Alemtuzumab – Uses, Dosage, Side Effects, Interactions

Alemtuzumab is a monoclonal anti-CD52 antibody used in the treatment of B-cell chronic lymphocytic leukemia and relapsing forms of multiple sclerosis. Alemtuzumab is a humanized monoclonal antibody specific to lymphocyte antigens. It is a recombinant DNA-derived humanized monoclonal antibody (Campath-1H) that is directed against the 21-28 kD cell surface glycoprotein, CD52. The Campath-1H antibody is an IgG1 kappa with the human variable framework and constant regions, and complementarity-determining regions from a murine (rat) monoclonal antibody (Campath-1G). Alemtuzumab is produced in mammalian cell (Chinese hamster ovary) suspension culture in a medium containing neomycin.⁴

Mechanism of action

The precise mechanism by which alemtuzumab exerts its therapeutic effects in multiple sclerosis is unknown but is presumed to involve binding to CD52, a cell surface antigen present on T and B lymphocytes, and on natural killer cells, monocytes, and macrophages. Following cell surface binding to T and B lymphocytes, alemtuzumab results in antibody-dependent cellular cytolysis and complement-mediated lysis.^[rx] Research suggests that alemtuzumab can also exert immunomodulatory effects through the depletion and repopulation of lymphocytes, including alterations in the number, proportions, and properties of some lymphocyte subsets posttreatment, increasing representation of regulatory T cell subsets, and increasing representation of memory T- and B-lymphocytes.^[rx] The reduction in the level of circulating B and T cells by alemtuzumab and subsequent repopulation may reduce the potential for relapse, which ultimately delays disease progression.^[rx]

Alemtuzumab depletes circulating T and B lymphocytes after each treatment course. In clinical trials, the lowest cell counts occurred 1 month after a course of treatment at the time of the first post-treatment blood count. Lymphocyte counts then increased over time: B cell counts usually recovered within 6 months; T cell counts increased more slowly and usually remained below baseline 12 months after treatment. Approximately 60% of patients had total lymphocyte counts below the lower limit of normal 6 months after each treatment course and 20% had counts below the lower limit of normal after 12 months.^[rx]

Reconstitution of the lymphocyte population varies for the different lymphocyte subtypes. At Month 1 in clinical trials, the mean CD4+ lymphocyte count was 40 cells per microliter, and, at Month 12, 270 cells per microliter. At 30 months, approximately half of the patients had CD4+ lymphocyte counts that remained below the lower limit of normal.^[rx]

Indications

• Alemtuzumab is indicated for the treatment of relapsing forms of multiple sclerosis (MS), including relapsing-remitting disease and active secondary progressive disease, in adults. Because of its safety profile, the use of Alemtuzumab should generally be reserved for patients who have had an inadequate response to two or more drugs indicated for the treatment of MS.^[rx] Alemtuzumab contains the same active ingredient (alemtuzumab) found in CAMPATH, and CAMPATH is approved for the treatment of B-cell chronic lymphocytic leukemia (B-CLL), although generally administered at higher and more frequent doses (e.g., 30 mg) than recommended in the treatment of MS.^[rx]
• B-Cell Chronic Lymphocytic Leukemia (B-CLL)
• Kidney Transplant Rejection
• Leukemia, Prolymphocytic, T-Cell
• Relapsing-Remitting Multiple Sclerosis (RRMS)
• Secondary Progressive Multiple Sclerosis (SPMS)
• Steroid Refractory Acute Graft Versus Host Disease
• Refractory Autoimmune Hemolytic Anemia
• Refractory Idiopathic thrombocytopenic purpura
• Conditioning regimens for allogeneic stem cell transplantation therapy

Use in Cancer

Alemtuzumab is approved to treat:

• B-cell chronic lymphocytic leukemia (CLL).

Alemtuzumab (Campath) is only available as part of a special program called the U.S. Campath Distribution Program.

Alemtuzumab is also being studied in treating other conditions and types of cancer.

Alemtuzumab is primarily used for the treatment of relapsing-remitting multiple sclerosis (RRMS). Based on results from clinical trials, the UK National Institute for Health and Care Excellence (NICE) approved the use of this drug for RRMS in May 2014. In November 2014, the US FDA approved alemtuzumab for RRMS. A list of clinical trials for this drug in MS patients is available using this link to ClinicalTrials.gov.Alemtuzumab can also be used in B-cell chronic lymphocytic leukemia (CLL) therapy and transplant indications, but access for these indications is controlled through a patient access program (in the UK). In other jurisdictions use for this indication has been discontinued. Results from Phase 3 trial NCT00548405, suggest that treating RRMS patients with alemtuzumab earlier can improve pre-existing disability, rather than just slowing disease progression (with caveats around risk-benefit, and the serious side-effects of alemtuzumab therapy; side-effects such as infusion associated reactions, infections, and development of other autoimmune diseases)

Contraindications

The following conditions are contraindicated with this drug. Check with your physician if you have any of the following:

• are allergic to alemtuzumab or any ingredients of the medication
• are infected with Human Immunodeficiency Virus (HIV)
• have or have had tuberculosis
• currently, have any severe infection
• have active cancer
• are taking medications to treat cancer or medications that weaken your immune system
• have a history of progressive multifocal leukoencephalopathy (PML)
• have high blood pressure that is not controlled
• have a history of stroke or arterial dissection
• have a history of angina or heart attack
• have a clotting disorder or are taking anticoagulants
• In patients who are infected with Human Immunodeficiency Virus (HIV-None) because it causes prolonged reductions of CD4+ lymphocyte counts

Conditions That Contraindicated

• a bacterial infection
• HIV
• shingles
• a herpes simplex infection
• an unusual viral infection called cytomegalovirus infection
• opportunistic fungal infection
• pneumonia with a fungus called Pneumocystis jirovecii
• an infection due to a protozoa organism
• a type of blood disorder where the red blood cells burst called hemolytic anemia
• a type of blood disorder with a decrease in all types of blood cells called pancytopenia
• decreased blood platelets
• low levels of a type of white blood cell called neutrophils
• a decreased number of lymphocytes in the blood
• a low supply of oxygen-rich blood to the heart
• abnormal bleeding in the brain resulting in damage to brain tissue called a hemorrhagic stroke
• low blood pressure
• pregnancy
• a patient who is producing milk and breastfeeding
• low CD4 count
• acute thromboembolic stroke
• an increased risk of developing an uncommon viral infection called an opportunistic infection
• pure red cell aplasia
• a small tear or dissection of the cervicocephalic artery
• active tuberculosis
• inactive tuberculosis
• infection by the bacteria Listeria monocytogenes
• HIV
• chronic hepatitis B
• chronic hepatitis C
• cancer or malignancy
• overactive thyroid gland
• a condition with low thyroid hormone levels
• low blood counts due to bone marrow failure
• thrombotic thrombocytopenic purpura, a type of blood disorder
• a type of inflammation of the lung called interstitial pneumonitis
• glomerulonephritis, a condition that affects the kidneys
• progressive multifocal leukoencephalopathy, a type of brain infection

Dosage

Strengths: 10 mg/mL; 30 mg/mL

Multiple Sclerosis

LEMTRADA(R) 10 mg/mL:

• First treatment course: 12 mg IV over 4 hours daily for 5 consecutive days
• Second treatment course: 12 mg IV over 4 hours daily for 3 consecutive days administered 12 months after the first treatment course
• Maintenance dose: 12 mg IV over 4 hours daily for 3 consecutive days may be administered, if needed, at least 12 months after the last dose of the prior treatment course

Chronic Lymphocytic Leukemia

CAMPATH (R) 30 mg/mL:

• Escalate dosing over 3 to 7 days at the initiation of treatment or if dosing is held 7 days or more:
• ESCALATION STRATEGY: 3 mg IV over 2 hours daily until infusion reactions are Grade 2 or less, then 10 mg IV over 2 hours daily until infusion reactions are Grade 2 or less, then 30 mg/day IV over 2 hours 3 times a week on alternate days (e.g., Mon/Wed/Fri).
• Duration of therapy: 12 weeks (including dose escalation)
  

Usual Pediatric Dose for Multiple Sclerosis

17 years and older:
LEMTRADA(R) 10 mg/mL:

• First treatment course: 12 mg IV over 4 hours daily for 5 consecutive days
• Second treatment course: 12 mg IV over 4 hours daily for 3 consecutive days administered 12 months after the first treatment course
• Maintenance dose: 12 mg IV over 4 hours daily for 3 consecutive days may be administered, if needed, at least 12 months after the last dose of the prior treatment course

For relapsing forms of multiple sclerosis (MS) including relapsing-remitting disease and active secondary progressive disease; because of its safety profile, use should be reserved for patients who have had an inadequate response to 2 or more drugs for MS; not recommended for use in patients with clinically isolated syndrome (CIS) because of its safety profile

Dose Adjustments

CAMPATH (R):
DOSE MODIFICATIONS FOR B-CELL CHRONIC LYMPHOCYTIC LEUKEMIA (B-CLL):

• Withhold therapy during serious infection or other serious adverse reactions until resolution.
• Discontinue therapy for autoimmune anemia or autoimmune thrombocytopenia.
• There are no dose modifications recommended for lymphopenia.

DOSE MODIFICATION FOR NEUTROPENIA OR THROMBOCYTOPENIA:
ANC LESS THAN 250 PER MICROLITER AND/OR PLATELET COUNT LESS THAN OR EQUAL TO 25,000 PER MICROLITER:

• FIRST OCCURRENCE: Withhold therapy; resume at 30 mg when ANC is greater than or equal to 500 per microliter and platelet count is greater than or equal to 50,000 per microliter.
• SECOND OCCURRENCE: Withhold therapy; resume at 10 mg when ANC is greater than or equal to 500 per microliter and platelet count is greater than or equal to 50,000 per microliter.
• THIRD OCCURRENCE: Discontinue therapy.

GREATER THAN OR EQUAL TO 50% DECREASE FROM BASELINE IN PATIENTS INITIATING THERAPY WITH A BASELINE ANC LESS THAN OR EQUAL TO 250 PER MICROLITER AND/OR A BASELINE PLATELET COUNT LESS THAN OR EQUAL TO 25,000 PER MICROLITER:

• FIRST OCCURRENCE: Withhold therapy; resume at 30 mg upon return to baseline.
• SECOND OCCURRENCE: Withhold therapy; resume at 10 mg upon return to baseline.
• THIRD OCCURRENCE: Discontinue therapy.

Side Effects

The Most Common

• nausea, vomiting
• stomach pain, diarrhea
• loss of appetite
• mouth sores
• headache
• difficulty falling asleep or staying asleep
• uncontrollable shaking of a part of the body
• muscle pain
• signs of heart attack (e.g., sudden chest pain or pain radiating to back, down the arm, or jaw; feeling of fullness of the chest; nausea; vomiting; sweating; or anxiety)
• signs of stroke (e.g., sudden or severe headache, sudden loss of coordination, vision changes, sudden slurring of speech, or unexplained weakness, numbness, or pain in arm or leg)
• symptoms of an infusion reaction (e.g., changes in heart rate, headache, rash, feeling tired, nausea, fever, hives, chills, or reddening of the face and neck)
• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• drooping on one side of the face; sudden weakness or numbness of an arm or leg, especially on one side of the body; or difficulty speaking or understanding
• swelling in legs and ankles, weight gain, fatigue. or foamy urine (may occur months or years after your final dose)

More Common

• anxiety
• blisters
• blurred or double vision
• difficulty swallowing
• fast or irregular heartbeat
• fever
• flu-like symptoms (sudden lack of energy, fever, cough, sore throat)
• inflammation of the gallbladder (e.g., stomach pain or discomfort, fever, nausea, or vomiting)
• irregular or heavy menstrual periods
• lung problems (e.g., shortness of breath, cough, wheezing, chest pain or tightness, coughing or spitting up blood)
• mouth pain or inflammation
• muscle pain or weakness
• nervousness
• numbness or tingling; burning or prickling sensation

Rare

• rash
• signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
• signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• signs of kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine, swelling in the feet and legs)
• signs of liver damage (e.g., nausea, vomiting, abdominal pain, fatigue, loss of appetite, yellowing of the skin or eyes, dark urine)
• signs of decreased thyroid function (e.g., dry skin, constipation, weight gain, fatigue, aches, pains and stiffness, intolerance to cold, depression, memory problems)
• sore throat
• symptoms of infection (e.g., fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, listlessness, cold sores, or shingles)
• symptoms of overactive thyroid (e.g., anxiety or nervousness; weight loss; frequent and loose bowel movements; breathlessness; feeling hot; feeling of having rapid, fluttering, or pounding hear

Interactions

There may be an interaction between alemtuzumab and any of the following:

DRUG	INTERACTION
Abatacept	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Abatacept.
Abciximab	The risk or severity of bleeding can be increased when Abciximab is combined with Alemtuzumab.
Acenocoumarol	The risk or severity of bleeding can be increased when Acenocoumarol is combined with Alemtuzumab.
Acetylsalicylic acid	The risk or severity of bleeding can be increased when Acetylsalicylic acid is combined with Alemtuzumab.
Adalimumab	The risk or severity of adverse effects can be increased when Adalimumab is combined with Alemtuzumab.
Adenovirus type 7 vaccine live	The risk or severity of infection can be increased when the Adenovirus type 7 vaccine live is combined with Alemtuzumab.
Aducanumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Aducanumab.
Aldesleukin	The risk or severity of adverse effects can be increased when Aldesleukin is combined with Alemtuzumab.
Alefacept	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Alefacept.
Alirocumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Alirocumab.
The allogeneic processed thymus tissue	The therapeutic efficacy of Allogeneic processed thymus tissue can be decreased when used in combination with Alemtuzumab.
Allopurinol	The risk or severity of adverse effects can be increased when Allopurinol is combined with Alemtuzumab.
Alteplase	The risk or severity of bleeding can be increased when Alteplase is combined with Alemtuzumab.
Altretamine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Altretamine.
Amivantamab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Amivantamab.
Amsacrine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Amsacrine.
Anagrelide	The risk or severity of bleeding can be increased when Anagrelide is combined with Alemtuzumab.
Anakinra	The risk or severity of adverse effects can be increased when Anakinra is combined with Alemtuzumab.
Ancrod	The risk or severity of bleeding can be increased when Ancrod is combined with Alemtuzumab.
Anifrolumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Anifrolumab.
Anistreplase	The risk or severity of bleeding can be increased when Anistreplase is combined with Alemtuzumab.
Ansuvimab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ansuvimab.
Anthrax immune globulin human	The therapeutic efficacy of Anthrax immune globulin in humans can be decreased when used in combination with Alemtuzumab.
Anthrax vaccine	The risk or severity of infection can be increased when the Anthrax vaccine is combined with Alemtuzumab.
antilymphocyte immunoglobulin (horse)	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Antilymphocyte immunoglobulin (horse).
Antithrombin Alfa	The risk or severity of bleeding can be increased when Antithrombin Alfa is combined with Alemtuzumab.
Antithrombin III human	The risk or severity of bleeding can be increased when Antithrombin III human is combined with Alemtuzumab.
Antithymocyte immunoglobulin (rabbit)	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Antithymocyte immunoglobulin (rabbit).
Apixaban	The risk or severity of bleeding can be increased when Apixaban is combined with Alemtuzumab.
Apremilast	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Apremilast.
Ardeparin	The risk or severity of bleeding can be increased when Ardeparin is combined with Alemtuzumab.
Argatroban	The risk or severity of bleeding can be increased when Argatroban is combined with Alemtuzumab.
Arsenic trioxide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Arsenic trioxide.
Articaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Articaine.
Asfotase alfa	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Asfotase alfa.
AstraZeneca COVID-19 Vaccine	The therapeutic efficacy of the AstraZeneca COVID-19 Vaccine can be decreased when used in combination with Alemtuzumab.
Atezolizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Atezolizumab.
Atoltivimab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Atoltivimab.
Avelumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Avelumab.
Azacitidine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Azacitidine.
Azathioprine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Azathioprine.
Bacillus Calmette-Guerin substrain Connaught live antigen	The risk or severity of infection can be increased when Bacillus Calmette-Guerin substrain Connaught live antigen is combined with Alemtuzumab.
Bacillus Calmette-Guerin substrain Russian BCG-I live antigen	The therapeutic efficacy of Bacillus Calmette-Guerin substrain Russian BCG-I live antigen can be decreased when used in combination with Alemtuzumab.
Bacillus Calmette-Guerin substrain tice live antigen	The risk or severity of infection can be increased when Bacillus Calmette-Guerin substrain tice live antigen is combined with Alemtuzumab.
Bamlanivimab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Bamlanivimab.
Baricitinib	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Baricitinib.
Basiliximab	The risk or severity of adverse effects can be increased when Basiliximab is combined with Alemtuzumab.
BCG vaccine	The risk or severity of infection can be increased when the BCG vaccine is combined with Alemtuzumab.
Bebtelovimab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Bebtelovimab.
Beclomethasone dipropionate	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Beclomethasone dipropionate.
Belantamab mandolin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Belantamab mandolin.
Belatacept	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Belatacept.
Belimumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Belimumab.
Belinostat	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Belinostat.
Belumosudil	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Belumosudil.
Bemiparin	The risk or severity of bleeding can be increased when Bemiparin is combined with Alemtuzumab.
Bendamustine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Bendamustine.
Bendroflumethiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Bendroflumethiazide is combined with Alemtuzumab.
Benralizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Benralizumab.
Benzocaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Benzocaine.
Benzthiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Benzthiazide is combined with Alemtuzumab.
Benzyl alcohol	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Benzyl alcohol.
Besilesomab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Besilesomab.
Betamethasone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Betamethasone.
Betrixaban	The risk or severity of bleeding can be increased when Betrixaban is combined with Alemtuzumab.
Bevacizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Bevacizumab.
Bexarotene	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Bexarotene.
Bezlotoxumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Bezlotoxumab.
Bimekizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Bimekizumab.
Bivalirudin	The risk or severity of bleeding can be increased when Bivalirudin is combined with Alemtuzumab.
Bleomycin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Bleomycin.
Blinatumomab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Blinatumomab.
Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated)	The therapeutic efficacy of Bordetella pertussis toxoid antigen (formaldehyde, glutaraldehyde inactivated) can be decreased when used in combination with Alemtuzumab.
Bortezomib	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Bortezomib.
Bosutinib	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Bosutinib.
Brentuximab vedotin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Brentuximab vedotin.
Brodalumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Brodalumab.
Brolucizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Brolucizumab.
Budesonide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Budesonide.
Bupivacaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Bupivacaine.
Burosumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Burosumab.
Busulfan	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Busulfan.
Butacaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Butacaine.
Butamben	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Butamben.
Cabazitaxel	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Cabazitaxel.
Canakinumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Canakinumab.
Cangrelor	The risk or severity of bleeding can be increased when Cangrelor is combined with Alemtuzumab.
Capecitabine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Capecitabine.
Caplacizumab	The risk or severity of bleeding can be increased when Caplacizumab is combined with Alemtuzumab.
Capromab pendetide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Capromab pendetide.
Capsaicin	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Capsaicin.
Carbamazepine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Carbamazepine.
Carboplatin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Carboplatin.
Carfilzomib	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Carfilzomib.
Carmustine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Carmustine.
Casirivimab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Casirivimab.
Catumaxomab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Catumaxomab.
Cemiplimab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Cemiplimab.
Certolizumab pegol	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Certolizumab pegol.
Cetuximab	The risk or severity of adverse effects can be increased when Cetuximab is combined with Alemtuzumab.

Chloramphenicol	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Chloramphenicol.
Chloroprocaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Chloroprocaine.
Chlorothiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Chlorothiazide is combined with Alemtuzumab.
Ciclesonide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ciclesonide.
Cilgavimab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Cilgavimab.
Cilostazol	The risk or severity of bleeding can be increased when Cilostazol is combined with Alemtuzumab.
Cinchocaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Cinchocaine.
Cisplatin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Cisplatin.
Cladribine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Cladribine.
Clobetasol propionate	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Clobetasol propionate.
Clofarabine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Clofarabine.
Clopidogrel	The risk or severity of bleeding can be increased when Clopidogrel is combined with Alemtuzumab.
Clostridium tetani toxoid antigen (formaldehyde inactivated)	The therapeutic efficacy of Clostridium tetani toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Alemtuzumab.
Clozapine	The risk or severity of neutropenia can be increased when Alemtuzumab is combined with Clozapine.
Cocaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Cocaine.
Conjugated estrogens	Conjugated estrogens may increase the thrombogenic activities of Alemtuzumab.
Corticotropin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Corticotropin.
Cortisone acetate	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Cortisone acetate.
Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated)	The therapeutic efficacy of Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated) can be decreased when used in combination with Alemtuzumab.
Cyanocobalamin	The therapeutic efficacy of Cyanocobalamin can be decreased when used in combination with Alemtuzumab.
Cyclopenthiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclopenthiazide is combined with Alemtuzumab.
Cyclophosphamide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Cyclophosphamide.
Cyclosporine	Alemtuzumab may increase the immunosuppressive activities of Cyclosporine.
Cyclothiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Cyclothiazide is combined with Alemtuzumab.
Cytarabine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Cytarabine.
Dabigatran	The risk or severity of bleeding can be increased when Dabigatran is combined with Alemtuzumab.
Dabigatran etexilate	The risk or severity of bleeding can be increased when Dabigatran etexilate is combined with Alemtuzumab.
Dacarbazine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Dacarbazine.
Dactinomycin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Dactinomycin.
Dalteparin	The risk or severity of bleeding can be increased when Dalteparin is combined with Alemtuzumab.
Danaparoid	The risk or severity of bleeding can be increased when Danaparoid is combined with Alemtuzumab.
Daratumumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Daratumumab.
Darbepoetin alfa	The risk or severity of Thrombosis can be increased when Darbepoetin alfa is combined with Alemtuzumab.
Dasatinib	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Dasatinib.
Daunorubicin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Daunorubicin.
Decitabine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Decitabine.
Defibrotide	The risk or severity of bleeding can be increased when Defibrotide is combined with Alemtuzumab.
Deflazacort	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Deflazacort.
Denosumab	The risk or severity of adverse effects can be increased when Denosumab is combined with Alemtuzumab.
Desirudin	The risk or severity of bleeding can be increased when Desirudin is combined with Alemtuzumab.
Desoximetasone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Desoximetasone.
Deucravacitinib	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Deucravacitinib.
Dexamethasone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Dexamethasone.
Dexrazoxane	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Dexrazoxane.
Dextran	The risk or severity of bleeding can be increased when Dextran is combined with Alemtuzumab.
Dicoumarol	The risk or severity of bleeding can be increased when Dicoumarol is combined with Alemtuzumab.
Dienestrol	Dienestrol may increase the thrombogenic activities of Alemtuzumab.
Diethylstilbestrol	Diethylstilbestrol may increase the thrombogenic activities of Alemtuzumab.
Difluocortolone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Difluocortolone.
Digoxin Immune Fab (Ovine)	The risk or severity of adverse effects can be increased when Digoxin Immune Fab (Ovine) is combined with Alemtuzumab.
Dimethyl fumarate	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Dimethyl fumarate.
Dinutuximab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Dinutuximab.
Diphenhydramine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Diphenhydramine.
Dipyridamole	The risk or severity of bleeding can be increased when Dipyridamole is combined with Alemtuzumab.
Proximal fumarate	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Diroximel fumarate.
Docetaxel	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Docetaxel.
Dostarlimab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Dostarlimab.
Doxorubicin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Doxorubicin.
Drotrecogin alfa	The risk or severity of bleeding can be increased when Drotrecogin alfa is combined with Alemtuzumab.
Dulaglutide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Dulaglutide.
Dupilumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Dupilumab.
Durvalumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Durvalumab.
Dyclonine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Dyclonine.
Ebola Zaire vaccine (live, attenuated)	The therapeutic efficacy of the Ebola Zaire vaccine (live, attenuated) can be decreased when used in combination with Alemtuzumab.
Eculizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Eculizumab.
Edetic acid	The risk or severity of bleeding can be increased when Edetic acid is combined with Alemtuzumab.
Edoxaban	The risk or severity of bleeding can be increased when Edoxaban is combined with Alemtuzumab.
Efalizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Efalizumab.
Eflapegrastim	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Eflapegrastim.
Eftrenonacog alfa	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Eftrenonacog alfa.
Elotuzumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Elotuzumab.
Emapalumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Emapalumab.
Emicizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Emicizumab.
Enoxaparin	The risk or severity of bleeding can be increased when Enoxaparin is combined with Alemtuzumab.
Epirubicin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Epirubicin.
Epoprostenol	The risk or severity of bleeding can be increased when Epoprostenol is combined with Alemtuzumab.
Eptifibatide	The risk or severity of bleeding can be increased when Eptifibatide is combined with Alemtuzumab.
Eptinezumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Eptinezumab.
Erenumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Erenumab.
Eribulin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Eribulin.
Erythropoietin	The risk or severity of Thrombosis can be increased when Erythropoietin is combined with Alemtuzumab.
Esterified estrogens	Esterified estrogens may increase the thrombogenic activities of Alemtuzumab.
Estetrol	Estetrol may increase the thrombogenic activities of Alemtuzumab.
Estradiol	Estradiol may increase the thrombogenic activities of Alemtuzumab.
Estradiol acetate	Estradiol acetate may increase the thrombogenic activities of Alemtuzumab.
Estradiol benzoate	Estradiol benzoate may increase the thrombogenic activities of Alemtuzumab.
Estradiol cypionate	Estradiol cypionate may increase the thrombogenic activities of Alemtuzumab.
Estradiol valerate	Estradiol valerate may increase the thrombogenic activities of Alemtuzumab.
Estramustine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Estramustine.
Estriol	Estriol may increase the thrombogenic activities of Alemtuzumab.
Estrone	Estrone may increase the thrombogenic activities of Alemtuzumab.
Estrone sulfate	Estrone sulfate may increase the thrombogenic activities of Alemtuzumab.
Etanercept	The risk or severity of adverse effects can be increased when Etanercept is combined with Alemtuzumab.
Ethinylestradiol	Ethinylestradiol may increase the thrombogenic activities of Alemtuzumab.
Ethyl chloride	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Ethyl chloride.
Etidocaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Etidocaine.
Etoposide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Etoposide.
Everolimus	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Everolimus.
Evolocumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Evolocumab.

Filgotinib	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Filgotinib.
Fingolimod	Alemtuzumab may increase the immunosuppressive activities of Fingolimod.
Floxuridine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Floxuridine.
Flucytosine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Flucytosine.
Fludarabine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Fludarabine.
Fludrocortisone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Fludrocortisone.
Fluindione	The risk or severity of bleeding can be increased when Fluindione is combined with Alemtuzumab.
Flunisolide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Flunisolide.
Fluocinolone acetonide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Fluocinolone acetonide.
Fluocinonide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Fluocinonide.
Fluocortolone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Fluocortolone.
Fluorometholone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Fluorometholone.
Fluorouracil	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Fluorouracil.
Flupentixol	The risk or severity of myelosuppression can be increased when Flupentixol is combined with Alemtuzumab.
Fluprednisolone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Fluprednisolone.
Fluticasone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Fluticasone.
Fluticasone furoate	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Fluticasone furoate.
Fluticasone propionate	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Fluticasone propionate.
Fondaparinux	The risk or severity of bleeding can be increased when Fondaparinux is combined with Alemtuzumab.
Fremanezumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Fremanezumab.
Galcanezumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Galcanezumab.
Gallium nitrate	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Gallium nitrate.
Gemcitabine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Gemcitabine.
Gemtuzumab ozogamicin	The risk or severity of adverse effects can be increased when Gemtuzumab ozogamicin is combined with Alemtuzumab.
Glatiramer	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Glatiramer.
Golimumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Golimumab.

Ipilimumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ipilimumab.
Irinotecan	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Irinotecan.
Isatuximab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Isatuximab.
Ixabepilone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ixabepilone.
Ixekizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ixekizumab.
Janssen COVID-19 Vaccine	The therapeutic efficacy of the Janssen COVID-19 Vaccine can be decreased when used in combination with Alemtuzumab.
Japanese encephalitis virus strain a 14-14-2 antigen (formaldehyde inactivated)	The therapeutic efficacy of Japanese encephalitis virus strain a 14-14-2 antigen (formaldehyde inactivated) can be decreased when used in combination with Alemtuzumab.
Lanadelumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Lanadelumab.
Leflunomide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Leflunomide.
Lenalidomide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Lenalidomide.
Lepirudin	The risk or severity of bleeding can be increased when Lepirudin is combined with Alemtuzumab.
Levobupivacaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Levobupivacaine.
Lidocaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Lidocaine.
Linezolid	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Linezolid.
Lipegfilgrastim	Alemtuzumab may increase the myelosuppressive activities of Lipegfilgrastim.
Lomustine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Lomustine.
Loncastuximab tesirine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Loncastuximab tesirine.
Lopinavir	The serum concentration of Alemtuzumab can be increased when it is combined with Lopinavir.
Maftivimab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Maftivimab.

Mepivacaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Mepivacaine.
Mepolizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Mepolizumab.
Meprednisone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Meprednisone.
Mercaptopurine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Mercaptopurine.
Mestranol	Mestranol may increase the thrombogenic activities of Alemtuzumab.
Methimazole	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Methimazole.
Methotrexate	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Methotrexate.
Methoxy polyethylene glycol-epoetin beta	The risk or severity of Thrombosis can be increased when Methoxy polyethylene glycol-epoetin beta is combined with Alemtuzumab.
Methylprednisolone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Methylprednisolone.
Mitomycin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Mitomycin.
Mitoxantrone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Mitoxantrone.
Moderna COVID-19 Vaccine	The therapeutic efficacy of the Moderna COVID-19 Vaccine can be decreased when used in combination with Alemtuzumab.
Modified vaccinia ankara	The therapeutic efficacy of Modified vaccinia Ankara can be decreased when used in combination with Alemtuzumab.
Mogamulizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Mogamulizumab.
Mometasone furoate	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Mometasone furoate.
Monomethyl fumarate	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Monomethyl fumarate.
Mosunetuzumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Mosunetuzumab.
Mumps virus strain B level jeryl Lynn live antigen	The therapeutic efficacy of Mumps virus strain B level jeryl Lynn lives antigen can be decreased when used in combination with Alemtuzumab.
Muromonab	The risk or severity of adverse effects can be increased when Muromonab is combined with Alemtuzumab.
Mycophenolate mofetil	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Mycophenolate mofetil.
Mycophenolic acid	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Mycophenolic acid.
Nadroparin	The risk or severity of bleeding can be increased when Nadroparin is combined with Alemtuzumab.
Natalizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Natalizumab.
Necitumumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Necitumumab.
Nelarabine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Nelarabine.
Nilotinib	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Nilotinib.
Nimesulide	The risk or severity of bleeding can be increased when Nimesulide is combined with Alemtuzumab.
Nivolumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Nivolumab.
Nuvaxovid	The therapeutic efficacy of Nuvaxovid can be decreased when used in combination with Alemtuzumab.
Obiltoxaximab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Obiltoxaximab.
Obinutuzumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Obinutuzumab.
Ocrelizumab	Ocrelizumab may increase the immunosuppressive activities of Alemtuzumab.
Odesivimab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Odesivimab.
Ofatumumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ofatumumab.
Olaparib	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Olaparib.
Olaratumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Olaratumab.
Omalizumab	The risk or severity of adverse effects can be increased when Omalizumab is combined with Alemtuzumab.
Oxaliplatin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Oxaliplatin.
Oxetacaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Oxetacaine.
Oxybuprocaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Oxybuprocaine.
Ozanimod	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ozanimod.
Paclitaxel	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Paclitaxel.
Palbociclib	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Palbociclib.
Palifermin	The therapeutic efficacy of Palifermin can be decreased when used in combination with Alemtuzumab.
Palivizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Palivizumab.
Panitumumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Panitumumab.
Panobinostat	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Panobinostat.
Parnaparin	The risk or severity of bleeding can be increased when Parnaparin is combined with Alemtuzumab.
Pazopanib	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Pazopanib.
Pegaspargase	The risk or severity of adverse effects can be increased when Pegaspargase is combined with Alemtuzumab.
Pegcetacoplan	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Pegcetacoplan.
Peginesatide	The risk or severity of Thrombosis can be increased when Peginesatide is combined with Alemtuzumab.
Peginterferon alfa-2a	The risk or severity of adverse effects can be increased when Peginterferon alfa-2a is combined with Alemtuzumab.
Peginterferon alfa-2b	The risk or severity of adverse effects can be increased when Peginterferon alfa-2b is combined with Alemtuzumab.
Peginterferon beta-1a	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Peginterferon beta-1a.
Pembrolizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Pembrolizumab.
Pemetrexed	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Pemetrexed.
Penicillamine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Penicillamine.
Pentosan polysulfate	The risk or severity of bleeding can be increased when Pentosan polysulfate is combined with Alemtuzumab.
Pentostatin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Pentostatin.
Pentoxifylline	The risk or severity of bleeding can be increased when Pentoxifylline is combined with Alemtuzumab.
Pertussis vaccine	The therapeutic efficacy of the Pertussis vaccine can be decreased when used in combination with Alemtuzumab.
Pertuzumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Pertuzumab.
Phenindione	The risk or severity of bleeding can be increased when Phenindione is combined with Alemtuzumab.
Phenol	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Phenol.
Phenprocoumon	The risk or severity of bleeding can be increased when Phenprocoumon is combined with Alemtuzumab.
Phenylalanine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Phenylalanine.
Pimecrolimus	The risk or severity of adverse effects can be increased when Pimecrolimus is combined with Alemtuzumab.
Pirfenidone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Pirfenidone.
Polatuzumab vedotin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Polatuzumab vedotin.
Polyestradiol phosphate	Polyestradiol phosphate may increase the thrombogenic activities of Alemtuzumab.
Polythiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Polythiazide is combined with Alemtuzumab.
Pomalidomide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Pomalidomide.
Ponatinib	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ponatinib.
Ponesimod	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ponesimod.
Pralatrexate	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Pralatrexate.
Pramocaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Pramocaine.
Prasugrel	The risk or severity of bleeding can be increased when Prasugrel is combined with Alemtuzumab.
Prednisolone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Prednisolone.
Prednisone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Prednisone.
Prilocaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Prilocaine.
Procaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Procaine.
Procarbazine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Procarbazine.
Proparacaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Proparacaine.
Propoxycaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Propoxycaine.
Propylthiouracil	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Propylthiouracil.
Protein C	The risk or severity of bleeding can be increased when Protein C is combined with Alemtuzumab.

Ramucirumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ramucirumab.
Ranibizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ranibizumab.
Ravulizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ravulizumab.
Raxibacumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Raxibacumab.
Reslizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Reslizumab.
Reteplase	The risk or severity of bleeding can be increased when Reteplase is combined with Alemtuzumab.
Reviparin	The risk or severity of bleeding can be increased when Reviparin is combined with Alemtuzumab.
Rilonacept	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Rilonacept.
Risankizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Risankizumab.
Rituximab	The risk or severity of adverse effects can be increased when Rituximab is combined with Alemtuzumab.
Rivaroxaban	The risk or severity of bleeding can be increased when Rivaroxaban is combined with Alemtuzumab.
Roflumilast	Roflumilast may increase the immunosuppressive activities of Alemtuzumab.
Romosozumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Romosozumab.
Ropeginterferon alfa-2b	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ropeginterferon alfa-2b.
Ropivacaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Ropivacaine.
Rotavirus vaccine	The therapeutic efficacy of the Rotavirus vaccine can be decreased when used in combination with Alemtuzumab.
Rubella virus vaccine	The risk or severity of infection can be increased when the Rubella virus vaccine is combined with Alemtuzumab.
Ruxolitinib	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ruxolitinib.
Sacituzumab govitecan	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with sacituzumab govitecan.
Sarilumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Sarilumab.
Natalizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Satralizumab.
Secukinumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Secukinumab.
Siltuximab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Siltuximab.
Siponimod	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Siponimod.
Sipuleucel-T	The therapeutic efficacy of Sipuleucel-T can be decreased when used in combination with Alemtuzumab.
Sirolimus	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Sirolimus.
Smallpox (Vaccinia) Vaccine, Live	The therapeutic efficacy of the Smallpox (Vaccinia) Vaccine, Live can be decreased when used in combination with Alemtuzumab.
Sodium citrate	The risk or severity of bleeding can be increased when Sodium citrate is combined with Alemtuzumab.
Sorafenib	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Sorafenib.
Sotrovimab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Sotrovimab.
Spesolimab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Spesolimab.
Streptokinase	The risk or severity of bleeding can be increased when Streptokinase is combined with Alemtuzumab.
Streptozocin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Streptozocin.
Sulesomab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Sulesomab.
Sulfamethoxazole	The risk or severity of myelosuppression can be increased when Sulfamethoxazole is combined with Alemtuzumab.
Sulfasalazine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Sulfasalazine.
Sulfinpyrazone	The risk or severity of bleeding can be increased when Sulfinpyrazone is combined with Alemtuzumab.
Sulodexide	The risk or severity of bleeding can be increased when Sulodexide is combined with Alemtuzumab.
Sunitinib	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Sunitinib.
Sutimlimab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Sutimlimab.
Synthetic Conjugated Estrogens, A	Synthetic Conjugated estrogen, A may increase the thrombogenic activities of Alemtuzumab.
Synthetic Conjugated Estrogens, B	Synthetic Conjugated estrogen, B may increase the thrombogenic activities of Alemtuzumab.
Tacrolimus	Tacrolimus may increase the immunosuppressive activities of Alemtuzumab.
Tafasitamab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Tafasitamab.
Tedizolid phosphate	The risk or severity of myelosuppression can be increased when Alemtuzumab is combined with Tedizolid phosphate.
Temozolomide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Temozolomide.
Temsirolimus	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Temsirolimus.
Tenecteplase	The risk or severity of bleeding can be increased when Tenecteplase is combined with Alemtuzumab.
Teniposide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Teniposide.
Teprotumumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Teprotumumab.
Teriflunomide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Teriflunomide.
Tetanus immune globulin, human	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Tetanus immune globulin, human.
Tetracaine	The risk or severity of methemoglobinemia can be increased when Alemtuzumab is combined with Tetracaine.
Tezepelumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Tezepelumab.
Thalidomide	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Thalidomide.
Thiotepa	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Thiotepa.
Tibolone	Tibolone may increase the thrombogenic activities of Alemtuzumab.
Ticagrelor	The risk or severity of bleeding can be increased when Ticagrelor is combined with Alemtuzumab.
Tick-borne encephalitis vaccine (whole virus, inactivated)	The therapeutic efficacy of the Tick-borne encephalitis vaccine (whole virus, inactivated) can be decreased when used in combination with Alemtuzumab.
Ticlopidine	The risk or severity of bleeding can be increased when Ticlopidine is combined with Alemtuzumab.
Tildrakizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Tildrakizumab.
Tinzaparin	The risk or severity of bleeding can be increased when Tinzaparin is combined with Alemtuzumab.
Tioguanine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Tioguanine.
Tirofiban	The risk or severity of bleeding can be increased when Tirofiban is combined with Alemtuzumab.
Tisotumab vedotin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Tisotumab vedotin.
Tixagevimab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Tixagevimab.
Tixocortol	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Tixocortol.
Tocilizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Tocilizumab.
Tofacitinib	Alemtuzumab may increase the immunosuppressive activities of Tofacitinib.
Topotecan	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Topotecan.
Tositumomab	The risk or severity of adverse effects can be increased when Tositumomab is combined with Alemtuzumab.
Trabectedin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Trabectedin.
Tralokinumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Tralokinumab.
Trastuzumab	Trastuzumab may increase the neutropenic activities of Alemtuzumab.
Trastuzumab deruxtecan	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Trastuzumab deruxtecan.
Trastuzumab emtansine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Trastuzumab emtansine.
Tretinoin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Tretinoin.
Triamcinolone	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Triamcinolone.
Trichlormethiazide	The risk or severity of neutropenia and thrombocytopenia can be increased when Trichlormethiazide is combined with Alemtuzumab.
Trifluridine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Trifluridine.
Triflusal	The risk or severity of bleeding can be increased when Triflusal is combined with Alemtuzumab.
Trilostane	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Trilostane.
Typhoid vaccine	The therapeutic efficacy of the Typhoid vaccine can be decreased when used in combination with Alemtuzumab.
Typhoid Vaccine Live	The risk or severity of infection can be increased when Typhoid Vaccine Live is combined with Alemtuzumab.
Typhoid Vi polysaccharide vaccine	The therapeutic efficacy of the Typhoid Vi polysaccharide vaccine can be decreased when used in combination with Alemtuzumab.
Upadacitinib	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Upadacitinib.
Urokinase	The risk or severity of bleeding can be increased when Urokinase is combined with Alemtuzumab.
Ustekinumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Ustekinumab.
Varicella zoster vaccine (live/attenuated)	The risk or severity of infection can be increased when the Varicella zoster vaccine (live/attenuated) is combined with Alemtuzumab.
Varicella zoster vaccine (recombinant)	The therapeutic efficacy of the Varicella zoster vaccine (recombinant) can be decreased when used in combination with Alemtuzumab.
Vedolizumab	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Vedolizumab.
Vibrio cholerae CVD 103-HgR strain live antigen	The therapeutic efficacy of Vibrio cholera CVD 103-HgR strain lives antigen can be decreased when used in combination with Alemtuzumab.
Vilanterol	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Vilanterol.
Vinblastine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Vinblastine.
Vincristine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Vincristine.
Vindesine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Vindesine.
Vinorelbine	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Vinorelbine.
Voclosporin	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Voclosporin.
Vorapaxar	The risk or severity of bleeding can be increased when Vorapaxar is combined with Alemtuzumab.
Vorinostat	The risk or severity of adverse effects can be increased when Alemtuzumab is combined with Vorinostat.

Pregnancy and Lactation

FDA Pregnancy Category C.

Pregnancy

This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately. Women who may become pregnant should use effective birth control when receiving alemtuzumab and for at least 4 months after the course of treatment.

Breast-feeding

It is not known if alemtuzumab passes into breast milk. If you are a breastfeeding mother and are taking this medication, it may affect your baby. Women should not breastfeed for at least 4 months after the last infusion of a treatment course. Talk to your doctor about whether you should continue breastfeeding.

Are there any other warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breastfeeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Autoimmune conditions: Rarely, alemtuzumab, like other similar medications, can cause other serious, possibly fatal autoimmune conditions. Your doctor will order blood tests to monitor for changes that could signal the development of one of these conditions. If you experience any unusual or unexpected effects, contact your doctor to have these effects checked out.

Bleeding: Alemtuzumab may cause a reduced number of platelets in the blood, which can make it difficult to stop cuts from bleeding. If you notice any signs of bleeding, such as frequent nosebleeds, unexplained bruising, or black, and tarry stools, notify your doctor as soon as possible. Your doctor will order routine blood tests to make sure potential problems are caught early.

Immune system and infections: Alemtuzumab may lower your ability to fight infections and may increase the risk of infections and reactivate inactive infections. Your doctor may test for tuberculosis before starting this medication.

Your doctor will do regular tests of immune system function while you are using this medication. If you develop a severe infection, contact your doctor as soon as possible.

Infusion reactions: Alemtuzumab may cause side effects while the medication is being given, and for some time afterward. If you experience headache, rash, fever, itchiness, chills, flushing, chest pain or discomfort, or dizziness, let your doctor know immediately. Your doctor may give you medications to help prevent these effects.

Kidney function: Alemtuzumab may decrease kidney function. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Rarely, this medication may cause severe and possibly life-threatening liver problems. If you experience signs of decreased liver function, such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Malignancies (cancer): Alemtuzumab may increase the risk of developing cancer including thyroid cancer, certain types of lymphoma, and skin cancer. Discuss any concerns you have with your doctor.

Progressive multifocal leukoencephalopathy (PML): There have been reports of PML after using alemtuzumab. PML is a rare disorder that causes nerve damage in the brain. If you experience memory loss, vision loss, trouble thinking, or difficulty walking, contact your doctor immediately.

Serious infections: Alemtuzumab can affect the way your body’s natural defenses work to fight infection. This makes the body more likely to develop infections due to bacteria, viruses, and fungi. This effect is increased if you are taking alemtuzumab with other medications that reduce the body’s ability to fight infection. For some people, these infections have been fatal. If you have a history of chronic or frequent infections, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Stop taking the medication and tell your doctor right away if you notice symptoms of a serious infection, such as fever, chills, headache, flu-like symptoms, feeling tired, cough, blood in the sputum, shortness of breath, night sweats, weight loss, nausea, vomiting, diarrhea, frequency or burning while passing urine, redness or swelling of skin or joint, cold sores, tooth pain, or new or worsening pain in any part of the body.

Stroke and heart attack: There have been reports of people experiencing a stroke, heart attack, or other serious reactions including bleeding in the lung or tears in blood vessels supplying the brain after receiving an infusion of alemtuzumab. Stroke symptoms may include confusion, sudden or severe headache, sudden loss of coordination, vision changes, sudden slurring of speech, or unexplained weakness, numbness, or pain in the arm or leg. Heart attack symptoms may include sudden chest pain or pain radiating to the back, down arm, or jaw; a sensation of fullness of the chest; nausea; vomiting; sweating; or anxiety. If you experience any of these symptoms, get immediate medical attention.

Thyroid problems: Some people taking this medication to develop changes in the function of their thyroid. Symptoms of these changes include feeling cold or hot all the time, a change in weight (gain or loss) without a change in your diet or the amount of exercise you get, or feeling emotional. Contact your doctor if you experience these symptoms.

Vaccinations: It is not known how effective vaccines may be after treatment with this medication. Certain immunizations may be dangerous if given while receiving or shortly after receiving a treatment course of alemtuzumab. Before starting treatment with this medication, check with your doctor to ensure your immunizations are up to date. Vaccinations should be completed at least 6 weeks before starting alemtuzumab.

References

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