Drug interactions
Cyclophosphamide + Lomustine
Severity: Major
Cyclophosphamide and Lomustine: 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 alkylating agents cause myelosuppression, often delayed and prolonged with lomustine, so combination increases the risk of severe cytopenias and infection. Immunosuppression is also additive.
What this interaction means in plain words
Cyclophosphamide and Lomustine 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; Lomustine belongs to Oncology.
Why it happens
Additive myelosuppressive and immunosuppressive effects of two alkylating agents.
What to do
Monitor complete blood counts frequently, including the delayed nadir after lomustine, and reduce doses or lengthen intervals as needed.
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 Lomustine
- Adenovirus types 4 and 7 live + Lomustine Contraindicated
- Bcg vaccine live + Lomustine Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Lomustine Contraindicated
- Lomustine + Measles mumps and rubella vaccine Contraindicated
- Lomustine + Measles mumps and rubella vaccine live Contraindicated
- Lomustine + Measles mumps rubella and varicella vaccine live Contraindicated
Frequently asked questions
Can I take Cyclophosphamide with Lomustine?
MediHelp rates the interaction as major. Cyclophosphamide and Lomustine 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 alkylating agents cause myelosuppression, often delayed and prolonged with lomustine, so combination increases the risk of severe cytopenias and infection. Immunosuppression is also additive.
How serious is the interaction between Cyclophosphamide and Lomustine?
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 frequently, including the delayed nadir after lomustine, and reduce doses or lengthen intervals as needed.
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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