Drug Interaction Report

Clofarabine may cause liver problems, and using it with other medications that can also affect the liver such as phenytoin may increase that risk. You should avoid or limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. Talk to your doctor or pharmacist if you have any questions or concerns. 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.

Phenytoin levels may decrease when the suspension is given with enteral feedings. This could lead to a loss of seizure control. You could interrupt the feeding for 2 hours before and after the phenytoin dose. Alternatively, you may give the phenytoin suspension diluted in water and flush the tube with water after administration. These would make it easier for your body to absorb the medication. However, this still may not entirely avoid the interaction and may not always be feasible. You should have your phenytoin levels checked upon starting and stopping of enteral feedings. In addition, using phenytoin together with food may alter the effects of phenytoin. Contact your doctor if you experience worsening of seizure control or symptoms of toxicity, including twitching eye movements, slurred speech, loss of balance, tremor, muscle stiffness or weakness, nausea, vomiting, feeling light-headed, fainting, and slow or shallow breathing. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Ask your doctor before making any changes to your therapy.