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Drug Interactions between Hexalen and Luminal

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

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Interactions between your drugs

Moderate

PHENobarbital altretamine

Applies to: Luminal (phenobarbital) and Hexalen (altretamine)

GENERALLY AVOID: According to a rat model, the coadministration with phenobarbital (PB) may decrease the plasma, liver, and tumor concentrations of altretamine, as well as reduce its antitumor activity. The likely mechanism is PB induction of altretamine metabolism via CYP450 isoenzymes, resulting in decreased time of exposure of tumor cells to altretamine and its active metabolites. In the study, mice pretreated with PB had altretamine plasma, liver, and tumor area under the concentration-time curve (AUC) values that were 17%, 17%, and 34%, respectively, of those observed in the control group. AUCs for almost all of the metabolites were also much lower compared to controls. In addition, PB pretreatment reduced the effectiveness of altretamine as reflected in tumor weight reduction.

MANAGEMENT: Until further data are available, the concomitant use of altretamine and phenobarbital should probably be avoided if possible. The same precaution may be applicable to other barbiturates because of their potential to induce CYP450 isoenzymes.

References

  1. Paolini A, D'Incalci M "Effect of phenobarbital pretreatment on the metabolism and antitumor activity of hexamethylmelamine." Cancer Treat Rep 70 (1986): 513-6

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Drug and food interactions

Major

PHENobarbital food

Applies to: Luminal (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

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

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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

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