Drug interactions
Ifosfamide + Phenobarbital
Severity: Moderate
Ifosfamide and Phenobarbital: 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
Phenobarbital is an inducer of CYP2B6 and CYP3A4 and can speed the metabolism of ifosfamide. This may raise levels of active alkylating metabolites and of neurotoxic and nephrotoxic chloroacetaldehyde. Increased toxicity is possible, although effects on efficacy are less clear.
What this interaction means in plain words
Ifosfamide and Phenobarbital 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
Enzyme induction of CYP2B6 and CYP3A4 alters ifosfamide bioactivation and increases chloroacetaldehyde formation.
What to do
Prefer a non-inducing anticonvulsant such as levetiracetam when possible. If phenobarbital is needed, monitor for neurotoxicity, renal toxicity and myelosuppression.
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 Phenobarbital?
MediHelp rates the interaction as moderate. Ifosfamide and Phenobarbital 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. Phenobarbital is an inducer of CYP2B6 and CYP3A4 and can speed the metabolism of ifosfamide. This may raise levels of active alkylating metabolites and of neurotoxic and nephrotoxic chloroacetaldehyde. Increased toxicity is possible, although effects on efficacy are less clear.
How serious is the interaction between Ifosfamide and Phenobarbital?
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 a non-inducing anticonvulsant such as levetiracetam when possible. If phenobarbital is needed, monitor for neurotoxicity, renal toxicity and myelosuppression.
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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