Drug interactions
Cyclophosphamide + Nefazodone
Severity: Moderate
Cyclophosphamide and Nefazodone: moderate 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
Nefazodone is a strong CYP3A4 inhibitor and may reduce the CYP-mediated bioactivation of cyclophosphamide to 4-hydroxycyclophosphamide, possibly altering its efficacy and the balance of toxic metabolites. Nefazodone also carries hepatotoxicity risk, which is relevant in patients receiving chemotherapy.
What this interaction means in plain words
Cyclophosphamide and Nefazodone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Inhibition of CYP3A4-mediated metabolism of cyclophosphamide by nefazodone.
What to do
Prefer an antidepressant without strong CYP3A4 inhibition, such as sertraline or escitalopram, in patients on cyclophosphamide. If used together, monitor liver function and treatment response.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Cyclophosphamide
Frequently asked questions
Can I take Cyclophosphamide with Nefazodone?
MediHelp rates the interaction as moderate. Cyclophosphamide and Nefazodone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Nefazodone is a strong CYP3A4 inhibitor and may reduce the CYP-mediated bioactivation of cyclophosphamide to 4-hydroxycyclophosphamide, possibly altering its efficacy and the balance of toxic metabolites. Nefazodone also carries hepatotoxicity risk, which is relevant in patients receiving chemotherapy.
How serious is the interaction between Cyclophosphamide and Nefazodone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an antidepressant without strong CYP3A4 inhibition, such as sertraline or escitalopram, in patients on cyclophosphamide. If used together, monitor liver function and treatment response.
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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