aldesleukin, Proleukin (cont.)

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PRESCRIBED FOR: Aldesleukin is used in treating wide-spread (metastatic) cancer of the kidney (renal cell cancer) and skin (melanoma). It also being investigated in several other diseases including acute myelogenous leukemia, non-Hodgkin's lymphoma, HIV infection, Kaposi's sarcoma, and leprosy.

DOSING: The recommended dose is 600,000 IU/kg intravenously over 15 minutes every 8 hours for 14 doses followed by 9 days of rest then another 14 doses.

DRUG INTERACTIONS: Use of aldesleukin with drugs that share similar toxicity and side effects results in shared side effects that are more severe. For example, drugs that cause damage to the heart, for example, doxorubicin (Adriamycin), can worsen the toxic effects of aldesleukin on the heart. Similarly, drugs that damage the kidneys such as aminoglycosides (Garamycin, Nebcin, Amikin) or nonsteroidal anti-inflammatory drugs, for example, ibuprofen (Motrin, Advil) can worsen the toxic effects of aldesleukin on the kidneys. Aldesleukin also affects the nervous system; therefore, combining it with narcotics, sedatives, or tranquilizers may add to its effects on the nervous system. Finally, drugs that cause liver damage such as isoniazid (INH) increase the toxic effects of aldesleukin on the liver.

Aldesleukin stimulates the immune system. Corticosteroids (for example, methylprednisolone [Medrol] or prednisone) inhibit the immune system. Therefore, aldesleukin and corticosteroids will have opposing effects if used together. Use of such combinations, in fact, may decrease the anti-tumor effect of aldesleukin. Nevertheless, when aldesleukin is used, clinicians may use dexamethasone (a very powerful corticosteroid) to decrease side effects of aldesleukin such as dyspnea, confusion, fever, nephrotoxicity, or hepatotoxicity, despite the possible decrease in benefit.

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