Drug interactions
Chlorambucil + Ifosfamide
Severity: Major
Chlorambucil and Ifosfamide: major interaction.
Last updated Sources: Health Canada product monograph
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both are alkylating agents with overlapping myelosuppression, and ifosfamide adds urotoxicity, neurotoxicity and nephrotoxicity. Combined use raises the risk of severe cytopenias and infection.
What this interaction means in plain words
Chlorambucil and Ifosfamide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Chlorambucil belongs to Oncology; Ifosfamide belongs to Oncology.
Why it happens
Additive myelosuppression from two alkylating agents.
What to do
Monitor complete blood counts, renal function and urinalysis, and reduce doses or delay cycles for cytopenias. Use mesna and hydration with ifosfamide.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Chlorambucil and Ifosfamide, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Chlorambucil
Other interactions of Ifosfamide
- Adenovirus types 4 and 7 live + Ifosfamide Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine Contraindicated
- Ifosfamide + Measles mumps and rubella vaccine live Contraindicated
- Ifosfamide + Measles mumps rubella and varicella vaccine live Contraindicated
- Ifosfamide + Measles vaccine Contraindicated
- Ifosfamide + Rotavirus oral vaccine live Contraindicated
Frequently asked questions
Can I take Chlorambucil with Ifosfamide?
MediHelp rates the interaction as major. Chlorambucil and Ifosfamide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both are alkylating agents with overlapping myelosuppression, and ifosfamide adds urotoxicity, neurotoxicity and nephrotoxicity. Combined use raises the risk of severe cytopenias and infection.
How serious is the interaction between Chlorambucil and Ifosfamide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor complete blood counts, renal function and urinalysis, and reduce doses or delay cycles for cytopenias. Use mesna and hydration with ifosfamide.
What other medicines interact with Chlorambucil?
MediHelp also lists interactions of Chlorambucil with, for example, Adenovirus types 4 and 7 live, Axicabtagene ciloleucel, Belatacept. The full list is on the Chlorambucil page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
