Drug interactions
Ifosfamide + Primidone
Severity: Moderate
Ifosfamide and Primidone: 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
Primidone is metabolised partly to phenobarbital and induces CYP3A4 and CYP2B6. This can accelerate ifosfamide metabolism, increasing active metabolites and chloroacetaldehyde. The result may be more neurotoxicity, nephrotoxicity and myelosuppression.
What this interaction means in plain words
Ifosfamide and Primidone 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; Primidone belongs to Central Nervous System.
Why it happens
Induction of CYP2B6 and CYP3A4 increases ifosfamide activation and chloroacetaldehyde production.
What to do
Consider a non-inducing anticonvulsant during ifosfamide therapy. If primidone is continued, monitor for CNS toxicity, renal function and blood counts.
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
Other interactions of Primidone
- Lorlatinib + Primidone Contraindicated
- Lurasidone + Primidone Contraindicated
- Primidone + Ranolazine Contraindicated
- Primidone + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
- Primidone + Voriconazole Contraindicated
- Abiraterone + Primidone Major
Frequently asked questions
Can I take Ifosfamide with Primidone?
MediHelp rates the interaction as moderate. Ifosfamide and Primidone 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. Primidone is metabolised partly to phenobarbital and induces CYP3A4 and CYP2B6. This can accelerate ifosfamide metabolism, increasing active metabolites and chloroacetaldehyde. The result may be more neurotoxicity, nephrotoxicity and myelosuppression.
How serious is the interaction between Ifosfamide and Primidone?
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 a non-inducing anticonvulsant during ifosfamide therapy. If primidone is continued, monitor for CNS toxicity, renal function and blood counts.
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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