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Ifex / Mesnex (ifosfamide / mesna) Disease Interactions

There are 7 disease interactions with Ifex / Mesnex (ifosfamide / mesna):

Major

Antineoplastics (applies to Ifex/Mesnex) infections

Major Potential Hazard, High plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

References

  1. "Product Information. Novantrone (mitoxantrone)." Immunex Corporation, Seattle, WA.
  2. "Product Information. Doxil (doxorubicin liposomal)." Sequis Pharmaceuticals Inc, Menlo Park, CA.
  3. "Product Information. Gemzar (gemcitabine)." Lilly, Eli and Company, Indianapolis, IN.
  4. "Product Information. Taxol (paclitaxel)." Bristol-Myers Squibb, Princeton, NJ.
  5. "Product Information. Leukeran Tablets (chlorambucil)." Glaxo Welcome, Research Triangle Pk, NC.
  6. Frame JN, Dahut WL, Crowley S "Fludarabine and acute tumor lysis in chronic lymphocytic leukemia." N Engl J Med 327 (1992): 1396-7
  7. "Product Information. Leustatin (cladribine)." Ortho Biotech Inc, Raritan, NJ.
  8. "Product Information. Matulane (procarbazine)." Roche Laboratories, Nutley, NJ.
  9. "Product Information. Alkeran Tablets (melphalan)." Glaxo Wellcome, Research Triangle Pk, NC.
  10. "Product Information. Adriamycin PFS (doxorubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  11. Sanders C, Perez EA, Lawrence HJ "Opportunistic infections in patients with chronic lymphocytic leukemia following treatment with fludarabine." Am J Hematol 39 (1992): 314-5
  12. Schilling PJ, Vadhan-Raj S "Concurrent cytomegalovirus and pneumocystis pneumonia after fludarabine therapy for chronic lymphocytic leukemia." N Engl J Med 323 (1990): 833-4
  13. "Product Information. Tabloid (thioguanine)." Prasco Laboratories, Cincinnati, OH.
  14. "Product Information. Mutamycin (mitomycin)." Bristol-Myers Squibb, Princeton, NJ.
  15. "Product Information. Idamycin (idarubicin)." Pharmacia and Upjohn, Kalamazoo, MI.
  16. "Product Information. Hycamtin (topotecan)." SmithKline Beecham, Philadelphia, PA.
  17. "Product Information. Cytosar-U (cytarabine)." Pharmacia and Upjohn, Kalamazoo, MI.
  18. "Product Information. Purinethol (mercaptopurine)." Glaxo Wellcome, Research Triangle Pk, NC.
  19. Girmenia C, Mauro FR, Rahimi S "Late listeriosis after fludarabine plus prednisone treatment." Br J Haematol 87 (1994): 407-8
  20. "Product Information. Methotrexate (methotrexate)." Lederle Laboratories, Wayne, NJ.
  21. "Product Information. Vepesid (etoposide)." Bristol-Myers Squibb, Princeton, NJ.
  22. "Product Information. Xeloda (capecitabine)." Roche Laboratories, Nutley, NJ.
  23. Bastion Y, Coiffier B, Tigaud JD, Espinouse D, Bryon PA "Pneumocystis pneumonia in a patient treated with fludarabine for chronic lymphocytic leukemia." Eur J Cancer 27 (1991): 671
  24. "Product Information. Uracil Mustard (uracil mustard)." Roberts Pharmaceutical Corporation, Eatontown, NJ.
  25. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb, Princeton, NJ.
  26. "Product Information. Fludara (fludarabine)." Berlex, Richmond, CA.
  27. "Product Information. Taxotere (docetaxel)." Rhone-Poulenc Rorer, Collegeville, PA.
  28. "Product Information. Platinol (cisplatin)." Bristol-Myers Squibb, Princeton, NJ.
  29. "Product Information. Nipent (pentostatin)." Hospira Inc, Lake Forest, IL.
  30. "Product Information. DTIC-Dome (dacarbazine)." Bayer, West Haven, CT.
  31. "Product Information. Thiotepa (thiotepa)." Hikma USA (formerly West-Ward Pharmaceutical Corporation), Eatontown, NJ.
View all 31 references
Major

Ifosfamide (applies to Ifex/Mesnex) myelosuppression

Major Potential Hazard, Moderate plausibility. Applicable conditions: Infection - Bacterial/Fungal/Protozoal/Viral, Fever, Bleeding, Bone Marrow Depression/Low Blood Counts

Treatment with ifosfamide may cause myelosuppression and significant suppression of immune responses, which can lead to severe or fatal infections. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Complete blood counts should be obtained prior to administration of each dose and unless clinically essential, ifosfamide should be withheld if white blood cell counts falls below 1,500 to 2,000/mm3 and/or platelet counts falls below 50,000/mm3. Ifosfamide should be given cautiously, if at all, to patients with presence of an infection, severe immunosuppression or compromised bone marrow reserve, as indicated by leukopenia, granulocytopenia, extensive bone marrow metastases, prior radiation therapy, or prior therapy with other cytotoxic agents.

References

  1. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb, Princeton, NJ.
Major

MDVs (applies to Ifex/Mesnex) prematurity

Major Potential Hazard, Moderate plausibility. Applicable conditions: Prematurity/Underweight in Infancy

Parenteral medications formulated in multidose vials often contain benzyl alcohol as a preservative. Their use is considered by drug manufacturers to be contraindicated in neonates, particularly premature infants and infants of low birth weight. When used in bacteriostatic saline intravascular flush and endotracheal tube lavage solutions, benzyl alcohol has been associated with fatalities and severe respiratory and metabolic complications in low-birth-weight premature infants. Thus, single-dose formulations should always be used in infants whenever possible. However, many experts feel that, in the absence of benzyl alcohol-free equivalents, the amount of the preservative present in these formulations should not necessarily preclude their use if they are clearly indicated. The American Academy of Pediatrics considers benzyl alcohol in low doses (such as when used as a preservative in some medications) to be safe for newborns. However, the administration of high dosages of these medications must take into account the total amount of benzyl alcohol administered. The level at which toxicity may occur is unknown.

References

  1. ""Inactive" ingredients in pharmaceutical products: update (subject review). American Academy of Pediatrics Committee on Drugs. Available from: URL: http://www.aap.org/policy/re9706.html." Pediatrics 99 (1997): 268-78
  2. "Product Information. Fragmin (dalteparin)." Pharmacia and Upjohn, Kalamazoo, MI.
  3. "Product Information. Tracrium (atracurium)." Glaxo Wellcome, Research Triangle Park, NC.
  4. "Product Information. Mesnex (mesna)." Bristol-Myers Squibb, Princeton, NJ.
  5. "Product Information. Mivacron (mivacurium)." Glaxo Wellcome, Research Triangle Park, NC.
  6. "Product Information. Nuromax (doxacurium)." Glaxo Wellcome, Research Triangle Park, NC.
View all 6 references
Major

Mesna (applies to Ifex/Mesnex) autoimmune disorders

Major Potential Hazard, Moderate plausibility.

Mesna is a thiol (SH) compound. Hypersensitivity reactions including anaphylaxis have occurred in patients with autoimmune disorders, the majority of whom received high dosages of mesna orally. Therapy with mesna should be administered cautiously in patients with autoimmune disorders.

References

  1. Reinhold-Keller E, Mohr J, Christophers E, Nordmann K, Gross WL "Mesna side effects which imitate vasculitis." Clin Investig 70 (1992): 698-704
  2. Seidel A, Andrassy K, Ritz E, Kasser U, Lemmel EM "Allergic reactions to mesna." Lancet 338 (1991): 381
  3. Lang E, Goos M "Hypersensitivity to mesna." Lancet 2 (1985): 329
  4. Zonzits E, Aberer W, Tappeiner G "Drug eruptions from mesna. After cyclophosphamide treatment of patients with systemic lupus erythematosus and dermatomyositis." Arch Dermatol 128 (1992): 80-2
  5. "Product Information. Mesnex (mesna)." Bristol-Myers Squibb, Princeton, NJ.
View all 5 references
Moderate

Ifosfamide (applies to Ifex/Mesnex) CNS toxicity

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Psychosis

Administration of ifosfamide can cause CNS toxicity and other neurotoxic effects. The risk of CNS toxicity and other neurotoxic effects necessitates careful monitoring of the patient. Neurologic manifestations consisting of somnolence, confusion, hallucinations, blurred vision, psychotic behavior, and extrapyramidal symptoms, have been reported following ifosfamide therapy. There have also been reports of peripheral neuropathy associated with ifosfamide Episodes of depressive psychoses and hallucinations have been reported during ifosfamide therapy. These neurological symptoms are usually reversible, but ifosfamide should be discontinued and supportive care maintained until symptoms completely resolve. Therapy with ifosfamide should be administered cautiously in patients with a history of or predisposition to psychotic episodes.

References

  1. Cameron JC "Ifosfamide neurotoxicity. A challenge for nurses, a potential nightmare for patients." Cancer Nurs 16 (1993): 40-6
  2. Miller LJ, Eaton VE "Ifosfamide-induced neurotoxicity: a case report and review of the literature." Ann Pharmacother 26 (1992): 183-7
  3. Curtin JP, Koonings PP, Gutierrez M, Schlaerth JB, Morrow CP "Ifosfamide-induced neurotoxicity." Gynecol Oncol 42 (1991): 193-6;disc. 191-2
  4. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb, Princeton, NJ.
View all 4 references
Moderate

Ifosfamide (applies to Ifex/Mesnex) hepatic dysfunction

Moderate Potential Hazard, Low plausibility. Applicable conditions: Liver Disease

Ifosfamide is metabolized by the liver to a biologically active form. Metabolic activation and therapeutic activity may be altered in patients with hepatic impairment. Therapy with ifosfamide should be administered cautiously in patients with compromised hepatic function. Clinical monitoring of hepatic function is recommended.

References

  1. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb, Princeton, NJ.
Moderate

Ifosfamide (applies to Ifex/Mesnex) renal dysfunction

Moderate Potential Hazard, High plausibility.

Ifosfamide is primarily eliminated by the kidney. Approximately 12% to 18% of ifosfamide is excreted unchanged in the urine. Additionally, iIfosfamide is both nephrotoxic and urotoxic. Hemorrhagic cystitis due to metabolites excreted in the urine can develop during therapy with ifosfamide. Adequate hydration and use of a prophylactic agent such as mesna prior to each course of ifosfamide therapy can reduce bladder irritation and hematuria. Clinical signs of renal toxicity such as elevation in BUN or serum creatinine or decrease in creatinine clearance have been reported. Therapy with ifosfamide should be administered cautiously in patients with a history of or predisposition to cystitis or impaired renal function. Close clinical monitoring of serum and urinary chemistries is recommended.

References

  1. "Product Information. Ifex (ifosfamide)." Bristol-Myers Squibb, Princeton, NJ.
  2. Kramer A, Goldschmidt H, Hahn U, Andrassy K "Progressive renal failure in two breast cancer patients after high- dose ifosfamide." Lancet 344 (1994): 1569
  3. Moncrieff M, Foot A "Fanconi syndrome after ifosfamide." Cancer Chemother Pharmacol 23 (1989): 121-2
  4. Fujita J, Matsumoto K, Kakizoe T, Murase T "Prevention of ifosfamide-induced hemorrhagic cystitis by continuous bladder irrigation." Urology 18 (1981): 250-1
  5. Beckwith C, Flaharty KK, Cheung AK, Beatty PG "Fanconi's syndrome due to ifosfamide." Bone Marrow Transplant 11 (1993): 71-3
  6. Skinner R, Pearson AD, Price L, Coulthard MG, Craft AW "Nephrotoxicity after ifosfamide." Arch Dis Child 65 (1990): 732-8
  7. Garcia AA "Ifosfamide-induced Fanconi syndrome." Ann Pharmacother 29 (1995): 590-1
  8. Patterson WP, Khojasteh A "Ifosfamide-induced renal tubular defects." Cancer 63 (1989): 649-51
  9. Goren MP, Wright RK, Horowitz ME, Pratt CB "Ifosfamide-induced subclinical tubular nephrotoxicity despite mesna." Cancer Treat Rep 71 (1987): 127-30
View all 9 references

Ifex / Mesnex (ifosfamide / mesna) drug interactions

There are 462 drug interactions with Ifex / Mesnex (ifosfamide / mesna)

Ifex / Mesnex (ifosfamide / mesna) alcohol/food interactions

There is 1 alcohol/food interaction with Ifex / Mesnex (ifosfamide / mesna)

More about Ifex / Mesnex (ifosfamide / mesna)

Related treatment guides

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.