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interactions

Using a drug with certain vaccines, foods, and others can affect how the drug works. These effects are called interactions.

Before receiving Kymriah, be sure to tell your doctor about all medications you are taking, including prescription and over-the-counter medications. Also describe any vitamins, herbs or supplements you use. Your doctor or pharmacist can tell you about any interactions these may cause with Kymriah.

For additional information on drug-condition interactions, see “Other Warnings” section below.

Interactions with Medications or Supplements

There are currently no medications or supplements known to interact with Kymriah. But you should always tell your doctor and pharmacist about any medicines you are taking in addition to Kymriah.

Other interactions

Kymriah may interact with certain HIV laboratory tests, such as HIV RNA tests. It is possible for Kymriah to cause a false positive result on this test. (A false positive occurs when the test shows that HIV is present even if the person tested does not have HIV.)

If you need an HIV test, tell your doctor that you have received Kymriah. They may recommend taking another HIV test that does not interact with Kymriah.

Additionally, Kymriah may interact with live vaccines. (Live vaccines are made from a weakened form of the bacteria or virus that the vaccines protect against.)

The following are examples of live vaccines:

It is not known what effects the drug may have on live vaccines. But you should not receive any of these vaccines within 6 weeks before starting chemotherapy and until your immune system has recovered after your Kymriah infusion. This is because chemotherapy and Kymriah can weaken your immune system, which could make live vaccines sick.

If you need to get vaccinated, tell your doctor or pharmacist that you have received Kymriah. They will be able to help you determine if it is safe for you to receive your vaccine.

Boxed warnings

Kymriah has two framed warnings. These are serious warnings from the Food and Drug Administration (FDA) about the effects of drugs that can be dangerous.

Boxed warnings include:

Risk of cytokine release syndrome. Kymriah can cause a condition called cytokine release syndrome (CRS). This condition can occur after certain cancer treatments, such as Kymriah, and it causes your body to release proteins called cytokines into your blood. Symptoms of CRS include fever, nausea, and rapid heartbeat. CRS can be life-threatening in some cases.

Because of this risk, your doctor will monitor you for at least 4 weeks after your Kymriah infusion to make sure you do not develop symptoms of CRS. If you notice any symptoms, seek immediate medical attention or go to the nearest hospital.

Risk of neurological toxicity. Kymriah can cause neurological toxicity (damage to the nervous system, which includes the brain and nerves). Examples of neurological toxicity include headaches, anxiety, sleep problems, dizziness, confusion, tremors, and nerve pain. More serious forms of neurological toxicity include seizures and encephalopathy, which can be life-threatening.

Because of these risks, your doctor will monitor you closely for at least 4 weeks after your Kymriah infusion to make sure you do not develop these side effects. If you notice symptoms of neurological toxicity, seek immediate medical attention or go to the nearest hospital.

Other warnings

Kymriah may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also determine whether Kymriah is an appropriate treatment option for you.

Talk to your doctor about your medical history before taking Kymriah. The list below includes factors to consider.

  • infections. You should tell your doctor if you have any infections before you receive Kymriah. Kymriah can cause infections, and if you already have an infection, this medicine may make it worse. Your doctor will recommend that you treat any infections before you receive your dose of Kymriah.
  • Hepatitis B virus. Kymriah may cause the hepatitis B virus (HBV) to reactivate (cause symptoms again) in people who have had the virus. In some cases, it can be serious and even life-threatening. If you have ever had HBV, ask your doctor if Kymriah is safe for you.

There are no known contraindications for Kymriah. (A contraindication is a condition that may make it unsafe to take a specific drug.)

Kymriah and alcohol

There are no known interactions between Kymriah and alcohol. But Kymriah and alcohol can cause nausea, vomiting, or headache. So, combining the two may increase your risk of these side effects or make them worse if they occur.

Additionally, alcohol can weaken your immune system. This can decrease your body’s ability to fight cancer. It can also increase your risk of infection, which is also a side effect of Kymriah.

If you drink alcohol, discuss with your doctor how much (if any) you can safely drink given your condition and treatment plan.

Pregnancy and breastfeeding

You should not use Kymriah during pregnancy. The safety of Kymriah during pregnancy has not been studied, so it is not known if the medicine may be safe or what effects it may have on the fetus. But based on how Kymriah works, it’s possible it could harm the fetus.

If you can get pregnant, your doctor will give you a pregnancy test before you receive Kymriah. They may also recommend the use of birth control when you receive chemotherapy before your Kymriah infusion.

No studies have been performed with Kymriah during lactation. It is therefore not known whether the medicine can pass into breast milk or what effects it may have on a nursing child.

If you are pregnant or breastfeeding, or planning to become pregnant or breastfeeding, tell your doctor before you receive Kymriah.

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