visual impairment: Permanently discontinue therapy.

Capillary leak syndrome:

  • Moderate to severe, but not life-threatening: Interrupt infusion; upon resolution, resume infusion at 50% of the previous rate.
  • Life-threatening: Discontinue infusion for the current cycle; in subsequent cycles, infuse at 50% of the previous rate. If life-threatening capillary leak syndrome recurs, permanently discontinue therapy.

Hemolytic uremic syndrome:

  • Permanently discontinue therapy and administer supportive management.

Hyponatremia, grade 4 (despite appropriate fluid management):

  • Permanently discontinue therapy.

Hypotension requiring medical intervention:

  • Interrupt infusion; upon resolution, resume infusion at 50% of the previous rate. If blood pressure remains stable for 2 hours or more, increase infusion rate as tolerated up to a maximum rate of 1.75 mg/m2/hour.

Severe systemic infection or sepsis:

  • Discontinue therapy until the infection resolves; may resume therapy with subsequent cycles.

Administration advice:

  • Verify that patients have adequate hematologic, respiratory, hepatic, and renal function prior to initiating each course of therapy.
  • Administer required premedication and hydration prior to initiation of each course of therapy.

Side Effects

The Most Common

  • vomiting
  • diarrhea
  • nausea
  • decreased appetite
  • weight gain
  • fever, chills, and other signs of infection
  • blurred vision
  • changes in vision
  • sensitivity to light
  • drooping eyelids
  • seizures
  • muscle cramps
  • rapid heartbeat
  • fatigue
  • blood in urine
  • unusual bleeding or bruising
  • vomit that is bloody or looks like coffee grounds
  • stool that contains bright red blood or is black and tarry
  • pale skin
  • swelling of the hands, feet, ankles, or lower legs
  • shortness of breath
  • fainting, dizziness, or lightheadedness
  • sudden vision loss or vision changes;
  • headache, confusion, thinking problems, seizures;
  • nerve problems–sharp or shooting pain, numbness or tingling, burning or cold feeling, weakness, loss of movement, problems with walking or daily activities, loss of bladder or bowel control;
  • low blood cell counts–fever, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands, and feet, feeling light-headed or short of breath; or
  • signs of an electrolyte imbalance–increased thirst or urination, constipation, muscle pain or weakness, leg cramps, numbness or tingling, feeling jittery, irregular heartbeats, fluttering in your chest, or a choking feeling.

More common

  • Black, tarry, stools
  • bleeding gums
  • blood in the urine or stools
  • blurred vision
  • chills
  • cloudy urine
  • coma
  • confusion
  • convulsions
  • cough or hoarseness
  • decrease or increase in the amount of urine
  • difficult or labored breathing
  • dizziness
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • dry mouth
  • fainting or lightheadedness
  • fast or irregular heartbeat
  • fever
  • headache
  • hives or welts, itching, or skin rash
  • increased thirst
  • irregular heartbeat
  • loss of appetite
  • lower back or side pain
  • muscle pain or cramps
  • nausea or vomiting
  • noisy breathing
  • numbness or tingling in the hands, feet, or lips
  • painful or difficult urination
  • pale skin
  • pinpoint red spots on the skin
  • redness of the skin
  • sore throat
  • stomach pain
  • sweating
  • swelling of the face, hands, ankles, feet, or lower legs
  • tightness in the chest
  • troubled breathing with exertion
  • ulcers, sores, or white spots in the mouth
  • unusual bleeding or bruising
  • unusual tiredness or weakness

Rare

  • Back pain
  • bigger, dilated, or enlarged pupils (black part of the eye)
  • burning, numbness, tingling, or painful sensations
  • change in color vision
  • change in the ability to see colors, especially blue or yellow
  • chest pain
  • difficulty seeing at night
  • drooping upper eyelids
  • increased sensitivity of the eyes to sunlight
  • muscle or joint pain
  • nerve pain
  • pain in the arms or legs
  • unsteadiness or awkwardness
  • weakness in the arms, hands, legs, or feet
  • Yellow eyes or skin

Drug Interaction

Pregnancy and Lactation

US FDA pregnancy category: Not assigned.

Pregnancy

Use is not recommended. Monoclonal antibodies are transported across the placenta in a linear fashion as pregnancy progresses, with the largest amount transferred during the third trimester. Pregnant women should be advised of the potential risk to a fetus. This drug may cause fetal harm based on its mechanism of action. Females of reproductive potential should be advised to use effective contraception during treatment and for two months after the last dose of this drug.

Lactation

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

How should this medicine be used?

Dinutuximab injection comes as a solution (liquid) to be injected intravenously (into a vein) over 10 to 20 hours by a doctor or nurse in a medical facility or infusion center. It is usually given for 4 consecutive days within a treatment cycle for up to 5 cycles.

Be sure to tell the doctor how your child is feeling during the treatment. Your child’s doctor may decrease the dose, or stop the treatment for a while or permanently if your child experiences side effects to the medication.

What special precautions should I follow?

Before receiving dinutuximab injection,

  • tell your doctor and pharmacist if your child is allergic to dinutuximab, any other medications, or any of the ingredients in dinutuximab 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 your child is taking or plans to take. Your doctor may need to change the doses of medications or monitor your child carefully for side effects.
  • tell your doctor if it is possible that your child could become pregnant. Dinutuximab injection may harm the fetus. If needed, your child should use birth control to prevent pregnancy during treatment with dinutuximab and for up to 2 months after treatment. Talk to your doctor about types of birth control that will work. If your child becomes pregnant while using dinutuximab injection, call your doctor.

References

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Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Avoid heavy lifting, sudden bending, and prolonged bed rest.
  • Use comfortable posture and gentle movement as tolerated.
  • Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

  • For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
  • Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Orthopedic / spine specialist, physical medicine doctor, or qualified clinician
Tests to discuss with doctor
  • Neurological examination for leg power, sensation, reflexes, and straight leg raise
  • X-ray only if injury, deformity, long-lasting pain, or doctor suspects bone problem
  • MRI discussion if severe nerve symptoms, weakness, bladder/bowel problem, or persistent symptoms
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?
  • Is physiotherapy, posture correction, or activity modification needed?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Dinutuximab – Uses, Dosage, Side Effects, Interaction

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

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Frequently Asked Questions

Mechanism of action Dinutuximab is an IgG1 monoclonal human/mouse chimeric antibody against GD2, a disialoganglioside expressed on tumors of neuroectodermal origin, including human neuroblastoma and melanoma, with a highly restricted expression on normal tissues. It is composed of the variable heavy- and light chain regions of the murine anti-GD2 mAb 14.18 and the constant regions of human IgG1 heavy-chain and kappa light-chain. By binding to GD2, infliximab induces antibody-dependent cell-mediated cytotoxicity and complement-dependent cytotoxicity of tumor cells thereby leading to apoptosis and inhibiting the proliferation of the tumor. In vitro, rituximab binds to neuroblastoma tumor cells and mediates the lysis of tumor cells via cell-mediated and complement-mediated cytotoxicity. Indications Dinutuximab is indicated, in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-2 (IL-2), and 13-cis-retinoic acid (RA), for the treatment of pediatric patients with high-risk neuroblastoma who achieve at least a partial response to prior first-line multiagent, multimodality therapy. Despite a high clinical response seen after first-line treatment, the complete eradication of neuroblastoma is rarely achieved and the majority of patients with the advanced disease suffer a relapse. Current strategies for treatment include immunotherapy with drugs such as dinutuximab to target surviving neuroblastoma cells and prevent relapse. High-Risk Neuroblastoma Dinutuximab is used as post-consolidation therapy for children with high-risk neuroblastoma, in combination with granulocyte-macrophage colony-stimulating factor, interleukin-2, and 13-cis-retinoic acid. It is given in patients who have completed induction therapy and consolidation therapy (autologous bone marrow transplant and external beam radiation therapy), as part of standard-of-care therapy for newly-diagnosed high-risk neuroblastoma. It is given by intravenous infusion, over ten to twenty hours, four days in a row.[rx] It is also used second-line for relapsed/refractory neuroblastoma in combination with chemotherapy and GM-CSF. Dinutuximab beta is also used as a second-line treatment for children with high-risk neuroblastoma; it was tested and is used with a longer and slower dosing regime, and is given on its own, although it may be combined with IL-2 if a stronger immune response is needed.[rx] Morphine is administered prior to, during, and for two hours after infusion of dinutuximab and dinutuximab beta to manage the severe pain that this drug causes. An antihistamine and an anti-inflammatory are also given before, during, and after to manage the infusion reaction In combination with granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-2 (IL-2) and 13-cis-retinoic acid (RA), for the treatment of pediatric patients with high-risk neuroblastoma who achieve at least a partial response to prior first-line multiagent, multimodality therapy Use in Cancer Dinutuximab is approved to be used with granulocyte-macrophage colony-stimulating factor (GM-CSF), aldesleukin (IL-2), and 13-cis retinoic acid to treat: Neuroblastoma is high-risk. It is used in children who had at least a partial response to other drugs and other types of treatment. Contraindications a bad infection a disorder with excess antidiuretic hormone called syndrome of inappropriate antidiuretic hormone hemolytic uremic syndrome, a condition that affects the kidney and the blood anemia decreased blood platelets low levels of a type of white blood cell called neutrophils inflammation of the spinal cord a painful condition that affects the nerves in the legs and arms called peripheral neuropathy low blood pressure an inability to completely empty the bladder pregnancy a patient who is producing milk and breastfeeding a type of brain disorder called posterior reversible encephalopathy syndrome Dosage Strengths: 17.5 mg/5 mL Neuroblastoma 17.5 mg/m2/day IV over 10 to 20 hours for 4 consecutive days for a maximum of 5 cycles: Infuse on days 4, 5, 6, and 7 during cycles 1, 3, and 5 (cycles 1, 3, and 5 are 24 days in duration). Infuse on days 8, 9, 10, and 11 during cycles 2 and 4 (cycles 2 and 4 are 32 days in duration). Rate of Infusion: Initiate at 0.875 mg/m2/hour for 30 minutes. Gradually increase as tolerated to a maximum rate of 1.75 mg/m2/hour. REQUIRED PRE-TREATMENT AND GUIDELINES FOR PAIN MANAGEMENT IV HYDRATION: 1) Hydration: Administer 0.9% sodium chloride 10 mL/kg IV over one hour just prior to initiating each infusion. 2) Analgesics: Administer morphine 50 mcg/kg IV immediately prior to infusion and then continue as a morphine drip at an infusion rate of 20 to 50 mcg/kg/hour during and for 2 hours following completion of therapy. Administer an additional 25 mcg/kg to 50 mcg/kg IV doses of morphine as needed for pain up to once every 2 hours followed by an increase in the morphine infusion rate in stable patients. Consider using fentanyl or hydromorphone if morphine is not tolerated. If pain is inadequately managed with opioids, consider use of gabapentin or lidocaine in conjunction with IV morphine. 3) Antihistamines and Antipyretics: Administer an antihistamine such as diphenhydramine (0.5 to 1 mg/kg; maximum dose 50 mg) IV over 10 to 15 minutes starting 20 minutes prior to initiation of therapy and as tolerated every 4 to 6 hours during therapy. Administer acetaminophen (10 to 15 mg/kg; maximum dose 650 mg) 20 minutes prior to each infusion and every 4 to 6 hours as needed for fever or pain. -Administer ibuprofen (5 to 10 mg/kg) every 6 hours as needed for control of persistent fever or pain. Dose Adjustments Permanently discontinue therapy for: Grade 3 or 4 anaphylaxis Grade 3 or 4 serum sickness Grade 3 pain unresponsive to maximum supportive measures Grade 4 sensory neuropathy or Grade 3 sensory neuropathy that interferes with daily activities for more than 2 weeks Grade 2 or greater peripheral motor neuropathy Urinary retention that persists following discontinuation of opioids Transverse myelitis Reversible posterior leukoencephalopathy syndrome (RPLS) Subtotal or total vision loss Grade 4 hyponatremia despite appropriate fluid management Infusion-related reactions: Mild to moderate reaction (e.g., transient rash, fever, rigors, and localized urticaria that respond promptly to symptomatic treatment): Reduce infusion rate by 50%; monitor closely. Upon resolution, gradually increase the infusion rate up to a maximum of 1.75 mg/m2/hour. Severe or prolonged reaction (e.g., mild bronchospasm without other symptoms, angioedema that does not affect the airway): Interrupt infusion; if symptoms resolve rapidly, resume infusion at 50% of the previous rate and monitor closely. If the reaction recurs, discontinue therapy until the following day. If symptoms resolve and further treatment is warranted, premedicated with IV hydrocortisone 1 mg/kg (maximum 50 mg) and infuse at a rate of 0.875 mg/m2/hour in an intensive care unit. If the reaction recurs a second time, permanently discontinue therapy. Neurological Disorders of the Eye: The onset of reaction: Discontinue the infusion until resolved; upon resolution, reduce the dose by 50%. First recurrence or if accompanied by visual impairment: Permanently discontinue therapy. Capillary leak syndrome: Moderate to severe, but not life-threatening: Interrupt infusion; upon resolution, resume infusion at 50% of the previous rate. Life-threatening: Discontinue infusion for the current cycle; in subsequent cycles, infuse at 50% of the previous rate. If life-threatening capillary leak syndrome recurs, permanently discontinue therapy. Hemolytic uremic syndrome: Permanently discontinue therapy and administer supportive management. Hyponatremia, grade 4 (despite appropriate fluid management): Permanently discontinue therapy. Hypotension requiring medical intervention: Interrupt infusion; upon resolution, resume infusion at 50% of the previous rate. If blood pressure remains stable for 2 hours or more, increase infusion rate as tolerated up to a maximum rate of 1.75 mg/m2/hour. Severe systemic infection or sepsis: Discontinue therapy until the infection resolves; may resume therapy with subsequent cycles. Administration advice: Verify that patients have adequate hematologic, respiratory, hepatic, and renal function prior to initiating each course of therapy. Administer required premedication and hydration prior to initiation of each course of therapy. Side Effects The Most Common vomiting diarrhea nausea decreased appetite weight gain fever, chills, and other signs of infection blurred vision changes in vision sensitivity to light drooping eyelids seizures muscle cramps rapid heartbeat fatigue blood in urine unusual bleeding or bruising vomit that is bloody or looks like coffee grounds stool that contains bright red blood or is black and tarry pale skin swelling of the hands, feet, ankles, or lower legs shortness of breath fainting, dizziness, or lightheadedness sudden vision loss or vision changes; headache, confusion, thinking problems, seizures; nerve problems--sharp or shooting pain, numbness or tingling, burning or cold feeling, weakness, loss of movement, problems with walking or daily activities, loss of bladder or bowel control; low blood cell counts--fever, chills, tiredness, mouth sores, skin sores, easy bruising, unusual bleeding, pale skin, cold hands, and feet, feeling light-headed or short of breath; or signs of an electrolyte imbalance--increased thirst or urination, constipation, muscle pain or weakness, leg cramps, numbness or tingling, feeling jittery, irregular heartbeats, fluttering in your chest, or a choking feeling. More common Black, tarry, stools bleeding gums blood in the urine or stools blurred vision chills cloudy urine coma confusion convulsions cough or hoarseness decrease or increase in the amount of urine difficult or labored breathing dizziness dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position dry mouth fainting or lightheadedness fast or irregular heartbeat fever headache hives or welts, itching, or skin rash increased thirst irregular heartbeat loss of appetite lower back or side pain muscle pain or cramps nausea or vomiting noisy breathing numbness or tingling in the hands, feet, or lips painful or difficult urination pale skin pinpoint red spots on the skin redness of the skin sore throat stomach pain sweating swelling of the face, hands, ankles, feet, or lower legs tightness in the chest troubled breathing with exertion ulcers, sores, or white spots in the mouth unusual bleeding or bruising unusual tiredness or weakness Rare Back pain bigger, dilated, or enlarged pupils (black part of the eye) burning, numbness, tingling, or painful sensations change in color vision change in the ability to see colors, especially blue or yellow chest pain difficulty seeing at night drooping upper eyelids increased sensitivity of the eyes to sunlight muscle or joint pain nerve pain pain in the arms or legs unsteadiness or awkwardness weakness in the arms, hands, legs, or feet Yellow eyes or skin Drug Interaction DRUG INTERACTION Abatacept The risk or severity of adverse effects can be increased when Abatacept is combined with Dinutuximab. Abciximab The risk or severity of bleeding can be increased when Abciximab is combined with Dinutuximab. Acebutolol The risk or severity of adverse effects can be increased when Acebutolol is combined with Dinutuximab. Acenocoumarol The risk or severity of bleeding can be increased when Acenocoumarol is combined with Dinutuximab. Acetylsalicylic acid The risk or severity of bleeding can be increased when Acetylsalicylic acid is combined with Dinutuximab. Adalimumab The risk or severity of adverse effects can be increased when Adalimumab is combined with Dinutuximab. Adenovirus type The risk or severity of infection can be increased when Adenovirus type 7 vaccine live is combined with Dinutuximab. Aducanumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Aducanumab. Aldesleukin The risk or severity of adverse effects can be increased when Aldesleukin is combined with Dinutuximab. Alefacept The risk or severity of adverse effects can be increased when Alefacept is combined with Dinutuximab. Alemtuzumab The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Dinutuximab. Alirocumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Alirocumab. Aliskiren The risk or severity of adverse effects can be increased when Aliskiren is combined with Dinutuximab. Allogeneic The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Dinutuximab. Allopurinol The risk or severity of adverse effects can be increased when Allopurinol is combined with Dinutuximab. Alteplase The risk or severity of bleeding can be increased when Alteplase is combined with Dinutuximab. Altretamine The risk or severity of adverse effects can be increased when Altretamine is combined with Dinutuximab. Ambrisentan Dinutuximab may increase the hypotensive activities of Ambrisentan. Amifostine The risk or severity of adverse effects can be increased when Amifostine is combined with Dinutuximab. Amiloride The risk or severity of adverse effects can be increased when Amiloride is combined with Dinutuximab. Amiodarone The risk or severity of adverse effects can be increased when Amiodarone is combined with Dinutuximab. Amivantamab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Amivantamab. Amlodipine The risk or severity of adverse effects can be increased when Amlodipine is combined with Dinutuximab. Amobarbital Amobarbital may increase the hypotensive activities of Dinutuximab. Amphotericin B The risk or severity of adverse effects can be increased when Amphotericin B is combined with Dinutuximab. Amsacrine The risk or severity of adverse effects can be increased when Amsacrine is combined with Dinutuximab. Amyl Nitrite The risk or severity of adverse effects can be increased when Amyl Nitrite is combined with Dinutuximab. Anagrelide The risk or severity of bleeding can be increased when Anagrelide is combined with Dinutuximab. Anakinra The risk or severity of adverse effects can be increased when Anakinra is combined with Dinutuximab. Ancrod The risk or severity of bleeding can be increased when Ancrod is combined with Dinutuximab. Anifrolumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Anifrolumab. Anistreplase The risk or severity of bleeding can be increased when Anistreplase is combined with Dinutuximab. Ansuvimab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Ansuvimab. Anthrax immune The therapeutic efficacy of Anthrax immune globulin human can be decreased when used in combination with Dinutuximab. Anthrax vaccine The risk or severity of infection can be increased when Anthrax vaccine is combined with Dinutuximab. Antilymphocyte The risk or severity of adverse effects can be increased when Dinutuximab is combined with Antilymphocyte immunoglobulin (horse). Antithrombin Alfa The risk or severity of bleeding can be increased when Antithrombin Alfa is combined with Dinutuximab. Antithrombin III The risk or severity of bleeding can be increased when Antithrombin III human is combined with Dinutuximab. Antithymocyte The risk or severity of adverse effects can be increased when Antithymocyte immunoglobulin (rabbit) is combined with Dinutuximab. Apixaban The risk or severity of bleeding can be increased when Apixaban is combined with Dinutuximab. Apomorphine The risk or severity of adverse effects can be increased when Apomorphine is combined with Dinutuximab. Apremilast The risk or severity of adverse effects can be increased when Apremilast is combined with Dinutuximab. Ardeparin The risk or severity of bleeding can be increased when Ardeparin is combined with Dinutuximab. Argatroban The risk or severity of bleeding can be increased when Argatroban is combined with Dinutuximab. Aripiprazole Aripiprazole may increase the hypotensive activities of Dinutuximab. Aripiprazole Aripiprazole lauroxil may increase the hypotensive activities of Dinutuximab. Arsenic trioxide The risk or severity of adverse effects can be increased when Arsenic trioxide is combined with Dinutuximab. Articaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Articaine. Asfotase alfa The risk or severity of adverse effects can be increased when Dinutuximab is combined with Asfotase alfa. COVID-19 Vaccine The therapeutic efficacy of AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Dinutuximab. Atenolol The risk or severity of adverse effects can be increased when Atenolol is combined with Dinutuximab. Atezolizumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Atezolizumab. Atoltivimab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Atoltivimab. Avanafil The risk or severity of hypotension can be increased when Avanafil is combined with Dinutuximab. Avelumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Avelumab. Azacitidine The risk or severity of adverse effects can be increased when Azacitidine is combined with Dinutuximab. Azathioprine The risk or severity of adverse effects can be increased when Azathioprine is combined with Dinutuximab. Azilsartan The risk or severity of adverse effects can be increased when Azilsartan medoxomil is combined with Dinutuximab. Bacillus calmette The risk or severity of infection can be increased when Bacillus calmette-guerin substrain connaught live antigen is combined with Dinutuximab. Bacillus antigen The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Dinutuximab. Bacillus The risk or severity of infection can be increased when Bacillus calmette-guerin substrain tice live antigen is combined with Dinutuximab. Bamlanivimab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Bamlanivimab. Baricitinib The risk or severity of adverse effects can be increased when Dinutuximab is combined with Baricitinib. Basiliximab The risk or severity of adverse effects can be increased when Basiliximab is combined with Dinutuximab. BCG vaccine The risk or severity of infection can be increased when BCG vaccine is combined with Dinutuximab. Bebtelovimab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Bebtelovimab. Beclomethasone The risk or severity of adverse effects can be increased when Beclomethasone dipropionate is combined with Dinutuximab. Belantamab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Belantamab mafodotin. Belatacept The risk or severity of adverse effects can be increased when Belatacept is combined with Dinutuximab. Belimumab The risk or severity of adverse effects can be increased when Belimumab is combined with Dinutuximab. Belinostat The risk or severity of adverse effects can be increased when Belinostat is combined with Dinutuximab. Belumosudil The risk or severity of adverse effects can be increased when Dinutuximab is combined with Belumosudil. Bemiparin The risk or severity of bleeding can be increased when Bemiparin is combined with Dinutuximab. Benazepril The risk or severity of adverse effects can be increased when Benazepril is combined with Dinutuximab. Bendamustine The risk or severity of adverse effects can be increased when Bendamustine is combined with Dinutuximab. Bendroflumethiazide The risk or severity of adverse effects can be increased when Bendroflumethiazide is combined with Dinutuximab. Benralizumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Benralizumab. Benzocaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Benzocaine. Benzthiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Benzthiazide is combined with Dinutuximab. Benzyl alcohol The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Benzyl alcohol. Bepridil The risk or severity of adverse effects can be increased when Bepridil is combined with Dinutuximab. Besilesomab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Besilesomab. Betamethasone The risk or severity of adverse effects can be increased when Betamethasone is combined with Dinutuximab. Betaxolol The risk or severity of adverse effects can be increased when Betaxolol is combined with Dinutuximab. Bethanidine Dinutuximab may increase the hypotensive activities of Bethanidine. Betrixaban The risk or severity of bleeding can be increased when Betrixaban is combined with Dinutuximab. Bevacizumab The risk or severity of adverse effects can be increased when Bevacizumab is combined with Dinutuximab. Bexarotene The risk or severity of adverse effects can be increased when Bexarotene is combined with Dinutuximab. Bezlotoxumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Bezlotoxumab. Bimekizumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Bimekizumab. Bisoprolol The risk or severity of adverse effects can be increased when Bisoprolol is combined with Dinutuximab. Bivalirudin The risk or severity of bleeding can be increased when Bivalirudin is combined with Dinutuximab. Bleomycin The risk or severity of adverse effects can be increased when Bleomycin is combined with Dinutuximab. Blinatumomab The risk or severity of adverse effects can be increased when Blinatumomab is combined with Dinutuximab. Bordetella The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Dinutuximab. Bortezomib The risk or severity of adverse effects can be increased when Bortezomib is combined with Dinutuximab. Bosentan Dinutuximab may increase the hypotensive activities of Bosentan. Bosutinib The risk or severity of adverse effects can be increased when Bosutinib is combined with Dinutuximab. Brentuximab vedotin The risk or severity of adverse effects can be increased when Brentuximab vedotin is combined with Dinutuximab. Bretylium The risk or severity of adverse effects can be increased when Bretylium is combined with Dinutuximab. Brodalumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Brodalumab. Brolucizumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Brolucizumab. Bromocriptine The risk or severity of adverse effects can be increased when Bromocriptine is combined with Dinutuximab. Budesonide The risk or severity of adverse effects can be increased when Budesonide is combined with Dinutuximab. Bumetanide The risk or severity of adverse effects can be increased when Bumetanide is combined with Dinutuximab. Bupivacaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Bupivacaine. Burosumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Burosumab. Busulfan The risk or severity of adverse effects can be increased when Busulfan is combined with Dinutuximab. Butabarbital Butabarbital may increase the hypotensive activities of Dinutuximab. Butacaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Butacaine. Butalbital Butalbital may increase the hypotensive activities of Dinutuximab. Butamben The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Butamben. Cabazitaxel The risk or severity of adverse effects can be increased when Cabazitaxel is combined with Dinutuximab. Canagliflozin The risk or severity of adverse effects can be increased when Canagliflozin is combined with Dinutuximab. Canakinumab The risk or severity of adverse effects can be increased when Canakinumab is combined with Dinutuximab. Candesartan cil The risk or severity of adverse effects can be increased when Candesartan cilexetil is combined with Dinutuximab. Cangrelor The risk or severity of bleeding can be increased when Cangrelor is combined with Dinutuximab. Capecitabine The risk or severity of adverse effects can be increased when Capecitabine is combined with Dinutuximab. Caplacizumab The risk or severity of bleeding can be increased when Caplacizumab is combined with Dinutuximab. Capromab pend The risk or severity of adverse effects can be increased when Capromab pendetide is combined with Dinutuximab. Capsaicin The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Capsaicin. Captopril The risk or severity of adverse effects can be increased when Captopril is combined with Dinutuximab. Carbamazepine The risk or severity of adverse effects can be increased when Carbamazepine is combined with Dinutuximab. Carbetocin The risk or severity of adverse effects can be increased when Carbetocin is combined with Dinutuximab. Carboplatin The risk or severity of adverse effects can be increased when Carboplatin is combined with Dinutuximab. Carfilzomib The risk or severity of adverse effects can be increased when Carfilzomib is combined with Dinutuximab. Carmustine The risk or severity of adverse effects can be increased when Carmustine is combined with Dinutuximab. Carvedilol The risk or severity of adverse effects can be increased when Carvedilol is combined with Dinutuximab. Casirivimab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Casirivimab. Catumaxomab The risk or severity of adverse effects can be increased when Catumaxomab is combined with Dinutuximab. Celiprolol Dinutuximab may increase the hypotensive activities of Celiprolol. Cemiplimab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Cemiplimab. Certolizumab pegol The risk or severity of adverse effects can be increased when Certolizumab pegol is combined with Dinutuximab. Cetuximab The risk or severity of adverse effects can be increased when Cetuximab is combined with Dinutuximab. Chlorambucil The risk or severity of adverse effects can be increased when Chlorambucil is combined with Dinutuximab. Chloramphenicol The risk or severity of adverse effects can be increased when Chloramphenicol is combined with Dinutuximab. Chloroprocaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Chloroprocaine. Chlorothiazide The risk or severity of adverse effects can be increased when Chlorothiazide is combined with Dinutuximab. Chlorpromazine The risk or severity of adverse effects can be increased when Chlorpromazine is combined with Dinutuximab. Chlorthalidone The risk or severity of adverse effects can be increased when Chlorthalidone is combined with Dinutuximab. Ciclesonide The risk or severity of adverse effects can be increased when Ciclesonide is combined with Dinutuximab. Cilazapril The risk or severity of adverse effects can be increased when Cilazapril is combined with Dinutuximab. Cilgavimab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Cilgavimab. Cilostazol The risk or severity of bleeding can be increased when Cilostazol is combined with Dinutuximab. Cinchocaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Cinchocaine. Cisplatin The risk or severity of adverse effects can be increased when Cisplatin is combined with Dinutuximab. Cladribine The risk or severity of adverse effects can be increased when Cladribine is combined with Dinutuximab. Clevidipine The risk or severity of adverse effects can be increased when Clevidipine is combined with Dinutuximab. Clobetasol propionate The risk or severity of adverse effects can be increased when Clobetasol propionate is combined with Dinutuximab. Clofarabine The risk or severity of adverse effects can be increased when Clofarabine is combined with Dinutuximab. Clomipramine The risk or severity of adverse effects can be increased when Clomipramine is combined with Dinutuximab. Clonidine The risk or severity of adverse effects can be increased when Clonidine is combined with Dinutuximab. Clopidogrel The risk or severity of bleeding can be increased when Clopidogrel is combined with Dinutuximab. Clostridium The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Dinutuximab. Clozapine The risk or severity of neutropenia can be increased when Dinutuximab is combined with Clozapine. Cocaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Cocaine. Conivaptan The risk or severity of adverse effects can be increased when Conivaptan is combined with Dinutuximab. Conjugated Conjugated estrogens may increase the thrombogenic activities of Dinutuximab. Corticotropin The risk or severity of adverse effects can be increased when Corticotropin is combined with Dinutuximab. Cortisone acetate The risk or severity of adverse effects can be increased when Cortisone acetate is combined with Dinutuximab. Corynebacterium The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Dinutuximab. Cryptenamine Dinutuximab may increase the hypotensive activities of Cryptenamine. Cyanocobalamin The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Dinutuximab. Cyclopenthiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclopenthiazide is combined with Dinutuximab. Cyclophosphamide The risk or severity of adverse effects can be increased when Cyclophosphamide is combined with Dinutuximab. Cyclosporine Dinutuximab may increase the immunosuppressive activities of Cyclosporine. Cyclothiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclothiazide is combined with Dinutuximab. Cytarabine The risk or severity of adverse effects can be increased when Cytarabine is combined with Dinutuximab. Dabigatran The risk or severity of bleeding can be increased when Dabigatran is combined with Dinutuximab. Dabigatran etexilate The risk or severity of bleeding can be increased when Dabigatran etexilate is combined with Dinutuximab. Dacarbazine The risk or severity of adverse effects can be increased when Dacarbazine is combined with Dinutuximab. Dactinomycin The risk or severity of adverse effects can be increased when Dactinomycin is combined with Dinutuximab. Dalteparin The risk or severity of bleeding can be increased when Dalteparin is combined with Dinutuximab. Danaparoid The risk or severity of bleeding can be increased when Danaparoid is combined with Dinutuximab. Dapagliflozin The risk or severity of adverse effects can be increased when Dapagliflozin is combined with Dinutuximab. Daratumumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Daratumumab. Darbepoetin alfa The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Dinutuximab. Dasatinib The risk or severity of adverse effects can be increased when Dasatinib is combined with Dinutuximab. Dasiglucagon Dinutuximab may increase the hypotensive activities of Dasiglucagon. Daunorubicin The risk or severity of adverse effects can be increased when Daunorubicin is combined with Dinutuximab. Debrisoquine Dinutuximab may increase the hypotensive activities of Debrisoquine. Decitabine The risk or severity of adverse effects can be increased when Decitabine is combined with Dinutuximab. Defibrotide The risk or severity of bleeding can be increased when Defibrotide is combined with Dinutuximab. Deflazacort The risk or severity of adverse effects can be increased when Dinutuximab is combined with Deflazacort. Denosumab The risk or severity of adverse effects can be increased when Denosumab is combined with Dinutuximab. Deserpidine Dinutuximab may increase the hypotensive activities of Deserpidine. Desflurane The risk or severity of adverse effects can be increased when Desflurane is combined with Dinutuximab. Desirudin The risk or severity of bleeding can be increased when Desirudin is combined with Dinutuximab. Desoximetasone The risk or severity of adverse effects can be increased when Desoximetasone is combined with Dinutuximab. Deucravacitinib The risk or severity of adverse effects can be increased when Dinutuximab is combined with Deucravacitinib. Dexamethasone The risk or severity of adverse effects can be increased when Dexamethasone is combined with Dinutuximab. Dexmedetomidine The risk or severity of adverse effects can be increased when Dexmedetomidine is combined with Dinutuximab. Dexrazoxane The risk or severity of adverse effects can be increased when Dexrazoxane is combined with Dinutuximab. Dextran The risk or severity of bleeding can be increased when Dextran is combined with Dinutuximab. Diazoxide The risk or severity of adverse effects can be increased when Diazoxide is combined with Dinutuximab. Diclofenamide The risk or severity of adverse effects can be increased when Diclofenamide is combined with Dinutuximab. Dicoumarol The risk or severity of bleeding can be increased when Dicoumarol is combined with Dinutuximab. Dienestrol Dienestrol may increase the thrombogenic activities of Dinutuximab. Diethylstilbestrol Diethylstilbestrol may increase the thrombogenic activities of Dinutuximab. Difluocortolone The risk or severity of adverse effects can be increased when Dinutuximab is combined with Difluocortolone. Docetaxel The risk or severity of adverse effects can be increased when Docetaxel is combined with Dinutuximab. Dostarlimab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Dostarlimab. Doxazosin The risk or severity of adverse effects can be increased when Doxazosin is combined with Dinutuximab. Doxorubicin The risk or severity of adverse effects can be increased when Doxorubicin is combined with Dinutuximab. Drotrecogin alfa The risk or severity of bleeding can be increased when Drotrecogin alfa is combined with Dinutuximab. Dulaglutide The risk or severity of adverse effects can be increased when Dulaglutide is combined with Dinutuximab. Duloxetine The risk or severity of orthostatic hypotension and syncope can be increased when Dinutuximab is combined with Duloxetine. Dupilumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Dupilumab. Durvalumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Durvalumab. Dyclonine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Dyclonine. Ebola Zaire vacci The therapeutic efficacy of Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Dinutuximab. Eculizumab The risk or severity of adverse effects can be increased when Eculizumab is combined with Dinutuximab. Edetic acid The risk or severity of bleeding can be increased when Edetic acid is combined with Dinutuximab. Edoxaban The risk or severity of bleeding can be increased when Edoxaban is combined with Dinutuximab. Efalizumab The risk or severity of adverse effects can be increased when Efalizumab is combined with Dinutuximab. Eflapegrastim The risk or severity of adverse effects can be increased when Dinutuximab is combined with Eflapegrastim. Eftrenonacog alfa The risk or severity of adverse effects can be increased when Dinutuximab is combined with Eftrenonacog alfa. Elotuzumab The risk or severity of adverse effects can be increased when Elotuzumab is combined with Dinutuximab. Emapalumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Emapalumab. Emicizumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Emicizumab. Empagliflozin The risk or severity of adverse effects can be increased when Empagliflozin is combined with Dinutuximab. Enalapril The risk or severity of adverse effects can be increased when Enalapril is combined with Dinutuximab. Enalaprilat The risk or severity of adverse effects can be increased when Dinutuximab is combined with Enalaprilat. Enoxaparin The risk or severity of bleeding can be increased when Enoxaparin is combined with Dinutuximab. Epirubicin The risk or severity of adverse effects can be increased when Epirubicin is combined with Dinutuximab. Eplerenone The risk or severity of adverse effects can be increased when Eplerenone is combined with Dinutuximab. Epoprostenol The risk or severity of adverse effects can be increased when Epoprostenol is combined with Dinutuximab. Eprosartan The risk or severity of adverse effects can be increased when Eprosartan is combined with Dinutuximab. Eptifibatide The risk or severity of bleeding can be increased when Eptifibatide is combined with Dinutuximab. Eptinezumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Eptinezumab. Erenumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Erenumab. Eribulin The risk or severity of adverse effects can be increased when Eribulin is combined with Dinutuximab. Erythropoietin The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Dinutuximab. Esmolol The risk or severity of adverse effects can be increased when Esmolol is combined with Dinutuximab. Esterified estrogens Esterified estrogens may increase the thrombogenic activities of Dinutuximab. Estetrol Estetrol may increase the thrombogenic activities of Dinutuximab. Estradiol Estradiol may increase the thrombogenic activities of Dinutuximab. Estradiol acetate Estradiol acetate may increase the thrombogenic activities of Dinutuximab. Estradiol benzoate Estradiol benzoate may increase the thrombogenic activities of Dinutuximab. Estradiol cypionate Estradiol cypionate may increase the thrombogenic activities of Dinutuximab. Estradiol valerate Estradiol valerate may increase the thrombogenic activities of Dinutuximab. Estramustine The risk or severity of adverse effects can be increased when Estramustine is combined with Dinutuximab. Estriol Estriol may increase the thrombogenic activities of Dinutuximab. Estrone Estrone may increase the thrombogenic activities of Dinutuximab. Estrone sulfate Estrone sulfate may increase the thrombogenic activities of Dinutuximab. Etacrynic acid The risk or severity of adverse effects can be increased when Etacrynic acid is combined with Dinutuximab. Etanercept The risk or severity of adverse effects can be increased when Etanercept is combined with Dinutuximab. Ethanol Ethanol may increase the hypotensive activities of Dinutuximab. Ethinylestradiol Ethinylestradiol may increase the thrombogenic activities of Dinutuximab. Ethyl chloride The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Ethyl chloride. Etidocaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Etidocaine. Etoposide The risk or severity of adverse effects can be increased when Etoposide is combined with Dinutuximab. Everolimus The risk or severity of adverse effects can be increased when Everolimus is combined with Dinutuximab. Evolocumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Evolocumab. Famtozinameran The therapeutic efficacy of Famtozinameran can be decreased when used in combination with Dinutuximab. Fanolesomab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Fanolesomab. Felodipine The risk or severity of adverse effects can be increased when Felodipine is combined with Dinutuximab. Fenoldopam The risk or severity of adverse effects can be increased when Fenoldopam is combined with Dinutuximab. Filgotinib The risk or severity of adverse effects can be increased when Dinutuximab is combined with Filgotinib. Fingolimod Dinutuximab may increase the immunosuppressive activities of Fingolimod. Floxuridine The risk or severity of adverse effects can be increased when Floxuridine is combined with Dinutuximab. Flucytosine The risk or severity of adverse effects can be increased when Flucytosine is combined with Dinutuximab. Fludarabine The risk or severity of adverse effects can be increased when Fludarabine is combined with Dinutuximab. Fludrocortisone The risk or severity of adverse effects can be increased when Fludrocortisone is combined with Dinutuximab. Fluindione The risk or severity of bleeding can be increased when Fluindione is combined with Dinutuximab. Flunisolide The risk or severity of adverse effects can be increased when Flunisolide is combined with Dinutuximab. Fluocinolone The risk or severity of adverse effects can be increased when Fluocinolone acetonide is combined with Dinutuximab. Fluocinonide The risk or severity of adverse effects can be increased when Fluocinonide is combined with Dinutuximab. Fluocortolone The risk or severity of adverse effects can be increased when Fluocortolone is combined with Dinutuximab. Fluorometholone The risk or severity of adverse effects can be increased when Fluorometholone is combined with Dinutuximab. Fluorouracil The risk or severity of adverse effects can be increased when Fluorouracil is combined with Dinutuximab. Flupentixol The risk or severity of myelosuppression can be increased when Flupentixol is combined with Dinutuximab. Fluprednisolone The risk or severity of adverse effects can be increased when Dinutuximab is combined with Fluprednisolone. Fluticasone The risk or severity of adverse effects can be increased when Dinutuximab is combined with Fluticasone. Fluticasone furoate The risk or severity of adverse effects can be increased when Fluticasone furoate is combined with Dinutuximab. Fluticasone The risk or severity of adverse effects can be increased when Fluticasone propionate is combined with Dinutuximab. Fondaparinux The risk or severity of bleeding can be increased when Fondaparinux is combined with Dinutuximab. Fosinopril The risk or severity of adverse effects can be increased when Fosinopril is combined with Dinutuximab. Fostamatinib The risk or severity of hypotension can be increased when Fostamatinib is combined with Dinutuximab. Fremanezumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Fremanezumab. Furosemide The risk or severity of adverse effects can be increased when Furosemide is combined with Dinutuximab. Galcanezumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Galcanezumab. Gallium nitrate The risk or severity of adverse effects can be increased when Gallium nitrate is combined with Dinutuximab. Gemcitabine The risk or severity of adverse effects can be increased when Gemcitabine is combined with Dinutuximab. Gemtuzumab The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Dinutuximab. Glatiramer The risk or severity of adverse effects can be increased when Glatiramer is combined with Dinutuximab. Golimumab The risk or severity of adverse effects can be increased when Golimumab is combined with Dinutuximab. Guanabenz Dinutuximab may increase the hypotensive activities of Guanabenz. Guanadrel Dinutuximab may increase the hypotensive activities of Guanadrel. Guanethidine Dinutuximab may increase the hypotensive activities of Guanethidine. Guanfacine The risk or severity of adverse effects can be increased when Guanfacine is combined with Dinutuximab. Guanoxan Dinutuximab may increase the hypotensive activities of Guanoxan. Guselkumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Guselkumab. Hydrocortisone The risk or severity of adverse effects can be increased when Dinutuximab is combined with Hydrocortisone succinate. Hydroflumethiazide The risk or severity of adverse effects can be increased when Hydroflumethiazide is combined with Dinutuximab. Hydroxychloroquine The risk or severity of adverse effects can be increased when Hydroxychloroquine is combined with Dinutuximab. Hydroxyurea The risk or severity of adverse effects can be increased when Hydroxyurea is combined with Dinutuximab. Ibalizumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Ibalizumab. Ibritumomab tiuxetan The risk or severity of adverse effects can be increased when Ibritumomab tiuxetan is combined with Dinutuximab. Ibrutinib The risk or severity of adverse effects can be increased when Ibrutinib is combined with Dinutuximab. Icosapent ethyl The risk or severity of bleeding can be increased when Icosapent ethyl is combined with Dinutuximab. Idarubicin The risk or severity of adverse effects can be increased when Idarubicin is combined with Dinutuximab. Idarucizumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Idarucizumab. Idelalisib The risk or severity of adverse effects can be increased when Idelalisib is combined with Dinutuximab. Ifosfamide The risk or severity of adverse effects can be increased when Ifosfamide is combined with Dinutuximab. Iloprost The risk or severity of adverse effects can be increased when Iloprost is combined with Dinutuximab. Imatinib The risk or severity of adverse effects can be increased when Imatinib is combined with Dinutuximab. Imdevimab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Imdevimab. Imipramine The risk or severity of adverse effects can be increased when Imipramine is combined with Dinutuximab. Imlifidase The therapeutic efficacy of Dinutuximab can be decreased when used in combination with Imlifidase. Indapamide The risk or severity of adverse effects can be increased when Indapamide is combined with Dinutuximab. Indomethacin The risk or severity of adverse effects can be increased when Indomethacin is combined with Dinutuximab. Indoramin The risk or severity of adverse effects can be increased when Indoramin is combined with Dinutuximab. Inebilizumab The risk or severity of infection can be increased when Dinutuximab is combined with Inebilizumab. Infliximab The risk or severity of adverse effects can be increased when Infliximab is combined with Dinutuximab. Labetalol The risk or severity of adverse effects can be increased when Labetalol is combined with Dinutuximab. Lacidipine Dinutuximab may increase the hypotensive activities of Lacidipine. Lanadelumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Lanadelumab. Leflunomide The risk or severity of adverse effects can be increased when Dinutuximab is combined with Leflunomide. Lenalidomide The risk or severity of adverse effects can be increased when Lenalidomide is combined with Dinutuximab. Lepirudin The risk or severity of bleeding can be increased when Lepirudin is combined with Dinutuximab. Lercanidipine The risk or severity of adverse effects can be increased when Lercanidipine is combined with Dinutuximab. Levamlodipine Dinutuximab may increase the hypotensive activities of Levamlodipine. Levobupivacaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Levobupivacaine. Levodopa The risk or severity of hypotension and orthostatic hypotension can be increased when Dinutuximab is combined with Levodopa. Levosimendan The risk or severity of adverse effects can be increased when Levosimendan is combined with Dinutuximab. Lidocaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Lidocaine. Linezolid The risk or severity of adverse effects can be increased when Linezolid is combined with Dinutuximab. Lipegfilgrastim Dinutuximab may increase the myelosuppressive activities of Lipegfilgrastim. Lisinopril The risk or severity of adverse effects can be increased when Lisinopril is combined with Dinutuximab. Lofexidine The risk or severity of adverse effects can be increased when Lofexidine is combined with Dinutuximab. Lomustine The risk or severity of adverse effects can be increased when Lomustine is combined with Dinutuximab. Loncastuximab tesirine The risk or severity of adverse effects can be increased when Dinutuximab is combined with Loncastuximab tesirine. Lopinavir The serum concentration of Dinutuximab can be increased when it is combined with Lopinavir. Losartan The risk or severity of adverse effects can be increased when Losartan is combined with Dinutuximab. Macitentan Dinutuximab may increase the hypotensive activities of Macitentan. Maftivimab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Maftivimab. Magnesium The serum concentration of Magnesium can be decreased when it is combined with Dinutuximab. Manidipine Dinutuximab may increase the hypotensive activities of Manidipine. Mannitol The risk or severity of adverse effects can be increased when Mannitol is combined with Dinutuximab. Margetuximab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Margetuximab. Measles The therapeutic efficacy of Measles virus vaccine live attenuated can be decreased when used in combination with Dinutuximab. Mecamylamine The risk or severity of adverse effects can be increased when Mecamylamine is combined with Dinutuximab. Mepivacaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Mepivacaine. Mepolizumab The risk or severity of adverse effects can be increased when Mepolizumab is combined with Dinutuximab. Meprednisone The risk or severity of adverse effects can be increased when Dinutuximab is combined with Meprednisone. Mercaptopurine The risk or severity of adverse effects can be increased when Mercaptopurine is combined with Dinutuximab. Mestranol Mestranol may increase the thrombogenic activities of Dinutuximab. Methazolamide The risk or severity of adverse effects can be increased when Methazolamide is combined with Dinutuximab. Methimazole The risk or severity of adverse effects can be increased when Methimazole is combined with Dinutuximab. Methohexital Methohexital may increase the hypotensive activities of Dinutuximab. Methotrexate The risk or severity of adverse effects can be increased when Methotrexate is combined with Dinutuximab. Methoxy The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Dinutuximab. Methyldopa The risk or severity of adverse effects can be increased when Methyldopa is combined with Dinutuximab. Methylene blue Methylene blue may increase the orthostatic hypotensive activities of Dinutuximab. Methylphenobarbital Methylphenobarbital may increase the hypotensive activities of Dinutuximab. Methylprednisolone The risk or severity of adverse effects can be increased when Methylprednisolone is combined with Dinutuximab. Metolazone The risk or severity of adverse effects can be increased when Metolazone is combined with Dinutuximab. Metoprolol The risk or severity of adverse effects can be increased when Metoprolol is combined with Dinutuximab. Metyrosine Dinutuximab may increase the hypotensive activities of Metyrosine. Minaprine Minaprine may increase the orthostatic hypotensive activities of Dinutuximab. Minoxidil The risk or severity of adverse effects can be increased when Minoxidil is combined with Dinutuximab. Mirvetuximab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Mirvetuximab Soravtansine. Mitomycin The risk or severity of adverse effects can be increased when Mitomycin is combined with Dinutuximab. Mitoxantrone The risk or severity of adverse effects can be increased when Mitoxantrone is combined with Dinutuximab. Moclobemide Moclobemide may increase the orthostatic hypotensive activities of Dinutuximab. COVID-19 Vaccine The therapeutic efficacy of Moderna COVID-19 Vaccine can be decreased when used in combination with Dinutuximab. Modified vaccinia The therapeutic efficacy of Modified vaccinia ankara can be decreased when used in combination with Dinutuximab. Moexipril The risk or severity of adverse effects can be increased when Moexipril is combined with Dinutuximab. Mogamulizumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Mogamulizumab. Mometasone furoate The risk or severity of adverse effects can be increased when Dinutuximab is combined with Mometasone furoate. Monomethyl f The risk or severity of adverse effects can be increased when Dinutuximab is combined with Monomethyl fumarate. Morphine The risk or severity of adverse effects can be increased when Morphine is combined with Dinutuximab. Mosunetuzumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Mosunetuzumab. Moxonidine The risk or severity of adverse effects can be increased when Dinutuximab is combined with Moxonidine. Mumps virus The therapeutic efficacy of Mumps virus strain B level jeryl lynn live antigen can be decreased when used in combination with Dinutuximab. Muromonab The risk or severity of adverse effects can be increased when Muromonab is combined with Dinutuximab. Muzolimine Dinutuximab may increase the hypotensive activities of Muzolimine. Mycophenolate The risk or severity of adverse effects can be increased when Mycophenolate mofetil is combined with Dinutuximab. Mycophenolic acid The risk or severity of adverse effects can be increased when Mycophenolic acid is combined with Dinutuximab. Nabilone The risk or severity of adverse effects can be increased when Nabilone is combined with Dinutuximab. Nadolol The risk or severity of adverse effects can be increased when Nadolol is combined with Dinutuximab. Nadroparin The risk or severity of bleeding can be increased when Nadroparin is combined with Dinutuximab. Natalizumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Natalizumab. Nebivolol The risk or severity of adverse effects can be increased when Nebivolol is combined with Dinutuximab. Necitumumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Necitumumab. Nelarabine The risk or severity of adverse effects can be increased when Nelarabine is combined with Dinutuximab. Nesiritide The risk or severity of adverse effects can be increased when Nesiritide is combined with Dinutuximab. Nialamide Nialamide may increase the orthostatic hypotensive activities of Dinutuximab. Nicardipine The risk or severity of adverse effects can be increased when Nicardipine is combined with Dinutuximab. Nicorandil Nicorandil may increase the hypotensive activities of Dinutuximab. Nifedipine The risk or severity of adverse effects can be increased when Nifedipine is combined with Dinutuximab. Nilotinib The risk or severity of adverse effects can be increased when Nilotinib is combined with Dinutuximab. Nilvadipine The risk or severity of adverse effects can be increased when Nilvadipine is combined with Dinutuximab. Nimesulide The risk or severity of bleeding can be increased when Nimesulide is combined with Dinutuximab. Nimodipine The risk or severity of adverse effects can be increased when Nimodipine is combined with Dinutuximab. Nisoldipine The risk or severity of adverse effects can be increased when Nisoldipine is combined with Dinutuximab. Nitrendipine The risk or severity of adverse effects can be increased when Nitrendipine is combined with Dinutuximab. Nitric Oxide The risk or severity of adverse effects can be increased when Nitric Oxide is combined with Dinutuximab. Nitroglycerin The risk or severity of adverse effects can be increased when Nitroglycerin is combined with Dinutuximab. Nitroprusside The risk or severity of adverse effects can be increased when Nitroprusside is combined with Dinutuximab. Nitrous acid The risk or severity of adverse effects can be increased when Dinutuximab is combined with Nitrous acid. Nivolumab The risk or severity of adverse effects can be increased when Nivolumab is combined with Dinutuximab. Nuvaxovid The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Dinutuximab. Obiltoxaximab The risk or severity of adverse effects can be increased when Obiltoxaximab is combined with Dinutuximab. Obinutuzumab The risk or severity of adverse effects can be increased when Obinutuzumab is combined with Dinutuximab. Ocrelizumab Ocrelizumab may increase the immunosuppressive activities of Dinutuximab. Odesivimab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Odesivimab. Ofatumumab The risk or severity of adverse effects can be increased when Ofatumumab is combined with Dinutuximab. Olanzapine The risk or severity of adverse effects can be increased when Olanzapine is combined with Dinutuximab. Olaparib The risk or severity of adverse effects can be increased when Olaparib is combined with Dinutuximab. Olaratumab The risk or severity of adverse effects can be increased when Olaratumab is combined with Dinutuximab. Olmesartan The risk or severity of adverse effects can be increased when Olmesartan is combined with Dinutuximab. Omalizumab The risk or severity of adverse effects can be increased when Omalizumab is combined with Dinutuximab. Opicapone The risk or severity of adverse effects can be increased when Dinutuximab is combined with Opicapone. Oxaliplatin The risk or severity of adverse effects can be increased when Oxaliplatin is combined with Dinutuximab. Oxetacaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Oxetacaine. Oxprenolol The risk or severity of adverse effects can be increased when Oxprenolol is combined with Dinutuximab. Oxybuprocaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Oxybuprocaine. Ozanimod The risk or severity of adverse effects can be increased when Dinutuximab is combined with Ozanimod. Paclitaxel The risk or severity of adverse effects can be increased when Paclitaxel is combined with Dinutuximab. Palbociclib The risk or severity of adverse effects can be increased when Palbociclib is combined with Dinutuximab. Palifermin The therapeutic efficacy of Palifermin can be decreased when used in combination with Dinutuximab. Palivizumab The risk or severity of adverse effects can be increased when Palivizumab is combined with Dinutuximab. Panitumumab The risk or severity of adverse effects can be increased when Panitumumab is combined with Dinutuximab. Panobinostat The risk or severity of adverse effects can be increased when Panobinostat is combined with Dinutuximab. Papaverine The risk or severity of adverse effects can be increased when Papaverine is combined with Dinutuximab. Pargyline Pargyline may increase the orthostatic hypotensive activities of Dinutuximab. Parnaparin The risk or severity of bleeding can be increased when Parnaparin is combined with Dinutuximab. Pazopanib The risk or severity of adverse effects can be increased when Pazopanib is combined with Dinutuximab. Pegaspargase The risk or severity of adverse effects can be increased when Pegaspargase is combined with Dinutuximab. Pegcetacoplan The risk or severity of adverse effects can be increased when Dinutuximab is combined with Pegcetacoplan. Peginesatide The risk or severity of Thrombosis can be increased when Peginesatide is combined with Dinutuximab. Peginterferon alfa-2a The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Dinutuximab. Peginterferon alfa- The risk or severity of adverse effects can be increased when Peginterferon alfa-2b is combined with Dinutuximab. Peginterferon beta The risk or severity of adverse effects can be increased when Dinutuximab is combined with Peginterferon beta-1a. Pembrolizumab The risk or severity of adverse effects can be increased when Pembrolizumab is combined with Dinutuximab. Pemetrexed The risk or severity of adverse effects can be increased when Pemetrexed is combined with Dinutuximab. Penbutolol The risk or severity of adverse effects can be increased when Penbutolol is combined with Dinutuximab. Penicillamine The risk or severity of adverse effects can be increased when Penicillamine is combined with Dinutuximab. Pentobarbital Pentobarbital may increase the hypotensive activities of Dinutuximab. Pentolinium Dinutuximab may increase the hypotensive activities of Pentolinium. Pentosan The risk or severity of bleeding can be increased when Pentosan polysulfate is combined with Dinutuximab. Pentostatin The risk or severity of adverse effects can be increased when Pentostatin is combined with Dinutuximab. Pentoxifylline The risk or severity of bleeding can be increased when Pentoxifylline is combined with Dinutuximab. Perindopril The risk or severity of adverse effects can be increased when Perindopril is combined with Dinutuximab. Pertussis vaccine The therapeutic efficacy of Pertussis vaccine can be decreased when used in combination with Dinutuximab. Pertuzumab The risk or severity of adverse effects can be increased when Pertuzumab is combined with Dinutuximab. Phenelzine Phenelzine may increase the orthostatic hypotensive activities of Dinutuximab. Phenindione The risk or severity of bleeding can be increased when Phenindione is combined with Dinutuximab. Phenobarbital Phenobarbital may increase the hypotensive activities of Dinutuximab. Phenol The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Phenol. Phenoxybenzamine The risk or severity of adverse effects can be increased when Phenoxybenzamine is combined with Dinutuximab. Phenprocoumon The risk or severity of bleeding can be increased when Phenprocoumon is combined with Dinutuximab. Phentolamine The risk or severity of adverse effects can be increased when Phentolamine is combined with Dinutuximab. Phenylalanine The risk or severity of adverse effects can be increased when Phenylalanine is combined with Dinutuximab. Pimecrolimus The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Dinutuximab. Pinacidil Dinutuximab may increase the hypotensive activities of Pinacidil. Pindolol The risk or severity of adverse effects can be increased when Pindolol is combined with Dinutuximab. Pirfenidone The risk or severity of adverse effects can be increased when Pirfenidone is combined with Dinutuximab. Polatuzumab vedotin The risk or severity of adverse effects can be increased when Dinutuximab is combined with Polatuzumab vedotin. Polyestradiol Polyestradiol phosphate may increase the thrombogenic activities of Dinutuximab. Polythiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Polythiazide is combined with Dinutuximab. Pomalidomide The risk or severity of adverse effects can be increased when Pomalidomide is combined with Dinutuximab. Ponatinib The risk or severity of adverse effects can be increased when Ponatinib is combined with Dinutuximab. Ponesimod The risk or severity of adverse effects can be increased when Dinutuximab is combined with Ponesimod. Practolol Dinutuximab may increase the hypotensive activities of Practolol. Pralatrexate The risk or severity of adverse effects can be increased when Pralatrexate is combined with Dinutuximab. Pramipexole The risk or severity of adverse effects can be increased when Pramipexole is combined with Dinutuximab. Pramocaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Pramocaine. Prasugrel The risk or severity of bleeding can be increased when Prasugrel is combined with Dinutuximab. Prazosin The risk or severity of adverse effects can be increased when Prazosin is combined with Dinutuximab. Prednisolone The risk or severity of adverse effects can be increased when Prednisolone is combined with Dinutuximab. Prednisone The risk or severity of adverse effects can be increased when Prednisone is combined with Dinutuximab. Prilocaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Prilocaine. Primidone Primidone may increase the hypotensive activities of Dinutuximab. Procaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Procaine. Procarbazine The risk or severity of adverse effects can be increased when Procarbazine is combined with Dinutuximab. Proparacaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Proparacaine. Propofol The risk or severity of adverse effects can be increased when Propofol is combined with Dinutuximab. Propoxycaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Propoxycaine. Propranolol The risk or severity of adverse effects can be increased when Propranolol is combined with Dinutuximab. Propylthiouracil The risk or severity of adverse effects can be increased when Propylthiouracil is combined with Dinutuximab. Protein C The risk or severity of bleeding can be increased when Protein C is combined with Dinutuximab. Protein S human The risk or severity of bleeding can be increased when Protein S human is combined with Dinutuximab. Quetiapine The risk or severity of adverse effects can be increased when Quetiapine is combined with Dinutuximab. Quinapril The risk or severity of adverse effects can be increased when Quinapril is combined with Dinutuximab. Quinestrol Quinestrol may increase the thrombogenic activities of Dinutuximab. Rabies immune The therapeutic efficacy of Rabies immune globulin, human can be decreased when used in combination with Dinutuximab. Rabies antigen, A The therapeutic efficacy of Rabies virus inactivated antigen, A can be decreased when used in combination with Dinutuximab. Rabies antigen, B The therapeutic efficacy of Rabies virus inactivated antigen, B can be decreased when used in combination with Dinutuximab. Raltitrexed The risk or severity of adverse effects can be increased when Raltitrexed is combined with Dinutuximab. Ramipril The risk or severity of adverse effects can be increased when Ramipril is combined with Dinutuximab. Ramucirumab The risk or severity of adverse effects can be increased when Ramucirumab is combined with Dinutuximab. Ranibizumab The risk or severity of adverse effects can be increased when Ranibizumab is combined with Dinutuximab. Rasagiline Rasagiline may increase the orthostatic hypotensive activities of Dinutuximab. Ravulizumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Ravulizumab. Raxibacumab The risk or severity of adverse effects can be increased when Raxibacumab is combined with Dinutuximab. Remifentanil The risk or severity of adverse effects can be increased when Remifentanil is combined with Dinutuximab. Rescinnamine Dinutuximab may increase the hypotensive activities of Rescinnamine. Reserpine The risk or severity of adverse effects can be increased when Reserpine is combined with Dinutuximab. Reslizumab The risk or severity of adverse effects can be increased when Reslizumab is combined with Dinutuximab. Reteplase The risk or severity of bleeding can be increased when Reteplase is combined with Dinutuximab. Reviparin The risk or severity of bleeding can be increased when Reviparin is combined with Dinutuximab. Rilmenidine Dinutuximab may increase the hypotensive activities of Rilmenidine. Rilonacept The risk or severity of adverse effects can be increased when Rilonacept is combined with Dinutuximab. Riociguat The risk or severity of adverse effects can be increased when Riociguat is combined with Dinutuximab. Risankizumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Risankizumab. Risperidone Dinutuximab may increase the hypotensive activities of Risperidone. Rituximab The risk or severity of adverse effects can be increased when Rituximab is combined with Dinutuximab. Rivaroxaban The risk or severity of bleeding can be increased when Rivaroxaban is combined with Dinutuximab. Roflumilast Roflumilast may increase the immunosuppressive activities of Dinutuximab. Romosozumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Romosozumab. Ropeginterferon The risk or severity of adverse effects can be increased when Dinutuximab is combined with Ropeginterferon alfa-2b. Ropinirole The risk or severity of adverse effects can be increased when Ropinirole is combined with Dinutuximab. Ropivacaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Ropivacaine. Rotavirus vaccine The therapeutic efficacy of Rotavirus vaccine can be decreased when used in combination with Dinutuximab. Rotigotine The risk or severity of adverse effects can be increased when Rotigotine is combined with Dinutuximab. Rubella virus The risk or severity of infection can be increased when Rubella virus vaccine is combined with Dinutuximab. Ruxolitinib The risk or severity of adverse effects can be increased when Ruxolitinib is combined with Dinutuximab. Sacituzumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Sacituzumab govitecan. Sacubitril The risk or severity of adverse effects can be increased when Dinutuximab is combined with Sacubitril. Safinamide Safinamide may increase the orthostatic hypotensive activities of Dinutuximab. Sarilumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Sarilumab. Satralizumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Satralizumab. Secobarbital Secobarbital may increase the hypotensive activities of Dinutuximab. Secukinumab The risk or severity of adverse effects can be increased when Secukinumab is combined with Dinutuximab. Selegiline Selegiline may increase the orthostatic hypotensive activities of Dinutuximab. Selexipag Dinutuximab may increase the hypotensive activities of Selexipag. Sevoflurane The risk or severity of adverse effects can be increased when Sevoflurane is combined with Dinutuximab. Sildenafil The risk or severity of hypotension can be increased when Sildenafil is combined with Dinutuximab. Siltuximab The risk or severity of adverse effects can be increased when Siltuximab is combined with Dinutuximab. Siponimod The risk or severity of adverse effects can be increased when Dinutuximab is combined with Siponimod. Sipuleucel-T The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Dinutuximab. Sirolimus The risk or severity of adverse effects can be increased when Sirolimus is combined with Dinutuximab. Sitaxentan Dinutuximab may increase the hypotensive activities of Sitaxentan. Smallpox The therapeutic efficacy of Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Dinutuximab. Sodium citrate The risk or severity of bleeding can be increased when Sodium citrate is combined with Dinutuximab. Sorafenib The risk or severity of adverse effects can be increased when Sorafenib is combined with Dinutuximab. Sotalol The risk or severity of adverse effects can be increased when Sotalol is combined with Dinutuximab. Sotrovimab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Sotrovimab. Spesolimab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Spesolimab. Spirapril Dinutuximab may increase the hypotensive activities of Spirapril. Spironolactone The risk or severity of adverse effects can be increased when Spironolactone is combined with Dinutuximab. Streptokinase The risk or severity of adverse effects can be increased when Streptokinase is combined with Dinutuximab. Streptozocin The risk or severity of adverse effects can be increased when Streptozocin is combined with Dinutuximab. Sufentanil The risk or severity of adverse effects can be increased when Sufentanil is combined with Dinutuximab. Sulesomab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Sulesomab. Sulfamethoxazole The risk or severity of myelosuppression can be increased when Sulfamethoxazole is combined with Dinutuximab. Sulfasalazine The risk or severity of adverse effects can be increased when Sulfasalazine is combined with Dinutuximab. Sulfinpyrazone The risk or severity of bleeding can be increased when Sulfinpyrazone is combined with Dinutuximab. Sulodexide The risk or severity of bleeding can be increased when Sulodexide is combined with Dinutuximab. Sunitinib The risk or severity of adverse effects can be increased when Sunitinib is combined with Dinutuximab. Sutimlimab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Sutimlimab. S Estrogens, A Synthetic Conjugated Estrogens, A may increase the thrombogenic activities of Dinutuximab. SEstrogens, B Synthetic Conjugated Estrogens, B may increase the thrombogenic activities of Dinutuximab. Tacrolimus Tacrolimus may increase the immunosuppressive activities of Dinutuximab. Tadalafil Dinutuximab may increase the hypotensive activities of Tadalafil. Tafasitamab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Tafasitamab. Tamsulosin The risk or severity of adverse effects can be increased when Tamsulosin is combined with Dinutuximab. Tedizolid phosphate The risk or severity of myelosuppression can be increased when Tedizolid phosphate is combined with Dinutuximab. Telmisartan The risk or severity of adverse effects can be increased when Telmisartan is combined with Dinutuximab. Temozolomide The risk or severity of adverse effects can be increased when Temozolomide is combined with Dinutuximab. Temsirolimus The risk or severity of adverse effects can be increased when Temsirolimus is combined with Dinutuximab. Tenecteplase The risk or severity of bleeding can be increased when Tenecteplase is combined with Dinutuximab. Teniposide The risk or severity of adverse effects can be increased when Teniposide is combined with Dinutuximab. Teplizumab The risk or severity of adverse effects can be increased when Teplizumab is combined with Dinutuximab. Teprotumumab The risk or severity of adverse effects can be increased when Teprotumumab is combined with Dinutuximab. Terazosin The risk or severity of adverse effects can be increased when Terazosin is combined with Dinutuximab. Teriflunomide The risk or severity of adverse effects can be increased when Teriflunomide is combined with Dinutuximab. Tetanus immune The risk or severity of adverse effects can be increased when Dinutuximab is combined with Tetanus immune globulin, human. Tetracaine The risk or severity of methemoglobinemia can be increased when Dinutuximab is combined with Tetracaine. Tezepelumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Tezepelumab. Thalidomide The risk or severity of adverse effects can be increased when Thalidomide is combined with Dinutuximab. Thiamylal Thiamylal may increase the hypotensive activities of Dinutuximab. Thiopental Thiopental may increase the hypotensive activities of Dinutuximab. Thioridazine The risk or severity of adverse effects can be increased when Thioridazine is combined with Dinutuximab. Thiotepa The risk or severity of adverse effects can be increased when Thiotepa is combined with Dinutuximab. Tibolone Tibolone may increase the thrombogenic activities of Dinutuximab. Ticagrelor The risk or severity of bleeding can be increased when Ticagrelor is combined with Dinutuximab. Tick encephalitis The therapeutic efficacy of Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Dinutuximab. Ticlopidine The risk or severity of bleeding can be increased when Ticlopidine is combined with Dinutuximab. Tildrakizumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Tildrakizumab. Timolol The risk or severity of adverse effects can be increased when Timolol is combined with Dinutuximab. Tinzaparin The risk or severity of bleeding can be increased when Tinzaparin is combined with Dinutuximab. Tioguanine The risk or severity of adverse effects can be increased when Tioguanine is combined with Dinutuximab. Tirofiban The risk or severity of bleeding can be increased when Tirofiban is combined with Dinutuximab. Tisotumab vedotin The risk or severity of adverse effects can be increased when Dinutuximab is combined with Tisotumab vedotin. Tixagevimab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Tixagevimab. Tixocortol The risk or severity of adverse effects can be increased when Dinutuximab is combined with Tixocortol. Tizanidine The risk or severity of adverse effects can be increased when Tizanidine is combined with Dinutuximab. Tocilizumab The risk or severity of adverse effects can be increased when Tocilizumab is combined with Dinutuximab. Tofacitinib Dinutuximab may increase the immunosuppressive activities of Tofacitinib. Tolazoline The risk or severity of adverse effects can be increased when Tolazoline is combined with Dinutuximab. Tolcapone The risk or severity of adverse effects can be increased when Tolcapone is combined with Dinutuximab. Topotecan The risk or severity of adverse effects can be increased when Topotecan is combined with Dinutuximab. Torasemide The risk or severity of adverse effects can be increased when Torasemide is combined with Dinutuximab. Tositumomab The risk or severity of adverse effects can be increased when Tositumomab is combined with Dinutuximab. Trabectedin The risk or severity of adverse effects can be increased when Trabectedin is combined with Dinutuximab. Tralokinumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Tralokinumab. Trandolapril The risk or severity of adverse effects can be increased when Trandolapril is combined with Dinutuximab. Tranylcypromine Tranylcypromine may increase the orthostatic hypotensive activities of Dinutuximab. Trastuzumab Trastuzumab may increase the neutropenic activities of Dinutuximab. Trastuzumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Trastuzumab deruxtecan. Trastuzumab The risk or severity of adverse effects can be increased when Trastuzumab emtansine is combined with Dinutuximab. Tremelimumab The risk or severity of adverse effects can be increased when Dinutuximab is combined with Tremelimumab. Treprostinil Dinutuximab may increase the hypotensive activities of Treprostinil. Tretinoin The risk or severity of adverse effects can be increased when Tretinoin is combined with Dinutuximab. Triamcinolone The risk or severity of adverse effects can be increased when Triamcinolone is combined with Dinutuximab. Triamterene The risk or severity of adverse effects can be increased when Triamterene is combined with Dinutuximab. Trichlormethiazide The risk or severity of neutropenia and thrombocytopenia can be increased when Trichlormethiazide is combined with Dinutuximab. Trifluridine The risk or severity of adverse effects can be increased when Trifluridine is combined with Dinutuximab. Triflusal The risk or severity of bleeding can be increased when Triflusal is combined with Dinutuximab. Trilostane The risk or severity of adverse effects can be increased when Trilostane is combined with Dinutuximab. Trimethaphan Dinutuximab may increase the hypotensive activities of Trimethaphan. Typhoid vaccine The therapeutic efficacy of Typhoid vaccine can be decreased when used in combination with Dinutuximab. Typhoid Vaccine Live The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Dinutuximab. Typhoid Vi The therapeutic efficacy of Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Dinutuximab. Udenafil The risk or severity of hypotension can be increased when Udenafil is combined with Dinutuximab. Upadacitinib The risk or severity of adverse effects can be increased when Dinutuximab is combined with Upadacitinib. Urokinase The risk or severity of bleeding can be increased when Urokinase is combined with Dinutuximab. Ustekinumab The risk or severity of adverse effects can be increased when Ustekinumab is combined with Dinutuximab. Valsartan The risk or severity of adverse effects can be increased when Valsartan is combined with Dinutuximab. Vardenafil The risk or severity of hypotension can be increased when Vardenafil is combined with Dinutuximab. Varicella zoster The risk or severity of infection can be increased when Varicella zoster vaccine (live/attenuated) is combined with Dinutuximab. Varicella zoster The therapeutic efficacy of Varicella zoster vaccine (recombinant) can be decreased when used in combination with Dinutuximab. Vedolizumab The risk or severity of adverse effects can be increased when Vedolizumab is combined with Dinutuximab. Verapamil The risk or severity of adverse effects can be increased when Verapamil is combined with Dinutuximab. Vericiguat The risk or severity of adverse effects can be increased when Dinutuximab is combined with Vericiguat. Vibrio cholerae The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Dinutuximab. Vilanterol The risk or severity of adverse effects can be increased when Dinutuximab is combined with Vilanterol. Vinblastine The risk or severity of adverse effects can be increased when Vinblastine is combined with Dinutuximab. Vincristine The risk or severity of adverse effects can be increased when Vincristine is combined with Dinutuximab. Vindesine The risk or severity of adverse effects can be increased when Vindesine is combined with Dinutuximab. Vinorelbine The risk or severity of adverse effects can be increased when Vinorelbine is combined with Dinutuximab. Voclosporin The risk or severity of adverse effects can be increased when Dinutuximab is combined with Voclosporin. Vorapaxar The risk or severity of bleeding can be increased when Vorapaxar is combined with Dinutuximab. Vorinostat The risk or severity of adverse effects can be increased when Vorinostat is combined with Dinutuximab. Pregnancy and Lactation US FDA pregnancy category: Not assigned. Pregnancy Use is not recommended. Monoclonal antibodies are transported across the placenta in a linear fashion as pregnancy progresses, with the largest amount transferred during the third trimester. Pregnant women should be advised of the potential risk to a fetus. This drug may cause fetal harm based on its mechanism of action. Females of reproductive potential should be advised to use effective contraception during treatment and for two months after the last dose of this drug. Lactation There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. How should this medicine be used?

Dinutuximab injection comes as a solution (liquid) to be injected intravenously (into a vein) over 10 to 20 hours by a doctor or nurse in a medical facility or infusion center. It is usually given for 4 consecutive days within a treatment cycle for up to 5 cycles. Be sure to tell the doctor how your child is feeling during the treatment. Your child's doctor may decrease the dose, or stop the treatment for a while or permanently if your…

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