talimogene laherparepvec

Brand Name :

Imlygic

Synonyms :

talimogene laherparepvec

Class :

Oncolytic Immunotherapy

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Actions and spectrum: 

talimogene laherparepvec is an oncolytic viral therapy used in the treatment of advanced melanoma. It is a modified herpes simplex virus type 1 that selectively replicates in tumor cells, leading to their destruction. T

he virus also encodes granulocyte-macrophage colony-stimulating factor (GM-CSF), which stimulates the immune response against the tumor. The spectrum of talimogene laherparepvec is limited to its treatment of unresectable melanoma lesions in the skin and lymph nodes. 

 

DRUG INTERACTION

Talimogene Laherparepvec

&

  • Pembrolizumab / Berahyaluronidase
  • Bumetanide Intranasal
  • Gemcitabine intravesical
  • Rilzabrutinib
  • Zopapogene
  • Aceclidine
  • aluminium hydroxide
  • benzralizumab (Rx)
  • Rituximab
  • Trimetrexate Glucuronate
  • Mirdametinib
  • Suzetrigine
  • Potassium acid phosphate
  • Acellular Tissue Engineered Vessel
  • crinecerfont (pending approval from FDA)
  • Revumenib
  • pembrolizumab (Rx)
  • azathioprine (Rx)
  • Gemcitabine (Rx)
  • Seladelpar
  • Atezolizumab / Hyaluronidase-tqjs
  • Axatilimab-csfr
  • Afamitresgene Autoleucel
  • Lazertinib
  • Ocrelizumab / Hyaluronidase ocsq
  • Lebrikizumab
  • naloxone intranasal
  • clomiphene
  • patisiran
  • imetelstat
  • phenylephrine ophthalmic
  • myoinositol
  • vasicinone
  • soda lime
  • fisetin
  • Reynoutria Japonica
  • Coco Monoethanolamide
  • Betadex
  • lithopone
  • cyperus rotundus
  • papaya juice
  • 1-naphthaleneacetic acid
  • Nordazepam
  • Glechoma hederacea
  • Alternanthera sessilis
  • nicofetamide
  • napthol asol
  • cocamidopropyl betaine
  • musa x paradisiaca
  • dicyclomine/mefenamic acid
  • Sorghum
  • Manganese citrate
  • tovorafenib
  • mefenamic acid/paracetamol
  • eschscholzia californica
  • canna indica root
  • tranexamic acid/mefenamic acid
  • dexverapamil
  • sitogluside
  • secalciferol
  • cefatrizine
  • Sedum Acre
  • Flurogestone
  • Fluocortin
  • Bifendate
  • piprozolin
  • aminacrine undecylate
  • ethylenediamine mandelate
  • pelubiprofen
  • hesperetin
  • butethamine
  • epitiostanol
  • androstenediol
  • Nitroxoline
  • Iocarmic acid
  • Capobenic acid
  • dordaviprone (investigational drug)
  • Vitexin
  • Friluglanstat (investigational drug)
  • scorias spongiosa
  • Luseogliflozin
  • indoxacarb
  • prademagene zamikeracel
  • fidanacogene elaparvovec-dzkt
  • albifylline
  • idanpramine
  • araneus diadematus
  • Sulfamazone
  • Lycosa tarantula
  • malotilate
  • Ethacizine
  • Namilumab
  • Latrunculin B
  • stachyose
  • platinic oxide
  • iopronic acid
  • calcium chloride / potassium chloride/lactic acid/ sodium chloride/sodium hydroxide/sodium lactate solution
  • citric acid/ sodium bicarbonate/ sodium carbonate anhydrous
  • vadadustat
  • permethrin medical grade cis/trans isomers 25/75
  • lutetium, isotope of mass 177
  • human normal immunoglobulin
  • sacrosidase
  • apadamtase alfa, recombinant
  • acetyl hexapeptide-8 amide
  • pemivibart (Investigational)
  • govorestat
  • Zanidatamab
  • sotatеrcеpt
  • MV 140 vaccine
  • leuprorelin implant
  • cinchocaine hydrochloride/fluocortolone hexanoate/fluocortolone pivalate
  • Beautyberry
  • risedronate/calcium/vitamin D3
  • rhubarb extract/senna leaf/sulphur purified/wood charcoal
  • boric acid/kaolin/methyl salicylate/peppermint oil/thymol
  • docosahexaenoic acid/eicospentaenoic acid
  • aluminium hydroxide/magnesium hydroxide/simethicone
  • gentamicin/hydrocortisone
  • succinylcholine
  • sinefungin
  • letibotulinumtoxinA
  • coal tar/coconut oil/salicylic acid
  • camphor/camphor oil white/capsicum oleoresin /menthol/methyl salicylate
  • thioglycolic acid
  • acetic acid auricular
  • roluperidone
  • hydrocortisone/crotamiton topical
  • nystatin/chlorhexidine
  • aluminium chloride hexahydrate
  • ketoprofen topical
  • Chlormethine
  • podophyllotoxin
  • urea/lactic acid
  • autologous chondrocytes implant
  • afelimomab
  • gepotidacin
  • fludroxycortide
  • fentanyl transdermal
  • erythromycin/zinc acetate
  • dibotermin alfa powder
  • desferrioxamine mesilate
  • choline salicylate/magnesium salicylate
  • castor oil/peru balsam/trypsin
  • betamethasone/dexchlorpheniramine maleate
  • benzalkonium chloride solution/cetrimide
  • barzolvolimab
  • ascorbic acid / calcium laevulinate / nicotinamide / calcium pantothenate / calcium chloride / riboflavine / pyridoxine hydrochloride / thiamine hydrochloride
  • argipressin
  • arachis oil refined/chlorobutanol hemihydrate
  • arachis oil/eucalyptol/nutmeg oil/terpineol
  • ammonium chloride/diphenhydramine hydrochloride/levomenthol
  • amino acid mixture d / calcium chloride dihydrate / glucose monohydrate / glycine / magnesium chloride hexahydrate / olive oil / potassium chloride / sodium acetate trihydrate / sodium glycerophosphate pentahydrate / soya-bean oil
  • biotin/colecalciferol/copper (ii)sulfate dried/ cyanocobalamine/ dl-alpha tocopherol acetate/dibasic calcium phosphate anhydrous/folic acid/iron (ii)sulfate dried/ lecithin/ magnesium sulfate dried/ nicotinamide/ pyridoxine hydrochloride/ riboflavin
  • ampicillin sodium / cloxacillin sodium
  • undecylenic acid, undecylenate salts, zincundecate
  • omeprazole/sodium bicarbonate
  • efgartigimod alfa/hyaluronidase
  • xylometazoline/ipratropium
  • cefepime and enmetazobactam
  • isotonic sodium chloride
  • bee venom allergen injection
  • fentanyl intranasal
  • alglucosidase alfa
  • triprolidine/pseudoephedrine
  • pegademase bovine
  • castor oil and peru balsam
  • camphor/eucalyptus oil/menthol
  • oxyquinoline/sodium lauryl sulfate
  • somatorelin
  • menotrophin injection
  • menadiol
  • hylan g-f 20
  • cefepime and taniborbactum
  • water avens
  • camphor/menthol
  • acoramidis
  • elafibranor
  • arrowroot
  • miconazole nitrate/hydrocortisone
  • vildagliptin/metformin
  • dobesilic acid
  • aroxybutynin and atomoxetine
  • hygromycin
  • linvoseltamab
  • nemolizumab
  • aceprometazine
  • limaprost
  • oxazolam
  • trimegestone
  • teceleukin
  • beauty berry
  • dinotefuran
  • imiprothrin
  • transfluthrin
  • thymalfasin
  • technetium Tc 99m tilmanocept
  • glepaglutide
  • marstacimab
  • pixantrone
  • Andiroba
  • arabinoxylan
  • arenaria rubra
  • etripamil
  • jequirity
  • jiaogulan
  • dusquetide
  • rolipram
  • tradipitant
  • sinfungin
  • diclofenac/omeprazole
  • brinzolamide and timolol maleate
  • wormseed
  • wormwood
  • wood sorrel
  • carmellose sodium
  • ibandronic acid
  • cinnarizine and dimenhydrinate
  • ursodeoxycholic acid
  • rhubarb extract/salicylic acid
  • butamirate citrate
  • fumitory
  • taheebo
  • uva ursi
  • vervain
  • coleus
  • coltsfoot
  • crampbark
  • plantain
  • potassium nitrate and silver nitrate
  • gelsemium
  • gentian
  • glucomannan
  • walnut
  • meadowsweet
  • midomafetamine
  • pennyroyal
  • periwinkle
  • betony
  • bitter orange
  • bladderwrack
  • bloodroot
  • emu oil
  • garcinia
  • yellow dock
  • burdock
  • dehydroepiandrosterone
  • aucubin
  • jasmone
  • resacetophenone
  • ecamsule ditriethanolamine
  • feclobuzone
  • fenoprop triethanolamine
  • verdyl acetate
  • caffeic acid
  • cyclamen aldehyde
  • dicetyldimonium chloride
  • wogonin
  • impacarzine
  • laurylpyridinium chloride
  • stepronin
  • matrine
  • sakuranin
  • cannabichromene
  • sandalore
  • sabinene
  • oxypaeoniflora
  • ethylhexyl pelargonate
  • acrylonitrile
  • allyl alcohol
  • dipalmitoylethyl hydroxyethylmonium methosulfate
  • butidrine
  • clothiapine
  • propanediol dicaprylate
  • buchu
  • undecanol
  • enilconazole
  • xymenynic acid
  • angelica
  • nizubaglustat
  • resomelagon
  • ulecaciclib
  • apple cider vinegar
  • bacopa
  • barley grass
  • dandelion
  • deer velvet
  • dolomite
  • bugleweed
  • bupleurum
  • glyceryltrinitrate
  • pociredir
  • asnuciclib
  • actalycabtagene autoleucel
  • butantan–dengue vaccine
  • travoprost/timolol
  • furosemide/potassium chloride
  • amylamine
  • jaborandi
  • patritumab deruxtecan
  • jackfruit
  • sterculia
  • ascorbigen
  • ashitaba
  • androstenetrione
  • andrachne
  • cosibelimab
  • racecadotril
  • neomycin/chlorhexidine
  • octocog alfa
  • cetrimide
  • ispaghula husk
  • polyhexanide
  • octenidine
  • polygeline
  • heparinoid
  • jewelweed
  • boldo
  • anizatrectinib
  • alpinia
  • henbane
  • cynanchum vincetoxicum root and sulfur
  • boditrectinib
  • izumerogant
  • zavondemstat
  • abuta
  • fadogia agrestis
  • fly agaric mushroom
  • meptazinol
  • methoxyflurane
  • tramadol/dexketoprofen
  • betaine/polyhexanide
  • filgotinib
  • inosine acedoben dimepranol
  • alverine citrate
  • hyoscine butylbromide
  • senna+ ispaghula
  • cabbage palm
  • cajeput oil
  • calanus oil
  • calamint
  • canada balsam
  • carnosine
  • alverine citrate/simeticone
  • dihydroartemisinin/piperaquine
  • mebeverine/ispaghula
  • calcipotriol
  • tacalcitol
  • triethyl citrate/ethyl linoleate
  • sodium dilauramidoglutamide lysine
  • fazamorexant
  • avibactam tomilopil and ceftibuten
  • drostanolone
  • tigilanol tiglate
  • isorhynchophylline
  • rhynchophylline
  • crisugabalin
  • epigallocatechin gallate
  • clomocycline
  • corynoxeine
  • isocorynoxeine
  • Culmerciclib
  • Neladenoson
  • ambrein
  • hexylcaine
  • phensuximide
  • resencatinib (investigational)
  • rolusafine
  • pumecitinib
  • arhalofenic acid
  • berdazimer sodium
  • benzquinamide
  • clidinium
  • sulfametopyrazine
  • fulzerasib (Investigational Drug)
  • rovadicitinib (Investigational Drug)
  • Upleganan (Investigational Drug)
  • menthyl ethylamido oxalate
  • quaternium-90 montmorillonite
  • unecritinib (investigational drug)
  • etohexadiol
  • guaiol
  • proximadiol
  • verdinexor
  • sofnobrutinib
  • talbutal
  • ethoxzolamide
  • propiomazine
  • enprofylline
  • phenmetrazine
  • merigolix
  • pralurbactam
  • neracorvir
  • vonifimod
  • apaziquone hydroquinone
  • darizmetinib
  • zandelisib
  • xininurad
  • ritivixibat
  • amiselimod phosphate (investigational drug)
  • emzeltrectinib (investigational drug)
  • ficonalkib
  • cinalukast
  • ulobetasol
  • candoxatril
  • nitrofural
  • acetyldigitoxin
  • bentiromide
  • dextrothyroxine
  • chlorotrianisene
  • remikiren
  • pipobroman
  • vidarabine
  • immune globulin intravenous, human-stwk
  • spermine
  • serine
  • N-acetyl glucosamine
  • valine
  • adenine
  • asparagine
  • citrulline
  • adinazolam
  • interferon alfacon-1
  • interferon alfa-n1
  • felypressin
  • birch triterpenes
  • pyridoxal phosphate
  • technetium Tc-99m arcitumomab
  • beta-alanine
  • dihomo-gamma-linolenic acid
  • urea/hydrocortisone
  • R21/Matrix-M vaccine
  • povidone-iodine (ophthalmic)
  • pheniramine
  • hydrocortisone rectal
  • chloroxylenol/pramoxine/zinc acetate
  • chloroxylenol/pramoxine
  • dextrose/sucrose/vitamin C/zinc sulphate
  • furazolidone/metronidazole/dicyclomine
  • ergocalciferol (vitamin D2)
  • benoxaprofen (discontinued)
  • teicoplanin
  • carbomer
  • chromic chloride / iron (ii) chloride tetrahydrate / potassium iodide / manganese chloride / sodium fluoride / sodium selenite pentahydrate / sodium molybdate dihydrate / zinc chloride/ cupric chloride
  • bufylline
  • lidocaine/prilocaine
  • opium tincture, squill oxymel
  • dibrompropamidine
  • metronidazole/tetracycline/bismuth subsalicylate
  • agnus- castus
  • velaglucerase alfa
  • alendronic acid / colecalciferol
  • bimatoprost / timolol
  • efbemalenograstim alfa
  • dried ferrous sulfate/folic acid
  • dried ferrous sulfate / sodium ascorbate
  • nirogacestat
  • soya-bean oil, medium-chain triglycerides
  • demeclocycline hydrochloride and triamcinolone acetonide
  • fusidic acid / hydrocortisone acetate
  • macrogol
  • storax, benzoin
  • nomegestrol acetate/estradiol
  • flumetasone pivalate/ clioquinol
  • berdazimer topical (Pending FDA Approval)
  • buflomedil
  • butobarbital
  • andexanet alfa
  • methoxypolyethylene glycol-epoetin beta
  • viscum abietis
  • pramoxine vaginal
  • bupivacaine implant
  • cromolyn sodium, inhaled
  • pneumococcal vaccine 20-valent
  • bimatoprost ophthalmic implant
  • tick-borne encephalitis vaccine
  • chloroprocaine ophthalmic
  • travoprost intraocular implant (Pending FDA approval)
  • typhoid polysaccharide vaccine
  • sodium phosphate
  • human papillomavirus vaccine, nonavalent
  • peanut immunotherapy epicutaneous (FDA approval pending)
  • cromolyn sodium, intranasal
  • red blood cells(Blood component)
  • oral mucoadhesive
  • clindamycin vaginal
  • whole blood (Blood Component)
  • fibrinogen/thrombin
  • levothyroxine/liothyronine
  • ipratropium intranasal
  • metronidazole vaginal
  • cyamemazine
  • brinase
  • reviparin
  • ulinastatin
  • saruplase
  • acepromazine
  • emylcamate
  • methionine
  • amino acids and electrolytes in dextrose with calcium
  • slippery elm
  • camostat
  • hemoglobin crosfumaril
  • moperone
  • chlormidazole
  • brilaroxazine
  • palopegteriparatide
  • diazepam buccal
  • benegrastim (pending for FDA approval)
  • COVID-19 vaccine, adjuvanted-Novavax
  • vestronidase alfa-vjbk
  • tebipenem (Pending FDA Approval)
  • tislelizumab (Pending FDA Approval)
  • zolbetuximab (Pending FDA Approval)
  • zoliflodacin (pending FDA approval)
  • zibotentan and dapagliflozin
  • fluorine F18 DCFPyL
  • debamestrocel
  • givinostat
  • amubarvimab and romlusevimab(Pending FDA Approval)
  • sabizabulin(Pending FDA approval)
  • fexapotide(Phase 3 Clinical trial)
  • diatrizoic acid
  • drotaverine
  • diethyl phthalate
  • enclomiphene
  • epalrestat
  • ethamsylate
  • flupirtine
  • imidurea
  • sodium glycolate
  • feracrylum
  • ethacridine
  • furazolidone/metronidazole
  • ozagrel hydrochloride
  • leptazol
  • l-glutamic acid /vitamin B complex
  • etizolam
  • etizolam/propranolol
  • ethoheptazine citrate
  • etophylline and theophylline
  • etophylline
  • finger millet
  • drotaverine/mefenamic acid
  • dichloroxylenol
  • pneumococcal 7-valent vaccine
  • diclofenac and metaxalone
  • dipivefrin ophthalmic
  • enbucrilate
  • potassium citrate and citric acid
  • potassium gluconate
  • aclarubicin
  • alfuzosin/dutasteride
  • adrenochrome monosemicarbazone
  • selenium sulfide topical
  • sertaconazole
  • amorolfine cream
  • amsacrine
  • amylmetacresol
  • sulfonated phenolics in aqueous solution
  • technetium Tc-99m sulfur colloid
  • raltitrexed
  • romiplostim
  • acediasulfone
  • azulene
  • acebrophylline
  • clonazepam/escitalopram oxalate
  • allylestrenol
  • andrographolide
  • artemotil
  • technetium Tc-99m sestamibi
  • rubidium Rb-82
  • somapacitan
  • sodium sulfate, magnesium sulfate and potassium sulfate
  • almitrine
  • gramicidin
  • nikethamide
  • technetium Tc-99m sodium pertechnetate
  • betiatide
  • prilocaine/epinephrine
  • amlexanox
  • acetaminophen/salicylamide/phenyltoloxamine
  • neomycin topical
  • zilucoplan
  • antazoline and xylometazoline
  • toripalimab
  • iron isomaltoside
  • meningococcal A C Y and W polysaccharide tetanus toxoid conjugate vaccine
  • meningococcal A C Y and W-135 diphtheria conjugate vaccine
  • tetradecyl Sulfuric Acid
  • benzoyl peroxide, clindamycin phosphate, adapalene
  • ethylephedrine
  • actarit
  • pyrantel tartrate
  • tenofovir disoproxil fumarate or tenofovir DF
  • melitracen
  • amitriptylinoxide(Phase 4 Clinical Trials)
  • threonine
  • ditiocarb zinc
  • epicriptine
  • levallorphan
  • kinetin
  • laurocapram
  • pentagastrin
  • parthenolide
  • nicoboxil
  • protionamide
  • prulifloxacin
  • proscillaridin
  • tizanidine and rofecoxib
  • tolnaftate, gentamicin, chinoform and betamethasone valerate
  • pine bark extract
  • pipenzolate methylbromide
  • bephenium hydroxynaphthoate
  • niclosamide
  • pyrvinium
  • pipenzolate methylbromide/phenobarbitone
  • piracetam/ginkgo biloba/vinpocetine
  • benzyl benzoate/disulfiram
  • benzyl benzoate
  • loperamide/simethicone
  • piroctone olamine
  • sodium fusidate
  • piroxicam topical/capsaicin/menthol/methyl salicylate
  • sodium metabisulfite
  • sodium lauryl sulfate
  • taspoglutide
  • glyclopyramide
  • tolnaftate, gentamicin, iodochlorohydroxyquinoline, chlorocresol, betamethasone valerate
  • serratiopeptidase
  • sodium antimony gluconate
  • triamterene / benzthiazide
  • tribenoside / lidocaine
  • triclocarban
  • triprolidine/dextromethorphan  
  • vitamins/minerals/omega-3 Fatty acids
  • soyabean oil
  • sucralfate/oxethazaine
  • sucralfate/tinidazole/povidone iodine
  • sodium cromoglycate
  • aloe vera/liquid paraffin/white soft paraffin
  • aloe vera/jojoba oil/vitamin E
  • allantoin/triclosan/vitamin e/zinc oxide
  • alpha-Lipoic acid/minerals/multivitamins
  • alprazolam/paracetamol
  • alprazolam/melatonin
  • azithromycin/ambroxol
  • atorvastatin/clopidogrel/aspirin
  • aceclofenac, paracetamol and serratiopeptidase
  • alfacalcidol, vitamin B-complex, minerals and antioxidants
  • alpha- lipoic acid, vitamin b complex and vitamin c
  • alpha-galactosidase and simethicone
  • alpha-galactosidase, amylase, proteases, lipase and lactase
  • amikacin and cefepime
  • aminophylline, ephedrine and phenobarbitone
  • artesunate, sulphadoxine and pyrimethamine
  • finasteride/tamsulosin
  • flavoxate/ofloxacin
  • fenofibrate/metformin
  • lignocaine, hydrocortisone topical and allantoin
  • linoleic acid and sodium lactate
  • troxerutin
  • meclizine/nicotinic acid
  • mecobalamin/ginkgo Biloba
  • spirulina
  • loperamide and furazolidone
  • ketoconazole/cetrimide
  • ketoconazole/zinc pyrithione
  • lercanidipine/atenolol
  • levocetirizine/montelukast/ambroxol
  • levarterenol
  • levocetirizine/phenylpropanolamine 
  • indapamide/amlodipine
  • itopride/methyl polysiloxane
  • mebendazole/levamisole
  • eberconazole/mometasone
  • gliclazide/metformin/pioglitazone
  • fluconazole/tinidazole
  • haemocoagulase
  • halometasone
  • hesperidin
  • imipramine/chlordiazepoxide
  • idebenone / l-arginine / zinc sulphate/selenium/proanthocyanidin
  • mecobalamin and piracetam
  • mesterolone
  • mosapride and pantoprazole
  • atorvastatin, co enzyme q10, vitamin e, zinc, and selenium
  • azithromycin and benzalkonium chloride
  • beta carotene, vitamin c, vitamin e, minerals, lutein, eicosapentaenoic acid, docosahexenoic acid and vit b12
  • alpha-galactosidase
  • aloe vera gel/vitamin e/lactic acid
  • aloe vera gel/jojoba/vitamin e/glycerine
  • famotidine and domperidone
  • faropenem medoxomil
  • nedosiran
  • fluconazole/ornidazole/azithromycin
  • ebastine/montelukast
  • eberconazole
  • dienogest/estradiol valerate
  • ambroxol/salbutamol
  • benzoic acid/salicylic acid/ichthammol/ triamcinolone acetonide
  • desloratadine/ambroxol
  • dexibuprofen/paracetamol
  • atorvastatin/ramipril
  • diastase
  • diastase and simethicone
  • diazepam and propranolol
  • dexrabeprazole / domperidone
  • dexrabeprazole
  • dexketoprofen /paracetamol
  • beta carotene/vitamin C/minerals
  • aloe vera gel/urea
  • aloe vera gel/glycerine
  • alpha-lipoic acid/benfotiamine/chromium/folic acid/mecobalamin / vit b6
  • alprazolam/propranolol
  • alprazolam /sertraline
  • ibuprofen/dextropropoxyphene
  • ambroxol/cetirizine/phenylephrine/ guaiphenesin/menthol
  • dextropropoxyphene/dexchlorpheniramine maleate/bromhexine
  • promegestone
  • batroxobin
  • bencyclane
  • benfluorex
  • acetylpheneturide
  • abarelix
  • abetimus
  • naftidrofuryl
  • nalorphine
  • oxiracetam
  • letosteine
  • lafutidine
  • leuprorelin
  • levodropropizine
  • glutaral
  • losartan/ramipril
  • gallopamil
  • lanatoside c
  • lauromacrogol
  • gestodene
  • aceclofenac/methyl salicylate/menthol/linseed oil/capsaicin
  • aceclofenac/paracetamol/tizanidine
  • alginic acid/magaldrate/simethicone
  • aceclofenac/paracetamol
  • aceclofenac/rabeprazole
  • alginic acid
  • pantoprazole and domperidone
  • urokinase
  • rimiterol
  • olanzapine/fluoxetine
  • normethadone/hydroxyephedrine
  • myrtol
  • moxonidine
  • propylhexedrine
  • sodium hypochlorite solution
  • sodium chloride/sodium citrate
  • Hepatitis B Vaccine (Recombinant [Adjuvanted])
  • Hepatitis B Vaccine (Recombinant)
  • aceclofenac and serratiopeptidase
  • levosulpiride
  • niaprazine
  • tromantadine
  • trimetazidine
  • vinburnine
  • mizoribine
  • molgramostim
  • mosapride
  • eugenol
  • tolperisone
  • etamsylate
  • etynodiol
  • mizolastine
  • metenolone
  • reproterol
  • rebamipide
  • mephenoxalone
  • metandienone
  • furosemide/spironolactone
  • hydroxycarbamide
  • tenonitrozole
  • fenoverine
  • fenquizone
  • tiapride
  • tibolone
  • furazolidone
  • furosemide & amiloride
  • fosfestrol
  • fluclorolone
  • flubendazole
  • tertatolol
  • tetracosactide
  • tetryzoline
  • tolciclate
  • trapidil
  • troxipide
  • temoporfin
  • telbivudine
  • teprenone
  • hexamidine
  • mebhydrolin
  • mepartricin
  • fencamfamin
  • medazepam
  • theodrenaline
  • thiamazole
  • thiocolchicoside
  • psilocybin
  • veralipride
  • pyritinol
  • opipramol
  • oprelvekin
  • betamethasone + gentamicin
  • betamethasone + neomycin
  • betamethasone + salicylic acid
  • oxedrine
  • bopindolol
  • orgotein (investigational)
  • oxaceprol
  • ormeloxifene
  • bevantolol
  • bifemelane
  • clebopride
  • demoxytocin
  • cicletanine
  • cefsulodin
  • chlortalidon
  • sisomicin
  • somatrem
  • carbazochrome
  • caroverine
  • cathine
  • ipriflavone
  • isepamicin
  • silymarin
  • simethicone
  • sermorelin
  • diloxanide
  • dimethindene
  • diosmin/hesperidin
  • calamine
  • canrenone
  • captodiame
  • imidapril
  • cefetamet
  • cefodizime
  • cefoperazone + sulbactam
  • ivermectin + albendazole
  • serrapeptase
  • bromisoval
  • beraprost
  • pridinol
  • proglumide
  • bamipine
  • barnidipine
  • bamifylline
  • benzbromarone
  • betamethasone/fusidic acid
  • para-chlorophenol
  • pantethine
  • nomifensine
  • pemoline
  • parnaparin
  • pentolinium
  • nialamide
  • novobiocin
  • nicergoline
  • octocrylene
  • octisalate
  • oftasceine
  • oxolamine
  • oxyphencyclimine
  • penfluridol
  • pentoxyverine
  • phenoxymethylpenicillin
  • picloxydine
  • pilsicainide hydrochloride
  • piperazine
  • pirarubicin
  • policresulen
  • prifinium bromide
  • prethcamide
  • pristinamycin
  • pirenzepine
  • piribedil
  • pimethixene
  • pargyline
  • phosphatidyl choline
  • phthalylsulfathiazole
  • phytomenadione
  • pranlukast
  • pinazepam
  • oxyphenonium
  • noxytiolin
  • periciazine
  • pethidine
  • phenindamine
  • histidine
  • isoleucine
  • proline
  • lauric acid
  • lymecycline
  • hypromellose
  • abiraterone acetate and niraparib
  • ichthammol
  • levamisole
  • naftazone
  • nefopam
  • oxprenolol
  • oxybuprocaine
  • elranatamab-bcmm
  • lapyrium
  • isoaminile
  • iotrolan
  • mazindol
  • masoprocol
  • lypressin
  • meradimate
  • molsidomine
  • monobenzone
  • mequinol/gluconolactone/ lactobionic acid/ arbutin
  • medifoxamine
  • mebutamate
  • metergoline
  • methantheline
  • methdilazine
  • metocurine
  • micronomicin
  • metaraminol
  • mephenesin
  • menadione
  • medrysone
  • metixene
  • levobetaxolol
  • guaiacol glycerol ether
  • eucalyptol
  • sodium tetradecyl sulfate
  • sugammadex
  • carbetocin
  • certoparin
  • chlorcyclizine/pseudoephedrine
  • cephapirin
  • indecainide
  • iobitridol
  • iomeprol
  • chlorphenesin
  • msud analog
  • msud maxamum
  • iceland moss
  • glutethimide
  • hexachlorophene
  • haloprogin
  • deferoxamine
  • ethchlorvynol
  • dexpanthenol topical
  • etilefrine
  • deslanoside
  • carbocromen
  • diazolidinylurea
  • dibenzepin
  • etofamide
  • guanoxan
  • halazepam
  • guanadrel sulfate
  • dapiprazole
  • soapwort
  • debrisoquine
  • l-tryptophan
  • chlormerodrin
  • chlorquinaldol
  • cetrimonium
  • carbocisteine
  • chlorcyclizine/codeine
  • technetium Tc-99m tetrofosmin
  • technetium Tc-99m disofenin
  • technetium Tc-99m gluceptate
  • technetium Tc-99m labeled red blood cells
  • amylmetacresol/dextromethorphan hydrobromide
  • anileridine phosphate
  • pyrethrins
  • pyrantel pamoate
  • quinagolide
  • spiramycin
  • standard hyperkalemic cardioplegia solution
  • technetium tc-99m mertiatide
  • technetium tc-99m medronate
  • bemotrizinol / bisoctrizole
  • benfotiamine
  • bemotrizinol + titanium dioxide + zinc oxide
  • technetium Tc-99m oxidronate
  • technetium Tc-99m pentetate
  • technetium Tc-99m pyrophosphate
  • benziodarone
  • octinoxate/bisoctrizole
  • bicisate dihydrochloride
  • technetium Tc-99m bicisate
  • norelgestromin/ethinyl estradiol
  • norgestimate/ethinyl estradiol
  • ximelagatran (investigational)
  • xamoterol
  • trioxsalen
  • poly-urea urethane
  • rilmenidine
  • pemirolast
  • oxitriptan
  • beclomethasone, intranasal
  • thimerosal
  • camphor gel
  • camphor
  • mumps virus vaccine, live
  • rubella virus vaccine, live
  • aluminum chloride (dental)
  • alum irrigation
  • framycetin, phenylephrine, and gramicidin
  • ombitasvir, paritaprevir, ritonavir, and dasabuvir
  • olipudase alfa
  • etonogestrel/ethinyl estradiol
  • mycophenolate
  • fluoroestradiol F 18
  • donor organ cardioplegia solution
  • fluciclovine F 18
  • fusidic acid (ophthalmic)
  • fusidic acid and hydrocortisone
  • framycetin, dexamethasone, and gramicidin
  • fludeoxyglucose F-18
  • fluorouracil/salicylic acid
  • indium In-111 oxyquinoline
  • indium In-111 pentetreotide
  • indium In-111 capromab pendetide
  • lusutrombopag
  • mitomycin (ophthalmic)
  • mifepristone and misoprostol
  • minoxidil (systemic)
  • methyl aminolevulinate (topical)
  • methyl folate, methylcobalamin, and acetylcysteine
  • ciclesonide/formoterol/tiotropium
  • nedocromil (Oral Inhalation)
  • batefenterol (Investigational)
  • neostigmine and glycopyrrolate
  • nepafenac ophthalmic
  • netupitant/palonosetron
  • meperidine and promethazine
  • mepivacaine and levonordefrin
  • maltodextrin
  • medical cannabis
  • medium chain triglycerides
  • mometasone/glycopyrrolate (glycopyrronium)/ indacaterol
  • moxifloxacin ophthalmic
  • neomycin/fluocinolone
  • nadroparin
  • iodine I-125 iothalamate
  • amikacin liposome (oral inhalation)
  • bupivacaine liposome
  • natamycin
  • lopinavir and ritonavir
  • lysine
  • macitentan and tadalafil
  • mitomycin pyelocalyceal
  • moclobemide
  • mometasone and indacaterol
  • efinaconazole
  • blue-green algae
  • indocyanine green
  • follitropin beta
  • lumasiran
  • glycerin/lidocaine
  • edrophonium/atropine
  • indigo carmine
  • lutropin alfa
  • instant glucose/intravenous dextrose
  • iobenguane I-123
  • ixekizumab
  • isosulfan blue dye
  • levofloxacin ophthalmic
  • levonorgestrel oral/ferrous bisglycinate/ ethinylestradiol
  • ethinyl estradiol/levonorgestrel transdermal
  • hydroquinone
  • hydroxypropyl methylcellulose
  • icodextrin
  • lipid emulsion (soybean, medium-chain triglyceride, olive, and fish oils; [SMOF])
  • iodinated I 125 albumin
  • iodinated I 131 albumin
  • lipid emulsion (plant oil-based)
  • levonorgestrel intrauterine
  • levonorgestrel/ethinyl estradiol
  • lactic acid and sodium-PCA
  • lactated Ringer solution
  • ketotifen (systemic)
  • lanolin
  • leuprolide and norethindrone
  • levodopa and benserazide
  • gonadorelin acetate
  • hemodialysis solutions
  • nirsevimab
  • gentian violet
  • gallium ga-68 dotatate
  • fusidic acid and betamethasone
  • gallium citrate Ga-67
  • gadopentetate dimeglumine
  • gadofosveset
  • follitropin delta
  • follitropin alfa and lutropin alfa
  • follitropin alfa
  • rocatinlimab
  • grass pollens allergen extract
  • flotufolastat F18
  • fluorescein ophthalmic
  • barium
  • balanced salt solution
  • air polymer type A intrauterine device
  • clodronate
  • bentoquatam
  • clobetasone
  • alfacalcidol
  • citric acid/glucono-delta-lactone/magnesium carbonate
  • benzoin
  • desirudin
  • immune globulin IV (IGIV)
  • dequalinium
  • pseudoephedrine/desloratadine
  • clofedanol
  • cyproterone and ethinyl estradiol
  • dextranomer and hyaluronic acid or derivatives
  • diatrizoate meglumine and diatrizoate sodium
  • glucosamine sulfate, chondroitin sulfate and Msm
  • squill
  • gotu kola
  • blessed thistle
  • bitter melon
  • apraclonidine
  • chlophedianol/dexbrompheniramine/pseudoephedrine
  • wild jujube
  • chitosan
  • cilazapril/hydrochlorothiazide
  • dexbrompheniramine and phenylephrine
  • diethylene triamine penta-acetic acid
  • dexchlorpheniramine and pseudoephedrine
  • lily of the valley
  • diflucortolone
  • corydalis
  • lemon balm
  • MSM
  • calcium polystyrene sulfonate
  • caprylidene
  • peppermint oil
  • efavirenz/lamivudine/tenofovir DF
  • emtricitabine/tenofovir DF /efavirenz
  • dutasteride/tamsulosin
  • milk thistle
  • centaury
  • horseweed
  • lycopus
  • agrimony
  • alfalfa
  • kava
  • cetrorelix
  • cetylpyridinium
  • chlophedianol and dexbrompheniramine
  • betahistine
  • choline C-11
  • boric acid vaginal suppository
  • aluminum acetate
  • aluminum chloride hexahydrate
  • 14-C urea breath test
  • absorbable collagen
  • valoctocogene roxaparvovec-rvox
  • amlodipine and celecoxib
  • aspirin and omeprazole
  • azilsartan and chlorthalidone
  • landiolol (Pending FDA approval)
  • isosorbide dinitrate/hydralazine
  • losartan/hydrochorothiazide
  • udenafil
  • dextromethorphan/quinidine
  • onasemnogene abeparvovec
  • orphenadrine/aspirin/caffeine
  • Trace elements
  • sodium phenylbutyrate/ taurursodiol
  • fish oil triglycerides
  • infant formula
  • glutamine
  • chloroquine phosphate
  • afatinib
  • quinidine gluconate
  • methylergonovine
  • prothrombin complex concentrate, human
  • BCG intravesical live
  • capivasertib
  • cedazuridine
  • carbonyl iron
  • iron dextran complex
  • lovotibeglogene autotemcel (FDA Approval Pending)
  • sodium benzoate/sodium phenylacetate
  • mineral oil otic
  • zolmitriptan transdermal
  • midazolam intranasal
  • fosinopril/hydrochlorothiazide
  • caplacizumab
  • arginine
  • sodium phenylbutyrate
  • meloxicam/rizatriptan
  • manganese
  • acetaminophen/pamabrom/pyridoxine
  • varicella zoster immune globulin, human
  • amitriptyline/perphenazine
  • narsoplimab (Pending FDA Approval)
  • amlodipine/perindopril
  • imiglucerase
  • canagliflozin/metformin
  • tafamidis meglumine
  • somatrogon-ghla
  • glimepiride/rosiglitazone
  • becaplermin
  • lithium
  • loxapine inhaled
  • nicotine transdermal
  • tixagevimab and cilgavimab (Investigational)
  • muromonab CD3
  • ansuvimab
  • coal tar bath products
  • fibrin sealant
  • arimoclomol (FDA Approval Pending)
  • varenicline intranasal
  • aducanumab
  • oxycodone/naloxone
  • ritlecitinib
  • sodium polystyrene sulfonate
  • calcipotriene/betamethasone
  • calcium hydroxylapatite
  • cantharidin topical
  • doxepin cream
  • clocortolone
  • formaldehyde topical
  • sodium sulfide topical
  • collagenase
  • selegiline transdermal
  • foscarbidopa/foslevodopa (FDA approval pending)
  • saxagliptin/metformin
  • linagliptin/metformin
  • linzagolix (FDA approval pending)
  • efgartigimod/hyaluronidase SC
  • Elamipretide
  • rozanolixizumab
  • diazoxide
  • glimepiride/pioglitazone
  • cipaglucosidase alfa
  • dihydroergotamine intranasal
  • delandistrogene moxeparvovec
  • beremagene geperpavec
  • hyaluronic acid and derivatives
  • hyaluronic acid, non-animal stabilized
  • eplontersen (FDA Approval Pending)
  • nitric oxide gas
  • sodium phenylbutyrate and taurursodiol
  • treprostinil SC
  • viltolarsen
  • albuterol/ipratropium
  • budesonide inhaled
  • budesonide rectal
  • palovarotene
  • sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol
  • amino acids mixture
  • aminobenzoate potassium
  • elivaldogene autotemcel
  • naproxen and sumatriptan
  • sumatriptan intranasal
  • alglucerase
  • metformin/rosiglitazone
  • ertugliflozin/metformin
  • elosulfase alfa
  • calcium carbonate/magnesium hydroxide
  • starch suppository
  • abicipar pegol (FDA Approval Pending)
  • riboflavin 5′-phosphate ophthalmic
  • povidone ophthalmic
  • glycerin oropharyngeal
  • dimethicone topical
  • menthol topical, dimethicone topical
  • pramoxine topical, menthol topical and dimethicone topical
  • phosphorated carbohydrate
  • brilliant blue G ophthalmic
  • brolucizumab intravitreal
  • purified water, ophthalmic
  • hydroxyethyl cellulose ophthalmic
  • ranibizumab intravitreal implant
  • sodium chloride hypertonic, ophthalmic 
  • cetirizine ophthalmic
  • phentolamine ophthalmic
  • ganciclovir ophthalmic
  • triamcinolone intravitreal
  • ocriplasmin intravitreal
  • atoltivimab/maftivimab/odesivimab
  • pegcetacoplan intravitreal
  • triamcinolone acetonide extended-release injectable suspension
  • tobramycin/loteprednol ophthalmic
  • 2-octyl cyanoacrylate
  • vitamins A & D topical
  • diphenhydramine/allantoin topical
  • pyrethrins/piperonyl butoxide
  • lodoxamide ophthalmic
  • obeticholic acid
  • fluocinolone intravitreal implant
  • sincalide
  • linaclotide
  • nedocromil ophthalmic
  • cysteamine ophthalmic
  • avacincaptad pegol intravitreal
  • azelastine ophthalmic
  • bacitracin ophthalmic
  • propylene glycol ophthalmic
  • rimexolone ophthalmic
  • metoclopramide intranasal
  • mirikizumab
  • netarsudil ophthalmic
  • cenegermin
  • dexamethasone ophthalmic insert
  • prednisolone ophthalmic
  • phenylephrine and cocoa butter rectal
  • phenylephrine and witch hazel topical
  • phenylephrine, pramoxine, glycerin and petrolatum rectal
  • bisacodyl rectal
  • aluminum hydroxide/magnesium carbonate
  • aluminum hydroxide/magnesium hydroxide
  • hyoscyamine spray
  • methenamine/methylene blue/ hyoscyamine/ sodium phosphate monobasic/ phenyl salicylate
  • phenylephrine
  • chlorophyll
  • castor oil
  • cholic acid
  • phenol oropharyngeal
  • articaine/epinephrine
  • antithymocyte globulin equine
  • aluminum hydroxide/magnesium trisilicate
  • methenamine/hyoscyamine
  • hydrocortisone topical/pramoxine topical 
  • sodium fluoride topical
  • mesna
  • C1 esterase inhibitor recombinant
  • menthol and pectin
  • menthol oropharyngeal
  • pectin oropharyngeal
  • gepirone
  • Goldenseal
  • polyethylene glycol and electrolytes
  • polyethylene glycol/electrolytes/sodium ascorbate/ascorbic acid
  • brompheniramine/pseudoephedrine/dextromethorphan
  • brompheniramine phenylephrine
  • acetaminophen/doxylamine/phenylephrine
  • doxylamine/acetaminophen/pseudoephedrine/dextromethorphan
  • acetaminophen/doxylamine/dextromethorphan
  • acetaminophen/doxylamine/dextromethorphan/phenylephrine
  • eslicarbazepine
  • fluticasone and salmeterol
  • codeine, acetaminophen, butalbital and caffeine
  • codeine, chlorpheniramine and phenylephrine
  • iodine
  • povidone iodine
  • butalbital/aspirin/caffeine/codeine
  • polyethylene glycol 400/propylene glycol ophthalmic 
  • pegvaliase
  • amivantamab
  • iopamidol
  • codeine and pseudoephedrine
  • emtricitabine, rilpivirine, tenofovir DF
  • penicillin G aqueous
  • miconazole topical
  • miconazole vaginal
  • ciprofloxacin inhaled (Pending FDA approval)
  • ceftazidime/avibactam
  • ceftolozane/​tazobactam
  • aztreonam inhalation
  • amphotericin B cholesteryl sulfate
  • miconazole oral
  • elvitegravir/cobicistat/emtricitabine/tenofovir DF
  • isavuconazonium sulfate
  • dapivirine intravaginal (FDA Approval Pending)
  • lamivudine/raltegravir
  • codeine/triprolidine/pseudoephedrine
  • cadexomer iodine
  • brompheniramine/pseudoephedrine
  • codeine/acetaminophen
  • codeine/guaifenesin
  • beclomethasone inhaled
  • epoetin beta/methoxy polyethylene glycol
  • voreloxin(Orphan Drug)
  • rociletinib
  • pitcher plant
  • phosphatidylserine
  • telotristat ethyl
  • copper CU 64 dotatate
  • urea topical
  • exenatide subdermal implant
  • asenapine transdermal
  • ethiodized oil
  • urea oral
  • miglustat
  • acalisib(Investigational)
  • acetophenazine
  • guggul
  • aceneuramic acid
  • mestranol/norethindrone
  • reishi
  • lactitol
  • vonoprazan fumarate
  • motherwort
  • silver nitrate
  • salicylic acid/sulfur shampoo
  • salicylic acid topical
  • ketorolac ophthalmic
  • ketoconazole topical
  • Japanese encephalitis virus vaccine
  • dibucaine topical ointment
  • ketorolac intranasal
  • ketorolac/phenylephrine ophthalmic
  • rotavirus oral vaccine, live
  • guarana
  • hops
  • krill oil
  • salicylic acid/coal tar shampoo
  • sufentanil SL
  • pancrelipase
  • passion flower
  • pepdite one plus
  • nivolumab and relatlimab
  • relatlimab (Pending FDA Approval)
  • benzalkonium chloride/benzocaine
  • ketotifen, drug-eluting contact lens
  • calcitriol topical
  • oxymetazoline topical
  • alclometasone topical
  • capsaicin topical
  • diclofenac/misoprostol
  • diclofenac ophthalmic
  • diclofenac topical
  • pramoxine/calamine topical
  • veverimer
  • tolazoline
  • olopatadine ophthalmic
  • lutetium lu 177-dota-tate
  • lutetium lu 177 vipivotide tetraxetan
  • strontium 89 chloride
  • interferon alfa n3
  • lutetium Lu 177- Diethylenetriamine Pentaacetic acid-omburtamab (FDA Approval Pending)
  • samarium sm 153 lexidronam
  • cytomegalovirus immune globulin (CMV IG)
  • antithymocyte globulin rabbit
  • inolimomab (Pending FDA Approval)
  • olopatadine intranasal
  • olopatadine intranasal/​mometasone, intranasal
  • benzocaine/butamben/tetracaine topical
  • antipyrine/benzocaine/phenylephrine
  • dyclonine/menthol
  • surufatinib
  • fruquintinib
  • dostarlimab
  • hepatitis B immune globulin (HBIG)
  • remestemcel-L
  • benzocaine/menthol oropharyngeal
  • interferon beta 1b
  • tetracaine/oxymetazoline intranasal
  • benzocaine oropharyngeal
  • benzalkonium chloride/menthol/petrolatum topical
  • inamrinone
  • alpha 1 proteinase inhibitor
  • potassium bicarbonate/potassium citrate
  • potassium phosphate/sodium acid phosphate
  • asparaginase Erwinia chrysanthemi recombinant
  • motixafortide
  • pegloticase
  • etesevimab
  • Rho(D) immune globulin
  • tetanus immune globulin (TIG)
  • reltecimod (pending FDA approval)
  • avasopasem
  • trimethoprim/polymyxin B ophthalmic
  • naphazoline ophthalmic
  • sulfacetamide topical
  • sirolimus intravitreal (pending FDA approval)
  • sirolimus protein bound
  • sirolimus topical
  • glycopyrronium tosylate topical
  • sofpironium
  • olmesartan, amlodipine and hydrochlorothiazide
  • dovitinib (Pending FDA Approval)
  • epinephrine inhaled
  • quizartinib (Pending FDA Approval)
  • ranibizumab intravitreal injection
  • sodium hyaluronate
  • bacitracin and lidocaine topical
  • brimonidine topical
  • benzoyl peroxide and tretinoin topical
  • talquetamab
  • betrixaban
  • acetaminophen/caffeine/pyrilamine
  • fentanyl transmucosal
  • bacitracin topical
  • buprenorphine,long-acting injection
  • buprenorphine buccal
  • nalmefene intranasal
  • sulbactam/durlobactam
  • metronidazole topical 
  • daratumumab/hyaluronidase
  • glofitamab
  • rituximab-hyaluronidase
  • drospirenone/ethinyl estradiol/levomefolate
  • loncastuximab tesirine
  • ingenol mebutate topical
  • momelotinib
  • trastuzumab/deruxtecan
  • trastuzumab/hyaluronidase
  • trastuzumab duocarmazine
  • lifileucel
  • umbralisib
  • eflornithine/sulindac
  • cytarabine/daunorubicin liposomal
  • doxorubicin liposomal
  • epcoritamab
  • lanadelumab  
  • esomeprazole/naproxen 
  • terbinafine topical
  • ravulizumab
  • clotrimazole topical
  • choline magnesium trisalicylate
  • tacrolimus ointment
  • mechlorethamine topical
  • donislecel
  • pozelimab (Pending FDA Approval)
  • human rabies immune globulin (HRIG)
  • melphalan flufenamide
  • sintilimab (Pending FDA Approval)
  • oportuzumab monatox (Pending FDA Approval)
  • sotorasib
  • irinotecan liposomal
  • sulfur topical
  • silver sulfadiazine
  • capsaicin transdermal
  • sutimlimab
  • tretinoin topical
  • acetaminophen rectal
  • menthol topical
  • naftifine
  • oatmeal, colloidal topical
  • oxiconazole
  • methylsalicylate/menthol topical
  • C1 inhibitor human
  • lifitegrast ophthalmic
  • prednisolone/sulfacetamide ophthalmic
  • mannitol inhalation
  • ofloxacin otic
  • petrolatum & mineral oil topical
  • clascoterone topical
  • gefapixant (Pending FDA Approval)
  • colesevelam
  • technetium Tc 99m succimer
  • nebivolol/valsartan
  • ciprofloxacin/fluocinolone acetonide, otic
  • finafloxacin otic
  • magnesium hydroxide/mineral oil
  • phenylephrine/mineral oil/petrolatum rectal
  • carbamide peroxide oral
  • atropine ophthalmic
  • sodium sulfacetamide/sulfur
  • sulfacetamide ophthalmic
  • lucinactant
  • benzonatate
  • besifloxacin ophthalmic
  • benzhydrocodone/acetaminophen
  • beractant
  • trimagnesium citrate anhydrous
  • vitamin b2
  • carbamide peroxide otic
  • mineral oil topical
  • ethyl alcohol intranasal
  • boric acid/alcohol otic
  • absorbable gelatin compressed sponge, USP
  • absorbable gelatin sponge, USP
  • vincristine liposomal
  • technetium Tc 99m albumin aggregated injection
  • metaproterenol
  • budesonide inhaled/formoterol/glycopyrrolate inhaled
  • epinephrine racemic
  • umeclidinium bromide/vilanterol inhaled
  • indacaterol, inhaled/glycopyrrolate inhaled
  • betaine  
  • laronidase 
  • estrogens esterified/methyltestosterone            
  • cerliponase alfa
  • ertugliflozin/sitagliptin
  • hawthorn
  • shepherd’s purse
  • thiamine
  • naphazoline/glycerin ophthalmic
  • oxymetazoline ophthalmic
  • dorzolamide
  • dexamethasone intraocular
  • dexamethasone/ciprofloxacin
  • dexamethasone ophthalmic
  • metipranolol ophthalmic
  • timolol ophthalmic
  • boron
  • fezolinetant
  • pegunigalsidase alfa-iwxj
  • biotin
  • pantothenic acid
  • silicon
  • sodium acid phosphate
  • hypochlorous acid topical
  • methenamine/sodium acid phosphate
  • aviptadil 
  • bremelanotide
  • glucagon intranasal
  • metformin and repaglinide
  • bai ji
  • pau d’arco
  • juzentaihoto
  • mistletoe
  • quercetin
  • rosemary
  • sheng di huang
  • chasteberry
  • maitake
  • grapefruit
  • lentinan
  • juniper
  • nettle
  • parsley
  • rose hips
  • tongkat ali
  • horny goat weed
  • damiana
  • yohimbe
  • insulin NPH
  • aprocitentan
  • noni Juice
  • sodium iodide I-131
  • green tea
  • sea cucumber
  • wheat germ extract
  • fenofibrate micronized 
  • rogisen
  • danshen
  • lutein
  • witch hazel
  • dextroamphetamine transdermal
  • amphetamine/dextroamphetamine
  • hoodia
  • kolanut
  • boswellia
  • opuntia ficus indica
  • lavender
  • nadh
  • tea tree oil
  • metformin/sitagliptin 
  • dapagliflozin/ metformin/saxagliptin  
  • antihemophilic factor recombinant
  • inclisiran
  • bempedoic acid/ezetimibe
  • volanesorsen  
  • omega 3 carboxylic acids
  • pericyazine
  • levomepromazine (methotrimeprazine)
  • betaxolol ophthalmic
  • respiratory syncytial virus vaccine, adjuvanted
  • phenylephrine hydrochloride and tropicamide ophthalmic
  • alirocumab
  • neomycin/polymyxin B/gramicidin ophthalmic
  • factor IX
  • gentamicin topical
  • ansofaxine (Pending FDA Approval)
  • zuranolone
  • factor IX, recombinant
  • factor IX complex
  • factor XIII A-subunit, recombinant
  • factor X, human
  • mesalamine rectal
  • etrasimod
  • anti-inhibitor coagulant complex
  • factor IX, recombinant/albumin fusion protein
  • fibrinogen, human
  • aminocaproic acid
  • metyrosine
  • nonoxynol-9 vaginal
  • progesterone intravaginal gel
  • ipecac syrup
  • botulinum antitoxin, heptavalent
  • pentetate calcium trisodium
  • crotalidae polyvalent immune FAB (ovine)
  • dehydrated alcohol injection 
  • gold sodium thiomalate (Discontinued)
  • lactic acid/citric acid/potassium bitartrate vaginal
  • von Willebrand factor, recombinant
  • luspatercept
  • digoxin immune FAB (Antidote)
  • crotalidae immune FAB (equine)
  • magnesium (Antidote)
  • pyridoxine (Antidote)
  • edetate calcium disodium
  • albumin IV
  • nitroglycerin sublingual
  • obiltoxaximab
  • anthrax immune globulin
  • nitroglycerin topical
  • dextrose
  • nesiritide
  • estradiol vaginal
  • bazedoxifene/conjugated estrogens
  • botulism immune globulin iv
  • amoxicillin/omeprazole/rifabutin
  • synthetic human angiotensin II
  • nitroglycerin IV
  • nitroglycerin translingual
  • nitroprusside sodium
  • tetrahydrozoline/zinc sulfate/hypromellose ophthalmic
  • sodium citrate/citric acid
  • pemetrexate
  • Methicillin
  • plasminogen 
  • acai
  • american ginseng
  • cordyceps
  • tramadol/acetaminophen
  • belladonna alkaloids/phenobarbital
  • erythromycin topical/benzoyl peroxide
  • glucosamine sulfate
  • panax ginseng (suppl/herb)
  • tolnaftate
  • sulopenem etzadroxil/probenecid
  • sulfur hexafluoride
  • sotrovimab
  • arbaclofen
  • rifampin/isoniazid
  • clindamycin /tretinoin topical
  • benzoyl peroxide/clindamycin topical
  • apremilast
  • antivenins, centuroides (scorpion)
  • bamlanivimab and etesevimab
  • vilobelimab
  • gadobenate
  • pentosan polysulfate sodium
  • methylsalicylate/menthol/camphor topical
  • antivenin, black widow spider
  • benzoyl peroxide and hydrocortisone
  • clindamycin topical
  • isometheptene, dichloralphenazone and acetaminophen
  • acetaminophen and phenyltoloxamine
  • erythromycin topical
  • erythromycin ophthalmic
  • alpha hydroxy acids, topical
  • buprenorphine transdermal
  • butalbital/acetaminophen/caffeine
  • buprenorphine/samidorphan
  • buprenorphine subdermal implant
  • celecoxib/tramadol
  • drospirenone/ethinyl estradiol
  • resorcinol/sulfur
  • eflornithine
  • rifampin/isoniazid/pyrazinamide
  • tofersen
  • devil’s claw
  • ticarcillin/clavulanate
  • atropine/pralidoxime
  • aprepitant
  • suramin
  • phenelzine 
  • artichoke
  • american dogwood
  • attapulgite
  • atlantic cedar
  • axalimogene filolisbac
  • sodium thiosulfate & sodium nitrite
  • ataluren
  • omidubicel-onlv
  • capsicum
  • ginger
  • cryoprecipitate
  • bictegravir/emtricitabine/tenofovir DF
  • emtricitabine/tenofovir DF
  • fo-ti
  • siberian ginseng
  • granulocytes
  • zinc substituted heme C
  • zinc trihydroxide
  • ashwagandha 
  • cat’s claw
  • glandular products
  • SAMe
  • shark cartilage
  • altovis
  • feverfew
  • horse chestnut
  • magnesium aspartate
  • octacosanol
  • pleurisy root
  • star anise
  • butterbur
  • elderberry
  • licorice (Suppl/herb)
  • aconite
  • pentetate zinc trisodium
  • menthol topical/zinc oxide topical
  • corn-starch/kaolin/zinc oxide topical
  • 5-hydroxytryptophan (5-htp)
  • butcher’s broom
  • articulin
  • bearberry
  • goldenrod
  • progesterone, natural
  • black cohosh
  • wild yam
  • cranberry
  • dong quai
  • phytoestrogens
  • norethindrone
  • false Unicorn Root
  • raspberry Leaf
  • asafoetida
  • turmeric
  • dehydroepiandrosterone (DHEA)
  • hyaluronan
  • aliskiren/amlodipine
  • octreotide (Antidote)
  • tranexamic acid injection
  • duocal
  • neocate infant formula
  • pediatric Eo28
  • aloe
  • red clover
  • propolis
  • androstenedione
  • heartsease
  • comfrey
  • bilberry
  • chamomile
  • eyebright
  • calendula
  • sage
  • yucca
  • polypody
  • odevixibat
  • vinpocetine
  • olanzapine/samidorphan
  • creatine
  • yerba mate
  • spesolimab
  • azficel-T
  • tiludronate
  • estetrol and drospirenone
  • pseudoephedrine/fexofenadine
  • lincomycin
  • neomycin oral
  • fluocinolone acetonide, otic
  • tretinoin/ hydroquinone/ fluocinolone
  • halobetasol topical
  • hydrocortisone/​iodoquinol
  • penicillin G procaine /penicillin G benzathine
  • hydrocortisone probutate topical
  • colistin/neomycin/hydrocortisone/thonzonium otic
  • ebola zaire vaccine
  • hepatitis a/​b vaccine
  • vibegron
  • lindane
  • nystatin topical
  • respiratory syncytial virus (RSV) vaccine
  • chikungunya vaccine, live
  • tenecteplase
  • reteplase
  • anthrax vaccine adsorbed, adjuvanted
  • meningococcal ABCWY pentavalent vaccine
  • eculizumab
  • cholestyramine
  • tinzaparin
  • taurolidine/​citrate/​heparin
  • protein C concentrate
  • antithrombin alfa
  • antithrombin III
  • multivitamins, vision
  • ibuprofen/​chlorpheniramine/​pseudoephedrine
  • acetaminophen/ibuprofen
  • ibuprofen/pseudoephedrine
  • paclitaxel protein-bound
  • acetic acid vaginal
  • acetic acid otic
  • hydrocodone/ ibuprofen
  • methyl salicylate / isopropanol/ citronellyl acetate/ citric acid
  • ibuprofen and phenylephrine
  • acetylcysteine (Antidote)
  • iron/​folic acid/​vitamin/​mineral
  • iobenguane I-131
  • dolutegravir/rilpivirine
  • chlorhexidine topical
  • chlorhexidine oral
  • thyroid desiccated
  • proparacaine ophthalmic
  • podophyllum resin
  • phendimetrazine
  • phenoxybenzamine
  • polidocanol
  • phentermine and topiramate
  • piflufolastat F18
  • piperacillin/tazobactam
  • prednisolone and gentamicin ophthalmic
  • promethazine and codeine
  • poractant alfa
  • protamine sulfate
  • aflibercept intravitreal
  • prednicarbate
  • promethazine/dextromethorphan
  • codeine, phenylephrine, and promethazine
  • potassium phosphate
  • glatiramer acetate
  • gentamicin (Ophthalmic)
  • leniolisib
  • rezafungin
  • fluorometholone
  • dalfampridine
  • hydrocortisone topical 
  • empagliflozin and linagliptin
  • triamcinolone topical
  • minocycline topical
  • minocycline dental
  • ketotifen ophthalmic
  • darunavir and cobicistat
  • lidocaine topical
  • neomycin/polymyxin B/bacitracin/lidocaine (OTC)
  • lidocaine/ hydrocortisone
  • lidocaine anesthetic
  • lidocaine ophthalmic
  • lidocaine/tetracaine
  • desonide
  • dabigatran
  • fexofenadine
  • fluoride
  • decitabine and cedazuridine
  • dasiglucagon
  • hydroxypropyl cellulose ophthalmic
  • epoetin alfa
  • ibritumomab tiuxetan
  • trimethobenzamide
  • dexamethasone/ tobramycin
  • tafasitamab
  • valacyclovir
  • mebendazole
  • levoleucovorin
  • flaxseed
  • germanium
  • glutathione
  • lycopene
  • pygeum
  • horseradish
  • ziv-aflibercept
  • micafungin
  • trofinetide
  • taliglucerase alfa
  • tildrakizumab
  • sulopenem (Pending FDA Approval)
  • thyrotropin alfa
  • birch
  • thrombin, topical
  • tivozanib
  • tafluprost
  • methohexital
  • urea and hydrocortisone
  • unoprostone ophthalmic
  • trihexyphenidyl
  • ezetimibe
  • evolocumab
  • trifluridine and tipiracil
  • methenamine
  • misoprostol
  • miltefosine
  • rimantadine
  • maralixibat
  • coenzyme Q10
  • chlorella
  • garlic
  • forskolin
  • zavegepant
  • menotropins
  • margetuximab
  • meprobamate
  • melarsoprol
  • evening primrose oil
  • lemongrass
  • molindone
  • fenugreek
  • phytosterols
  • red yeast rice
  • uridine triacetate
  • tropicamide
  • incobotulinumtoxinA
  • Grape Seed Extract
  • carbachol ophthalmic
  • cosyntropin
  • cyclopentolate and phenylephrine
  • carteolol ophthalmic
  • pentazocine/naloxone
  • pentazocine/acetaminophen
  • casimersen
  • carisoprodol, aspirin, and codeine
  • carisoprodol
  • carboprost tromethamine
  • flurandrenolide
Talimogene Laherparepvec + 

l-methylfolate-pyridoxal 5′-phosphate-methylcobalamine

may decrease the serum concentration of Quinolones

lenograstim 

may decrease the therapeutic effect when combined with lenograstim

lipegfilgrastim 

may diminish the therapeutic effect when combined with lipegfilgrastim

palifermin 

may increase the adverse effect when combined with antineoplastic agents

maralixibat

may increase the levels of serum concentration

lenacapavir

may increase the levels of serum concentration

curcumin

may increase the levels of serum concentration

glecaprevir

may increase the levels of serum concentration

caspofungin

may increase the levels of serum concentration

maralixibat

may increase the levels of serum concentration

lenacapavir

may increase the levels of serum concentration

diacerein

may increase the levels of serum concentration

memantine/donepezil

may increase the levels of serum concentration

tranylcypromine

may increase the levels of serum concentration

diroximel fumarate

immunosuppressants increase the toxicity of talimogene laherparepvec

efalizumab

immunosuppressants increase the toxicity of talimogene laherparepvec

pimecrolimus

immunosuppressants increase the toxicity of talimogene laherparepvec

tacrolimus

immunosuppressants increase the toxicity of talimogene laherparepvec

abatacept

immunosuppressants increase the toxicity of talimogene laherparepvec

pimecrolimus topical

may have an increasingly adverse effect when combined with talimogene laherparepvec

cyclosporine ophthalmic

may have an increasingly adverse effect when combined with talimogene laherparepvec

reslizumab

may have an increasingly adverse effect when combined with talimogene laherparepvec

betamethasone (systemic)

may have an increasingly adverse effect when combined with talimogene laherparepvec

budesonide (oral inhalation)

may have an increasingly adverse effect when combined with talimogene laherparepvec

budesonide (nasal)

may have an increasingly adverse effect when combined with talimogene laherparepvec

budesonide (Topical)

may have an increasingly adverse effect when combined with talimogene laherparepvec

beclomethasone (nasal)

may have an increasingly adverse effect when combined with talimogene laherparepvec

abrocitinib

may have an increasingly adverse effect when combined with talimogene laherparepvec

avacopan

may have an increasingly adverse effect when combined with talimogene laherparepvec

siponimod

may have an increasingly adverse effect when combined with talimogene laherparepvec

methotrexate 

may have an increasingly adverse effect when combined with talimogene laherparepvec

pidotimod

talimogene laherparepvec: they may increase the toxic effect of immunostimulants

lipegfilgrastim

talimogene laherparepvec: they may increase the toxic effect of immunostimulants

filgrastim

talimogene laherparepvec: they may increase the toxic effect of immunostimulants

echinacea

talimogene laherparepvec: they may increase the toxic effect of immunostimulants

aldesleukin

talimogene laherparepvec: they may increase the toxic effect of immunostimulants

acyclovir 

acyclovir pharmacodynamically antagonizes talimogene laherparepvec to reduce its effects

thioguanine 

may increase the immunosuppressive effect of immunosuppressants

vilobelimab 

may increase the adverse effect of Immunosuppressants

ibalizumab

Antivirals may diminish the therapeutic effect of Talimogene Laherparepvec.

dolutegravir

Antivirals may diminish the therapeutic effect of Talimogene Laherparepvec.

dolutegravir and lamivudine

Antivirals may diminish the therapeutic effect of Talimogene Laherparepvec.

zidovudine and lamivudine

Antivirals may diminish the therapeutic effect of Talimogene Laherparepvec.

tecovirimat

Antivirals may diminish the therapeutic effect of Talimogene Laherparepvec.

ribavirin

antiherpetic antivirals decrease the efficacy of talimogene laherparepvec

beclomethasone (nasal)

it may diminish the excretion rate when combined with corifollitropin alfa resulting in an enhanced serum level

fluticasone (topical)

it may diminish the excretion rate when combined with corifollitropin alfa resulting in an enhanced serum level

beclomethasone dipropionate

it may diminish the excretion rate when combined with corifollitropin alfa resulting in an enhanced serum level

fluticasone (nasal)

it may diminish the excretion rate when combined with corifollitropin alfa resulting in an enhanced serum level

penciclovir 

may decrease the therapeutic effects of antiherpetic antivirals

bleomycin 

it enhance the risk of pulmonary toxicity

chlorambucil

may increase the risk of adverse effects

chloroquine

may increase the risk of adverse effects

pirfenidone

may increase the risk of adverse effects

diacerein

may increase the risk of adverse effects

diphenhydramine/ibuprofen

may increase the risk of adverse effects

aspirin, chlorpheniramine, and phenylephrine

may increase the risk of adverse effects

saccharomyces boulardii

may increase the risk of adverse effects

diroximel fumarate

may increase the risk of adverse effects

 

Dosage Forms & Strengths 

intralesional injectable solution 

106 (one million) plaque-formation units (PFU)/mL solution (available for use as a 1-mL single vial) 

108 (or 100 million) PFU/mL of the solution (available for use as a 1-mL single vial) 

Melanoma 

starting dose: about 4 mL concentration of 106 (one million) PFU/mL
Second dose: about 4 mL concentration in 108 (100 million) PFU/mL administered three weeks after the initial therapy
All subsequent therapies (reinitiation included): about 4 mL concentration in 108 (100 million) PFU/mL administered two weeks after the previous therapy
Continue therapy for 6 months or till there are no more injectable lesions.
If unresectable subcutaneous, cutaneous, or nodal lesions develop after a full response, restart therapy.
Determine the dose volume for every lesion
The size of a lesion depends on its longest dimension.
When the lesions are grouped together, they should be injected as a singular lesion based on the following:
Above 5 cm: 4 mL/lesion
Above 2.5 to 5 cm: 2 mL/lesion
Above 1.5 to 2.5 cm: 1 mL/lesion
Above 0.5 to 1.5 cm: 0.5 mL/lesion
Below 0.5 cm: 0.1 mL/lesion



Dose Adjustments

Dosage Modifications
Renal or Hepatic impairment: there are No clinical trials have been conducted on the pharmacokinetics of talimogene laherparepvec with renal or hepatic impairment.

 

Safety & efficacy not established 

 

Refer to the adult dosing regimen 

Frequency defined 

1-10% (all grades) 

Abdominal pain (8.9%) 

decreased Weight (5.8%) 

Oropharyngeal pain (5.8%) 

Dizziness (9.6%)  

1-10% (grade 3) 

Fatigue (2.1%) 

Pain in extremities (1.4%) 

Vomiting (1.7%)  

>10% (all grades) 

Chills (48.6%) 

Nausea (35.6%) 

Injection site pain (27.7%) 

Diarrhea (18.8%) 

Myalgia (17.5%) 

Pain in extremities (16.4%) 

Fatigue (50.3%) 

Pyrexia (42.8%) 

Influenza like illness (30.5%) 

Vomiting (21.2%) 

Headache (18.8%) 

Arthralgia (17.1%) 

Constipation (11.6%)  

<1% (grade 3) 

Injection site pain 

Diarrhea 

Myalgia 

Headache 

decreased Weight 

Influenza like illness 

Nausea 

Abdominal pain 

Arthralgia 

Black Box Warning: 

talimogene laherparepvec carries a black box warning regarding the risk of potential herpetic infections. The use of this medication can result in disseminated herpetic infection, including encephalitis and death. It is important to avoid the contact with herpetic lesions or bodily fluids from treated individuals. 

Contraindication/Caution: 

Contraindication: 

talimogene laherparepvec is contraindicated in individuals with a known history of severe hypersensitivity reactions to the medication or any of its components. Additionally, it should not be administered to patients with hypersensitivity to herpes simplex virus or other components of the product.

The safety and efficacy of talimogene laherparepvec have not been established in immunocompromised patients or individuals with active systemic infections. caution should be given to the potential risks and benefits before initiating treatment in these patient populations.  

Caution: 

  • talimogene laherparepvec should be used with caution in patients with a history of autoimmune disorders, as the treatment may exacerbate these conditions. 
  • talimogene laherparepvec in patients with a compromised immune system, as it may result in increased susceptibility to infections. 
  • The safety and efficacy of talimogene laherparepvec are not established in pregnant or lactating women. 
  • Close monitoring is recommended for signs of infection or systemic inflammatory response during and after treatment with talimogene laherparepvec. 
  • Patients should be advised to avoid direct contact with their eyes or mucous membranes after treatment, as talimogene laherparepvec is a live virus-based therapy. 
  • Concomitant use of immunosuppressive medications should be carefully considered, as they may interfere with the efficacy of talimogene laherparepvec. 
  • Patients should be used under caution about the potential for flu-like symptoms, injection site reactions, and other adverse effects associated with talimogene laherparepvec. 
  • Special caution should be exercised when administering talimogene laherparepvec to pediatric patients, as safety and efficacy data in this population are limited.

Comorbidities: 

The comorbidities associated with talimogene laherparepvec are not well known. However, it should be used under caution in patients with underlying medical conditions, particularly those affecting the immune system or autoimmune disorders.

talimogene laherparepvec is a live virus-based therapy and may potentially cause an exacerbation of autoimmune conditions or increase the risk of infections in patients with compromised immune systems.

Therefore, a thorough evaluation of the patient’s medical history and individual risk-benefit assessment should be performed before initiating treatment with talimogene laherparepvec. Close monitoring and appropriate management of comorbidities are essential during treatment. 

Pregnancy consideration: N/A 

Lactation: N/A  

Pregnancy category: 

  • Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
  • Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
  • Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   
  • Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 
  • Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 
  • Category N: There is no data available for the drug under this category. 

Pharmacology: 

talimogene laherparepvec is an oncolytic viral therapy designed to selectively replicate within tumor cells and induce tumor cell death. It is derived from the herpes simplex virus type 1 (HSV-1) and has been genetically modified to express the granulocyte-macrophage colony-stimulating factor (GM-CSF). The GM-CSF expression enhances the immune response against tumor cells by promoting the activation and proliferation of dendritic cells, T-cells, and macrophages.  

Pharmacodynamics: 

  • Selective Tumor Cell Replication: talimogene laherparepvec is engineered to selectively replicate within tumor cells. Once injected into tumors, it infects and replicates within cancer cells while sparing healthy cells. 
  • Tumor Cell Lysis: The replication of talimogene laherparepvec within tumor cells leads to their lysis, causing the destruction of cancerous tissue. This process releases tumor-associated antigens. 
  • Activation of Immune Response: talimogene laherparepvec is designed to express the granulocyte-macrophage colony-stimulating factor (GM-CSF). GM-CSF enhances the immune response by stimulating the activation and proliferation of dendritic cells, T-cells, and macrophages. 
  • Immune-Mediated Anti-Tumor Response: The expression of GM-CSF by talimogene laherparepvec promotes the recruitment and activation of immune cells. This leads to an immune-mediated anti-tumor response, where activated T-cells and dendritic cells migrate to both injected and non-injected tumors to target and destroy cancer cells.

Pharmacokinetics: 

Absorption 

talimogene laherparepvec is directly injected into tumor lesions, allowing it to directly access the tumor cells. It is designed to replicate within the tumor cells and spread to adjacent cancerous tissue. 

Distribution 

talimogene laherparepvec distribution is primarily limited to the injected tumor site and surrounding tissues. It does not have significant systemic distribution. 

Metabolism 

talimogene laherparepvec is designed to replicate within tumor cells, and its replication and metabolic processes occur within the tumor microenvironment. The exact details of its intracellular metabolism are not typically described in the literature. 

Elimination and excretion 

talimogene laherparepvec is not excreted in the traditional sense, as it remains localized within the tumor site and surrounding tissues. Over time, the virus-infected tumor cells may undergo lysis and be eliminated by the body’s natural processes. 

Administration: 

talimogene laherparepvec is administered through direct injection into tumor lesions. The injection is typically performed by a healthcare professional, such as an oncologist or surgeon, who has experience with this type of procedure. The injection is delivered directly into visible tumor lesions using a fine needle.

The exact dosage and frequency of administration may vary depending on factors such as the location and size of tumor and the patient’s overall health and treatment response. The administration procedure aims to deliver the viral therapy directly to the tumor site, allowing it to infect and replicate within the cancer cells. 

Patient information leaflet 

Generic Name: talimogene laherparepvec 

Pronounced: [ tal-IM-oh-jeen-la-HER-pa-REP-vek ]  

Why do we use talimogene laherparepvec? 

talimogene laherparepvec is a medication used for the treatment of certain types of skin cancer, specifically advanced melanoma that cannot be surgically removed. It is used in patients with unresectable cutaneous, subcutaneous, and nodal lesions. The medication is a genetically modified herpes simplex virus type 1 that selectively replicates within tumor cells and stimulates an immune response against the cancer cells.

By injecting talimogene laherparepvec directly into the tumor lesions, it can help shrink the size of the tumors, reduce their spread, and potentially improve overall survival rates. This therapy is typically used when surgical removal of the cancer is not feasible or as an adjunct to surgery in cases of high-risk melanoma. 

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talimogene laherparepvec

Brand Name :

Imlygic

Synonyms :

talimogene laherparepvec

Class :

Oncolytic Immunotherapy

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No data available for drug.

Dosage Forms & Strengths 

intralesional injectable solution 

106 (one million) plaque-formation units (PFU)/mL solution (available for use as a 1-mL single vial) 

108 (or 100 million) PFU/mL of the solution (available for use as a 1-mL single vial) 

Melanoma 

starting dose: about 4 mL concentration of 106 (one million) PFU/mL
Second dose: about 4 mL concentration in 108 (100 million) PFU/mL administered three weeks after the initial therapy
All subsequent therapies (reinitiation included): about 4 mL concentration in 108 (100 million) PFU/mL administered two weeks after the previous therapy
Continue therapy for 6 months or till there are no more injectable lesions.
If unresectable subcutaneous, cutaneous, or nodal lesions develop after a full response, restart therapy.
Determine the dose volume for every lesion
The size of a lesion depends on its longest dimension.
When the lesions are grouped together, they should be injected as a singular lesion based on the following:
Above 5 cm: 4 mL/lesion
Above 2.5 to 5 cm: 2 mL/lesion
Above 1.5 to 2.5 cm: 1 mL/lesion
Above 0.5 to 1.5 cm: 0.5 mL/lesion
Below 0.5 cm: 0.1 mL/lesion



Dose Adjustments

Dosage Modifications
Renal or Hepatic impairment: there are No clinical trials have been conducted on the pharmacokinetics of talimogene laherparepvec with renal or hepatic impairment.

Safety & efficacy not established 

Refer to the adult dosing regimen 

DRUG INTERACTION

Talimogene Laherparepvec

&

Talimogene Laherparepvec + 

l-methylfolate-pyridoxal 5′-phosphate-methylcobalamine

may decrease the serum concentration of Quinolones

lenograstim 

may decrease the therapeutic effect when combined with lenograstim

lipegfilgrastim 

may diminish the therapeutic effect when combined with lipegfilgrastim

palifermin 

may increase the adverse effect when combined with antineoplastic agents

maralixibat

may increase the levels of serum concentration

lenacapavir

may increase the levels of serum concentration

curcumin

may increase the levels of serum concentration

glecaprevir

may increase the levels of serum concentration

caspofungin

may increase the levels of serum concentration

maralixibat

may increase the levels of serum concentration

lenacapavir

may increase the levels of serum concentration

diacerein

may increase the levels of serum concentration

memantine/donepezil

may increase the levels of serum concentration

tranylcypromine

may increase the levels of serum concentration

diroximel fumarate

immunosuppressants increase the toxicity of talimogene laherparepvec

efalizumab

immunosuppressants increase the toxicity of talimogene laherparepvec

pimecrolimus

immunosuppressants increase the toxicity of talimogene laherparepvec

tacrolimus

immunosuppressants increase the toxicity of talimogene laherparepvec

abatacept

immunosuppressants increase the toxicity of talimogene laherparepvec

pimecrolimus topical

may have an increasingly adverse effect when combined with talimogene laherparepvec

cyclosporine ophthalmic

may have an increasingly adverse effect when combined with talimogene laherparepvec

reslizumab

may have an increasingly adverse effect when combined with talimogene laherparepvec

betamethasone (systemic)

may have an increasingly adverse effect when combined with talimogene laherparepvec

budesonide (oral inhalation)

may have an increasingly adverse effect when combined with talimogene laherparepvec

budesonide (nasal)

may have an increasingly adverse effect when combined with talimogene laherparepvec

budesonide (Topical)

may have an increasingly adverse effect when combined with talimogene laherparepvec

beclomethasone (nasal)

may have an increasingly adverse effect when combined with talimogene laherparepvec

abrocitinib

may have an increasingly adverse effect when combined with talimogene laherparepvec

avacopan

may have an increasingly adverse effect when combined with talimogene laherparepvec

siponimod

may have an increasingly adverse effect when combined with talimogene laherparepvec

methotrexate 

may have an increasingly adverse effect when combined with talimogene laherparepvec

pidotimod

talimogene laherparepvec: they may increase the toxic effect of immunostimulants

lipegfilgrastim

talimogene laherparepvec: they may increase the toxic effect of immunostimulants

filgrastim

talimogene laherparepvec: they may increase the toxic effect of immunostimulants

echinacea

talimogene laherparepvec: they may increase the toxic effect of immunostimulants

aldesleukin

talimogene laherparepvec: they may increase the toxic effect of immunostimulants

acyclovir 

acyclovir pharmacodynamically antagonizes talimogene laherparepvec to reduce its effects

thioguanine 

may increase the immunosuppressive effect of immunosuppressants

vilobelimab 

may increase the adverse effect of Immunosuppressants

ibalizumab

Antivirals may diminish the therapeutic effect of Talimogene Laherparepvec.

dolutegravir

Antivirals may diminish the therapeutic effect of Talimogene Laherparepvec.

dolutegravir and lamivudine

Antivirals may diminish the therapeutic effect of Talimogene Laherparepvec.

zidovudine and lamivudine

Antivirals may diminish the therapeutic effect of Talimogene Laherparepvec.

tecovirimat

Antivirals may diminish the therapeutic effect of Talimogene Laherparepvec.

ribavirin

antiherpetic antivirals decrease the efficacy of talimogene laherparepvec

beclomethasone (nasal)

it may diminish the excretion rate when combined with corifollitropin alfa resulting in an enhanced serum level

fluticasone (topical)

it may diminish the excretion rate when combined with corifollitropin alfa resulting in an enhanced serum level

beclomethasone dipropionate

it may diminish the excretion rate when combined with corifollitropin alfa resulting in an enhanced serum level

fluticasone (nasal)

it may diminish the excretion rate when combined with corifollitropin alfa resulting in an enhanced serum level

penciclovir 

may decrease the therapeutic effects of antiherpetic antivirals

bleomycin 

it enhance the risk of pulmonary toxicity

chlorambucil

may increase the risk of adverse effects

chloroquine

may increase the risk of adverse effects

pirfenidone

may increase the risk of adverse effects

diacerein

may increase the risk of adverse effects

diphenhydramine/ibuprofen

may increase the risk of adverse effects

aspirin, chlorpheniramine, and phenylephrine

may increase the risk of adverse effects

saccharomyces boulardii

may increase the risk of adverse effects

diroximel fumarate

may increase the risk of adverse effects

Actions and spectrum: 

talimogene laherparepvec is an oncolytic viral therapy used in the treatment of advanced melanoma. It is a modified herpes simplex virus type 1 that selectively replicates in tumor cells, leading to their destruction. T

he virus also encodes granulocyte-macrophage colony-stimulating factor (GM-CSF), which stimulates the immune response against the tumor. The spectrum of talimogene laherparepvec is limited to its treatment of unresectable melanoma lesions in the skin and lymph nodes. 

 

Frequency defined 

1-10% (all grades) 

Abdominal pain (8.9%) 

decreased Weight (5.8%) 

Oropharyngeal pain (5.8%) 

Dizziness (9.6%)  

1-10% (grade 3) 

Fatigue (2.1%) 

Pain in extremities (1.4%) 

Vomiting (1.7%)  

>10% (all grades) 

Chills (48.6%) 

Nausea (35.6%) 

Injection site pain (27.7%) 

Diarrhea (18.8%) 

Myalgia (17.5%) 

Pain in extremities (16.4%) 

Fatigue (50.3%) 

Pyrexia (42.8%) 

Influenza like illness (30.5%) 

Vomiting (21.2%) 

Headache (18.8%) 

Arthralgia (17.1%) 

Constipation (11.6%)  

<1% (grade 3) 

Injection site pain 

Diarrhea 

Myalgia 

Headache 

decreased Weight 

Influenza like illness 

Nausea 

Abdominal pain 

Arthralgia 

Black Box Warning: 

talimogene laherparepvec carries a black box warning regarding the risk of potential herpetic infections. The use of this medication can result in disseminated herpetic infection, including encephalitis and death. It is important to avoid the contact with herpetic lesions or bodily fluids from treated individuals. 

Contraindication/Caution: 

Contraindication: 

talimogene laherparepvec is contraindicated in individuals with a known history of severe hypersensitivity reactions to the medication or any of its components. Additionally, it should not be administered to patients with hypersensitivity to herpes simplex virus or other components of the product.

The safety and efficacy of talimogene laherparepvec have not been established in immunocompromised patients or individuals with active systemic infections. caution should be given to the potential risks and benefits before initiating treatment in these patient populations.  

Caution: 

  • talimogene laherparepvec should be used with caution in patients with a history of autoimmune disorders, as the treatment may exacerbate these conditions. 
  • talimogene laherparepvec in patients with a compromised immune system, as it may result in increased susceptibility to infections. 
  • The safety and efficacy of talimogene laherparepvec are not established in pregnant or lactating women. 
  • Close monitoring is recommended for signs of infection or systemic inflammatory response during and after treatment with talimogene laherparepvec. 
  • Patients should be advised to avoid direct contact with their eyes or mucous membranes after treatment, as talimogene laherparepvec is a live virus-based therapy. 
  • Concomitant use of immunosuppressive medications should be carefully considered, as they may interfere with the efficacy of talimogene laherparepvec. 
  • Patients should be used under caution about the potential for flu-like symptoms, injection site reactions, and other adverse effects associated with talimogene laherparepvec. 
  • Special caution should be exercised when administering talimogene laherparepvec to pediatric patients, as safety and efficacy data in this population are limited.

Comorbidities: 

The comorbidities associated with talimogene laherparepvec are not well known. However, it should be used under caution in patients with underlying medical conditions, particularly those affecting the immune system or autoimmune disorders.

talimogene laherparepvec is a live virus-based therapy and may potentially cause an exacerbation of autoimmune conditions or increase the risk of infections in patients with compromised immune systems.

Therefore, a thorough evaluation of the patient’s medical history and individual risk-benefit assessment should be performed before initiating treatment with talimogene laherparepvec. Close monitoring and appropriate management of comorbidities are essential during treatment. 

Pregnancy consideration: N/A 

Lactation: N/A  

Pregnancy category: 

  • Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
  • Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
  • Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   
  • Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 
  • Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 
  • Category N: There is no data available for the drug under this category. 

Pharmacology: 

talimogene laherparepvec is an oncolytic viral therapy designed to selectively replicate within tumor cells and induce tumor cell death. It is derived from the herpes simplex virus type 1 (HSV-1) and has been genetically modified to express the granulocyte-macrophage colony-stimulating factor (GM-CSF). The GM-CSF expression enhances the immune response against tumor cells by promoting the activation and proliferation of dendritic cells, T-cells, and macrophages.  

Pharmacodynamics: 

  • Selective Tumor Cell Replication: talimogene laherparepvec is engineered to selectively replicate within tumor cells. Once injected into tumors, it infects and replicates within cancer cells while sparing healthy cells. 
  • Tumor Cell Lysis: The replication of talimogene laherparepvec within tumor cells leads to their lysis, causing the destruction of cancerous tissue. This process releases tumor-associated antigens. 
  • Activation of Immune Response: talimogene laherparepvec is designed to express the granulocyte-macrophage colony-stimulating factor (GM-CSF). GM-CSF enhances the immune response by stimulating the activation and proliferation of dendritic cells, T-cells, and macrophages. 
  • Immune-Mediated Anti-Tumor Response: The expression of GM-CSF by talimogene laherparepvec promotes the recruitment and activation of immune cells. This leads to an immune-mediated anti-tumor response, where activated T-cells and dendritic cells migrate to both injected and non-injected tumors to target and destroy cancer cells.

Pharmacokinetics: 

Absorption 

talimogene laherparepvec is directly injected into tumor lesions, allowing it to directly access the tumor cells. It is designed to replicate within the tumor cells and spread to adjacent cancerous tissue. 

Distribution 

talimogene laherparepvec distribution is primarily limited to the injected tumor site and surrounding tissues. It does not have significant systemic distribution. 

Metabolism 

talimogene laherparepvec is designed to replicate within tumor cells, and its replication and metabolic processes occur within the tumor microenvironment. The exact details of its intracellular metabolism are not typically described in the literature. 

Elimination and excretion 

talimogene laherparepvec is not excreted in the traditional sense, as it remains localized within the tumor site and surrounding tissues. Over time, the virus-infected tumor cells may undergo lysis and be eliminated by the body’s natural processes. 

Administration: 

talimogene laherparepvec is administered through direct injection into tumor lesions. The injection is typically performed by a healthcare professional, such as an oncologist or surgeon, who has experience with this type of procedure. The injection is delivered directly into visible tumor lesions using a fine needle.

The exact dosage and frequency of administration may vary depending on factors such as the location and size of tumor and the patient’s overall health and treatment response. The administration procedure aims to deliver the viral therapy directly to the tumor site, allowing it to infect and replicate within the cancer cells. 

Patient information leaflet 

Generic Name: talimogene laherparepvec 

Pronounced: [ tal-IM-oh-jeen-la-HER-pa-REP-vek ]  

Why do we use talimogene laherparepvec? 

talimogene laherparepvec is a medication used for the treatment of certain types of skin cancer, specifically advanced melanoma that cannot be surgically removed. It is used in patients with unresectable cutaneous, subcutaneous, and nodal lesions. The medication is a genetically modified herpes simplex virus type 1 that selectively replicates within tumor cells and stimulates an immune response against the cancer cells.

By injecting talimogene laherparepvec directly into the tumor lesions, it can help shrink the size of the tumors, reduce their spread, and potentially improve overall survival rates. This therapy is typically used when surgical removal of the cancer is not feasible or as an adjunct to surgery in cases of high-risk melanoma. 

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