贝伐和错来磷酸一起注射可以吗？

医生说以后21天一次贝伐，那么可以和骨转针一起吗？还是要间隔几天？

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贝伐、唑来膦酸联用将增加下颚坏死的风险，但贝伐是救命的药，先用着；
如果发现下颚部分异样可能要停贝伐了，因为唑来膦酸在骨头上能停留数年。

yohoo 发表于 2017-12-16 20:21
贝伐、唑来膦酸联用将增加下颚坏死的风险，但贝伐是救命的药，先用着；
如果发现下颚部分异样可能要停贝伐了，因为唑来膦酸在骨头上能停留数年。

这么危险啊，知道了，那还是分开注射

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yohoo 发表于 2017-12-16 20:21
贝伐、唑来膦酸联用将增加下颚坏死的风险，但贝伐是救命的药，先用着；
如果发现下颚部分异样可能要停贝伐 ...

“贝伐、唑来膦酸联用将增加下颚坏死的风险”


请问根据是什么？

荷花池荒岛 发表于 2017-12-17 02:09
“贝伐、唑来膦酸联用将增加下颚坏死的风险”

zoledronic acid  bevacizumab
Applies to:Aclasta (zoledronic acid) and bevacizumab
MONITOR: Osteonecrosis of the jaw (ONJ) has been reported with the use of angiogenesis inhibitors including denosumab, bevacizumab, and sunitinib. Concomitant exposure with other risk factors such as bisphosphonates (potency, route of administration, and cumulative dose), cancer, chemotherapy, corticosteroids, radiotherapy to the head and neck, dental disease, invasive dental procedures, or poor oral hygiene may increase the risk. Most reported cases with bevacizumab have occurred in patients who received prior or concomitant treatment with intravenous bisphosphonates or had a history of dental disease requiring invasive dental procedures. For denosumab, the majority of reported cases of ONJ in clinical trials occurred within 5 months after the last dose; in clinical trials, the incidence increased with duration of exposure. Clinical trials in patients with breast or prostate cancer with an extension treatment phase of open-label denosumab reported a patient-year adjusted incidence of confirmed ONJ of 1.1% in the first year of treatment, 3.7% in the second year, and 4.6% thereafter, with a median time to ONJ onset of approximately 20.6 months. ONJ has been rarely reported in clinical trials with the use of denosumab for osteoporosis.

MANAGEMENT: Caution is advised if bisphosphonates are used simultaneously or sequentially with denosumab or bevacizumab. Prior to initiating treatment, a thorough dental examination and appropriate preventive dentistry should be considered. If possible, invasive dental procedures should be avoided in patients who have previously received or are receiving intravenous bisphosphonates. Good oral hygiene practices should be maintained during treatment. Patients should be advised to seek medical attention if they experience signs and symptoms of osteonecrosis in the jaw, such as: pain in the mouth, teeth, or jaw, swelling or sores inside the mouth, numbness or a feeling of heaviness in the jaw, loosening of a tooth, or exposure of bone in the jaw. Temporary interruption of treatment should be considered if clinically appropriate, until the condition resolves.

References

"Product Information. Sutent (sunitinib)." Pfizer U.S. Pharmaceuticals Group, New York, NY.
Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Cerner Multum, Inc. "Australian Product Information." O 0
"Product Information. Prolia (denosumab)." Amgen USA, Thousand Oaks, CA.

tracyzhang3893 发表于 2017-12-16 23:31
这么危险啊，知道了，那还是分开注射

只是增加风险，不是一定发生，就好比吸烟的得肺癌几率大但不一定得上肺癌。

yohoo 发表于 2017-12-17 09:16

                               
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只是增加风险，不是一定发生，就好比吸烟的得肺癌几率大但不一定得上肺癌。

是不是就跟吃易瑞沙可能产生间质性肺炎一样的！

yohoo 发表于 2017-12-17 09:11
zoledronic acid  bevacizumab
Applies to:Aclasta (zoledronic acid) and bevacizumab
MONITOR: Osteo ...

请给一下转发文章的原始链接。谢谢。

荷花池荒岛 发表于 2017-12-17 16:09
请给一下转发文章的原始链接。谢谢。

Clinical study evaluating the effect of bevacizumab on the severity of zoledronic acid-related osteonecrosis of the jaw in cancer patients

yohoo 发表于 2017-12-17 09:11
zoledronic acid  bevacizumab
Applies to:Aclasta (zoledronic acid) and bevacizumab
MONITOR: Osteonecrosis of the jaw (ONJ) has been reported with the use of angiogenesis inhibitors including denosumab, bevacizumab, and sunitinib. Concomitant exposure with other risk factors such as bisphosphonates (potency, route of administration, and cumulative dose), cancer, chemotherapy, corticosteroids, radiotherapy to the head and neck, dental disease, invasive dental procedures, or poor oral hygiene may increase the risk. Most reported cases with bevacizumab have occurred in patients who received prior or concomitant treatment with intravenous bisphosphonates or had a history of dental disease requiring invasive dental procedures. For denosumab, the majority of reported cases of ONJ in clinical trials occurred within 5 months after the last dose; in clinical trials, the incidence increased with duration of exposure. Clinical trials in patients with breast or prostate cancer with an extension treatment phase of open-label denosumab reported a patient-year adjusted incidence of confirmed ONJ of 1.1% in the first year of treatment, 3.7% in the second year, and 4.6% thereafter, with a median time to ONJ onset of approximately 20.6 months. ONJ has been rarely reported in clinical trials with the use of denosumab for osteoporosis.

MANAGEMENT: Caution is advised if bisphosphonates are used simultaneously or sequentially with denosumab or bevacizumab. Prior to initiating treatment, a thorough dental examination and appropriate preventive dentistry should be considered. If possible, invasive dental procedures should be avoided in patients who have previously received or are receiving intravenous bisphosphonates. Good oral hygiene practices should be maintained during treatment. Patients should be advised to seek medical attention if they experience signs and symptoms of osteonecrosis in the jaw, such as: pain in the mouth, teeth, or jaw, swelling or sores inside the mouth, numbness or a feeling of heaviness in the jaw, loosening of a tooth, or exposure of bone in the jaw. Temporary interruption of treatment should be considered if clinically appropriate, until the condition resolves.

References

&quotroduct Information. Sutent (sunitinib)." Pfizer U.S. Pharmaceuticals Group, New York, NY.
Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Cerner Multum, Inc. "Australian Product Information." O 0
&quotroduct Information. Prolia (denosumab)." Amgen USA, Thousand Oaks, CA.

您太专业了，谢谢啊

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