Drug interactions
Ifosfamide + Pentobarbital
Severity: Moderate
Ifosfamide and Pentobarbital: 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
Pentobarbital induces CYP3A4 and CYP2B6, which can increase conversion of ifosfamide to its active alkylating species. It may also increase formation of chloroacetaldehyde, the metabolite linked to neurotoxicity and nephrotoxicity. Barbiturate sedation can also be confused with ifosfamide encephalopathy.
What this interaction means in plain words
Ifosfamide and Pentobarbital 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
Induction of CYP3A4 and CYP2B6 shifts ifosfamide metabolism, increasing both activation and chloroacetaldehyde formation.
What to do
Avoid enzyme-inducing barbiturates where an alternative sedative or anticonvulsant exists. If combined, monitor closely for myelosuppression, CNS toxicity and renal function.
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 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 Ifosfamide with Pentobarbital?
MediHelp rates the interaction as moderate. Ifosfamide and Pentobarbital 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. Pentobarbital induces CYP3A4 and CYP2B6, which can increase conversion of ifosfamide to its active alkylating species. It may also increase formation of chloroacetaldehyde, the metabolite linked to neurotoxicity and nephrotoxicity. Barbiturate sedation can also be confused with ifosfamide encephalopathy.
How serious is the interaction between Ifosfamide and Pentobarbital?
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 enzyme-inducing barbiturates where an alternative sedative or anticonvulsant exists. If combined, monitor closely for myelosuppression, CNS toxicity and renal function.
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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