Drug interactions
Cyclophosphamide + Ifosfamide
Severity: Major
Cyclophosphamide and Ifosfamide: major interaction.
Last updated
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 oxazaphosphorine alkylating agents with overlapping myelosuppression, immunosuppression and urotoxicity. Combined use raises the risk of severe cytopenias, infection and hemorrhagic cystitis.
What this interaction means in plain words
Cyclophosphamide 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.
Cyclophosphamide belongs to Oncology; Ifosfamide belongs to Oncology.
Why it happens
Additive myelosuppressive, immunosuppressive and urotoxic effects of two related alkylators.
What to do
Avoid concurrent use unless part of a defined protocol; if used, give mesna with hydration and monitor blood counts, renal function and urinalysis.
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?
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Other interactions of Cyclophosphamide
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 Cyclophosphamide with Ifosfamide?
MediHelp rates the interaction as major. Cyclophosphamide 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 oxazaphosphorine alkylating agents with overlapping myelosuppression, immunosuppression and urotoxicity. Combined use raises the risk of severe cytopenias, infection and hemorrhagic cystitis.
How serious is the interaction between Cyclophosphamide 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: Avoid concurrent use unless part of a defined protocol; if used, give mesna with hydration and monitor blood counts, renal function and urinalysis.
What other medicines interact with Cyclophosphamide?
MediHelp also lists interactions of Cyclophosphamide with, for example, Adenovirus types 4 and 7 live, Belatacept, Bendamustine. The full list is on the Cyclophosphamide page.
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