Drug interactions
Erythromycin + Ifosfamide
Severity: Moderate
Erythromycin 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 partly by CYP3A4, and also forms a neurotoxic chloroacetaldehyde metabolite through CYP3A4. Erythromycin inhibits this enzyme, which may reduce activation and alter the balance of active and toxic metabolites. The clinical impact is uncertain.
What this interaction means in plain words
Erythromycin 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.
Erythromycin belongs to Anti Bacterial; Ifosfamide belongs to Oncology.
Why it happens
Erythromycin inhibits CYP3A4, altering the metabolic activation and side-pathway metabolism of ifosfamide.
What to do
Consider an alternative antibiotic that does not inhibit CYP3A4 during ifosfamide cycles. If unavoidable, monitor for reduced efficacy and for neurotoxicity.
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 Erythromycin
- Conivaptan + Erythromycin Contraindicated
- Dihydroergotamine intranasal + Erythromycin Contraindicated
- Dihydroergotamine + Erythromycin Contraindicated
- Domperidone + Erythromycin Contraindicated
- Dronedarone + Erythromycin Contraindicated
- Droperidol + Erythromycin Contraindicated
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 Erythromycin with Ifosfamide?
MediHelp rates the interaction as moderate. Erythromycin 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 partly by CYP3A4, and also forms a neurotoxic chloroacetaldehyde metabolite through CYP3A4. Erythromycin inhibits this enzyme, which may reduce activation and alter the balance of active and toxic metabolites. The clinical impact is uncertain.
How serious is the interaction between Erythromycin 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: Consider an alternative antibiotic that does not inhibit CYP3A4 during ifosfamide cycles. If unavoidable, monitor for reduced efficacy and for neurotoxicity.
What other medicines interact with Erythromycin?
MediHelp also lists interactions of Erythromycin with, for example, Conivaptan, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Erythromycin page.
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