Drug Interactions between fexinidazole and ifosfamide

Do not consume grapefruit or grapefruit juice while you are receiving treatment with ifosfamide, as this may decrease the anticancer effects of ifosfamide and may increase its adverse effects on your nervous system and your kidneys. Do not use alcohol while you are receiving treatment with ifosfamide. This may increase nervous system side effects such as somnolence, dizziness, confusion, difficulty concentrating, and impairment of thinking and judgment; and may also increase nausea and vomiting. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. Also, avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.

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Food can enhance the levels of fexinidazole in your body. To ensure maximal oral absorption, fexinidazole should be administered with or immediately after the main meal of the day. This will make it easier for your body to absorb the medication. Use of herbal medicines and supplements during treatment with fexinidazole should be avoided. Grapefruit or grapefruit juice should not be consumed during treatment with fexinidazole. Grapefruit juice can significantly increase the blood levels and effects of fexinidazole, which can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. Consumption of alcoholic beverages or products containing alcohol or propylene glycol during treatment with fexinidazole may occasionally trigger a reaction in some patients similar to the disulfiram reaction, which includes unpleasant effects such as flushing, throbbing in head and neck, throbbing headache, difficulty breathing, nausea, vomiting, sweating, thirst, chest pain, rapid heartbeat, palpitation, low blood pressure, dizziness, lightheadedness, blurred vision, and confusion. Rarely, more severe reactions may include abnormal heart rhythm, heart attack, heart failure, unconsciousness, convulsions, and even death. Patients treated with fexinidazole should avoid using any products containing alcohol or propylene glycol during and for at least 48 hours after completion of therapy. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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