Drug interactions
Diltiazem + Ifosfamide
Severity: Moderate
Diltiazem and Ifosfamide: 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
Ifosfamide is a prodrug activated by CYP3A4 and CYP2B6, so diltiazem may reduce formation of active metabolites while shifting metabolism toward neurotoxic chloroacetaldehyde. This could alter efficacy and toxicity.
What this interaction means in plain words
Diltiazem and Ifosfamide 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.
Diltiazem belongs to Cardiovascular; Ifosfamide belongs to Oncology.
Why it happens
Diltiazem inhibits CYP3A4, altering ifosfamide activation and toxic metabolite formation.
What to do
Monitor for reduced response and for neurotoxicity during ifosfamide treatment, and consider a non-CYP3A4-inhibiting alternative to diltiazem.
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 Diltiazem
- Diltiazem + Flibanserin Contraindicated
- Diltiazem + Ivabradine Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Diltiazem + Lonafarnib Contraindicated
- Acebutolol + Diltiazem Major
- Alfentanil + Diltiazem Major
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 Diltiazem with Ifosfamide?
MediHelp rates the interaction as moderate. Diltiazem and Ifosfamide 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. Ifosfamide is a prodrug activated by CYP3A4 and CYP2B6, so diltiazem may reduce formation of active metabolites while shifting metabolism toward neurotoxic chloroacetaldehyde. This could alter efficacy and toxicity.
How serious is the interaction between Diltiazem and Ifosfamide?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for reduced response and for neurotoxicity during ifosfamide treatment, and consider a non-CYP3A4-inhibiting alternative to diltiazem.
What other medicines interact with Diltiazem?
MediHelp also lists interactions of Diltiazem with, for example, Flibanserin, Ivabradine, Lomitapide. The full list is on the Diltiazem page.
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