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Drug Interactions between ifosfamide / mesna and Omnipaque Flexipak

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

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Interactions between your drugs

Major

ifosfamide iohexol

Applies to: ifosfamide / mesna and Omnipaque Flexipak (iohexol)

Before you undergo any imaging procedure where iohexol may be given by injection, let your doctor know if you are currently being treated with ifosfamide. Injection of iohexol and similar contrast agents can sometimes cause kidney damage, and combining it with other medications that can also affect the kidney such as ifosfamide may increase that risk. If you have been receiving ifosfamide, your doctor may need to take special precautionary measures before, during and after the contrast injection, particularly if you also have other risk factors such as diabetes, preexisting kidney problems, dehydration, old age, congestive heart failure, low blood pressure, anemia, and multiple myeloma. Alternatively, if the risk is too great, your doctor may choose to perform a different imaging procedure where injection of a contrast is not needed. Following the procedure, you should drink plenty of fluids to keep yourself hydrated and to help flush the contrast agent out of your kidneys. Seek medical attention if you develop signs and symptoms that may suggest kidney damage such as nausea, vomiting, loss of appetite, increased or decreased urination, sudden weight gain or weight loss, fluid retention, swelling, shortness of breath, muscle cramps, tiredness, weakness, dizziness, confusion, and irregular heart rhythm. 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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Drug and food interactions

Moderate

ifosfamide food

Applies to: ifosfamide / mesna

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Alcohol may potentiate some of the effects of CNS-active and/or CNS-toxic agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

GENERALLY AVOID: Grapefruit and/or grapefruit juice may increase the plasma concentrations and effects of drugs that are substrates of the CYP450 3A4 isoenzyme. The proposed mechanism is inhibition of CYP450 3A4 mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Inhibition of hepatic CYP450 3A4 may also contribute. Because pharmacokinetic interactions involving grapefruit juice are often subject to a high degree of interpatient variability, the extent to which a given patient may be affected is difficult to predict.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit the consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities. It may be advisable for patients to avoid consumption of grapefruit, grapefruit juice, or supplements that contain grapefruit during treatment with drugs that undergo metabolism by CYP450 3A4. Orange juice is not expected to interact with these drugs.

References

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View all 32 references

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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