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Drug interactions

Ifosfamide + Lonafarnib

Severity: Moderate

Ifosfamide and Lonafarnib: 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

Lonafarnib is a sensitive CYP3A substrate and also inhibits CYP3A, while ifosfamide is activated through CYP3A4 and CYP2B6 and is a CYP3A4 substrate. Lonafarnib may change ifosfamide activation and toxic metabolite formation, and the effect on lonafarnib exposure is uncertain. The clinical consequences have not been well studied.

What this interaction means in plain words

Ifosfamide and Lonafarnib 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 belongs to Oncology; Lonafarnib belongs to Miscellaneous.

Evidence level: Low

Why it happens

Lonafarnib inhibits CYP3A, altering ifosfamide metabolism, and ifosfamide may modestly affect lonafarnib clearance via CYP3A.

What to do

Avoid the combination if an alternative is available. If used together, monitor for ifosfamide neurotoxicity, nephrotoxicity and myelosuppression and for lonafarnib adverse effects such as gastrointestinal toxicity and arrhythmia symptoms.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Ifosfamide with Lonafarnib?

MediHelp rates the interaction as moderate. Ifosfamide and Lonafarnib 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. Lonafarnib is a sensitive CYP3A substrate and also inhibits CYP3A, while ifosfamide is activated through CYP3A4 and CYP2B6 and is a CYP3A4 substrate. Lonafarnib may change ifosfamide activation and toxic metabolite formation, and the effect on lonafarnib exposure is uncertain. The clinical consequences have not been well studied.

How serious is the interaction between Ifosfamide and Lonafarnib?

MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination if an alternative is available. If used together, monitor for ifosfamide neurotoxicity, nephrotoxicity and myelosuppression and for lonafarnib adverse effects such as gastrointestinal toxicity and arrhythmia symptoms.

What other medicines interact with Ifosfamide?

MediHelp also lists interactions of Ifosfamide with, for example, Adenovirus types 4 and 7 live, Measles mumps and rubella vaccine, Measles mumps and rubella vaccine live. The full list is on the Ifosfamide page.

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