Drug Interaction Report
1 potential interaction and/or warning found for the following 2 drugs:
- fosphenytoin
- vinorelbine
Interactions between your drugs
vinorelbine fosphenytoin
Applies to: vinorelbine, fosphenytoin
GENERALLY AVOID: Coadministration with potent inducers of CYP450 3A4 and/or P-glycoprotein such as phenytoin may significantly decrease the plasma concentrations of vinca alkaloids, which are substrates of both the hepatic microsomal isoenzyme and intracellular efflux transporter. Pharmacokinetic data are not available.
MONITOR: Cases have been reported in which patients receiving chemotherapy have experienced markedly reduced plasma phenytoin concentrations and seizures. The mechanism of this interaction has not been clearly established. One study showed that the absorption of phenytoin decreased significantly during chemotherapy. Intravenous phenytoin may be less likely to interact.
MANAGEMENT: The use of vinca alkaloids in combination with potent CYP450 3A4 and/or P-glycoprotein inducers such as phenytoin should generally be avoided.
References (9)
- Jarosinski PF, Moscow JA, Alexander MS, et al. (1988) "Altered phenytoin clearance during intensive chemotherapy for acute lymphoblastic leukemia." J Pediatr, 112, p. 996-9
- Bollini P, Riva R, Albani F, Ida, et al. (1983) "Decreased phenytoin level during antineoplastic therapy: a case report." Epilepsia, 24, p. 75-8
- Dofferhoff AS, Berendsen HH (1990) "Decreased phenytoin level after carboplatin treatment." Am J Med, 89, p. 247
- Fincham RW, Schottelius DD (1979) "Decreased phenytoin levels in antineoplastic therapy." Ther Drug Monit, 1, p. 277-83
- Sylvester RK, Lewis FB, Caldwell KC, Lobell M, Perri R, Sawchuk RA (1984) "Impaired phenytoin bioavailability secondary to cisplantin, vinblastine, and bleomycin." Ther Drug Monit, 6, p. 302-5
- Neef C, de Voogd-van der Straaten (1988) "An interaction between cytostatic and anticonvulsant drugs." Clin Pharmacol Ther, 43, p. 372-5
- Grossman SA, Sheidler VR, Gilbert MR (1989) "Decreased phenytoin levels in patients receiving chemotherapy." Am J Med, 87, p. 505-10
- (2001) "Product Information. Oncovin (vincristine)." Lilly, Eli and Company
- "Product Information. Marqibo (vinCRIStine liposome)." Talon Therapeutics Inc
Drug and food interactions
No alcohol/food interactions were found with the drugs in your list. However, this does not necessarily mean no food interactions exist. Always consult your healthcare provider.
Therapeutic duplication warnings
No duplication 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
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
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