Ifosfamide Amphotericin

Acute tubular necrosis (exogenous toxins) Aminoglycosides, amphotericin, cisplatin, radiocontrast agents, methoxyflurane, outdated tetracyclines, cephalosporins, mithramycin, calcineurin inhibitors, pentamidine, IVIG, ifosfamide, zoledronate, cidofovir, adefovir, tenofovir FENa>2%, UOsm <350, urinary sediment contains granular casts, renal epithelial cells... 

Beta-lactam induced renal toxicity can results from their use in monotherapy or when used in combination with other nephrotoxic drugs such as aminoglycosides, amphotericin B, cisplatin, cyclosporine, furosemide, ifosfamide, vancomycin and nephrotoxic p-lactams. While the risk of nephrotoxic injury from monotherapy with p-lactams is relatively low, this risk is substantially increased when multiple drug combinations are required. 

Use of conventional amphotericin B with nephrotoxic antineoplastics such as cisplatin and ifosfamide may increase the risk of renal impairment, and should generally be avoided. Liposomal amphotericin B may be an alternative, but renal function should still be closely monitored. 

The manufacturer of conventional amphotericin B states that nephrotoxic antineoplastics should not be given concurrently except with great caution. Of the antineoplastics, cisplatin, ifosfamide and methotrexate are well known for their nephrotoxicity. Amphotericin also reduces the renal clearance of methotrexate , (p.642). 

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See also in sourсe #XX -- [ ]

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