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Drug Interactions between etoposide and Sezaby

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

etoposide PHENobarbital

Applies to: etoposide and Sezaby (phenobarbital)

MONITOR: Some anticonvulsants such as carbamazepine, phenobarbital, phenytoin, and primidone may reduce the systemic exposure of etoposide. The proposed mechanism is accelerated clearance of etoposide due to induction of hepatic CYP450 enzymes by these anticonvulsants. In one study, the median clearance of etoposide in seven pediatric patients receiving concomitant therapy with phenobarbital and/or phenytoin was 77% higher than that in a matched control group of patients receiving the same chemotherapeutic protocol without anticonvulsant therapy. The investigators noted that clearance estimates for control patients were similar to previously published values for pediatric patients. No data are available for other anticonvulsants, but agents with similar potential for induction of hepatic metabolism should be expected to participate in the interaction.

MANAGEMENT: During concomitant therapy with certain anticonvulsants, patients should be observed for potentially inadequate or altered response to etoposide, and the dosage adjusted accordingly as necessary.

References (2)
  1. Rodman JH, Murry DJ, Madden T, Santana VM (1994) "Altered etoposide pharmacokinetics and time to engraftment in pediatric patients undergoing autologous bone marrow transplantation." J Clin Oncol, 12, p. 2390-7
  2. Rodman JH, Murry DJ, Madden T, Santana VM (1992) "Pharmacokinetics of high doses of etoposide and the influence of anticonvulsants in pediatric cancer patients." Clin Pharmacol Ther, 51, p. 156

Drug and food interactions

Major

PHENobarbital food

Applies to: Sezaby (phenobarbital)

GENERALLY AVOID: Concurrent acute use of barbiturates and ethanol may result in additive CNS effects, including impaired coordination, sedation, and death. Tolerance of these agents may occur with chronic use. The mechanism is related to inhibition of microsomal enzymes acutely and induction of hepatic microsomal enzymes chronically.

MANAGEMENT: The combination of ethanol and barbiturates should be avoided.

References (5)
  1. Gupta RC, Kofoed J (1966) "Toxological statistics for barbiturates, other sedatives, and tranquilizers in Ontario: a 10-year survey." Can Med Assoc J, 94, p. 863-5
  2. Misra PS, Lefevre A, Ishii H, Rubin E, Lieber CS (1971) "Increase of ethanol, meprobamate and pentobarbital metabolism after chronic ethanol administration in man and in rats." Am J Med, 51, p. 346-51
  3. Saario I, Linnoila M (1976) "Effect of subacute treatment with hypnotics, alone or in combination with alcohol, on psychomotor skills related to driving." Acta Pharmacol Toxicol (Copenh), 38, p. 382-92
  4. Stead AH, Moffat AC (1983) "Quantification of the interaction between barbiturates and alcohol and interpretation of fatal blood concentrations." Hum Toxicol, 2, p. 5-14
  5. Seixas FA (1979) "Drug/alcohol interactions: avert potential dangers." Geriatrics, 34, p. 89-102

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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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

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