Phenobarbital Cyclophosphamide

Azathioprine, chloramphenicol, colchicine, cyclophosphamide, cytarabine, 5-fluorodeoxyuridine, 5-fluorouracil, hydroxyurea, mercaptopurine, metformin, methotrexate, phenobarbital, phenytoin, primidone, proton pump inhibitors, pyrimethamine, sulfasalazine, and vinblastine... 

Aflatoxin Bl, bupropion, cyclophosphamide, dexamethasone, etoposide, ifosfamide, midazolam, phenobarbital, propofol, rifampin, teitiposide, thiotepa, vitamin D, xenobiotics Amitriptyhne, carisoprodol,... 

B6 Artemisinin, bupropion, cyclophosphamide, efavirenz, ifosfamide, ketamine, S-mephobarbital, S-mephenytoin (/V-demethylation to nirvanol), methadone, nevirapine, propofol, selegiline, sertraline, ticlopidine Phenobarbital, cyclophosphamide Ticlopidine, clopidogrel... 

Martin H, Sarsat JP, de Waziers I, et al. Induction of cytochrome P450 2B6 and 3A4 expression by phenobarbital and cyclophosphamide in cultured human liver slices. Pharm Res 2003 20 557-568. 

Clinically important, potentially hazardous interactions with albendazole, aminoglutethimide, aspirin, bexarotene, carbamazepine, cyclophosphamide, dasatinib, diuretics, ephedrine, imatinib, itraconazole, lapatinib, live vaccines, lopinavir, methotrexate, phenobarbital, phenytoin, praziquantel, primidone, rifampicin, rifampin, temsirolimus, warfarin... 

Clinically important, potentially hazardous interactions with aluminum, aminophylline, aspirin, chlorambucil, cimetidine, clarithromycin, cyclophosphamide, cyclosporine, dicumarol, diuretics, docetaxel, estrogens, grapefruit juice, indomethacin, influenza vaccines, itraconazole, ketoconazole, lansoprazole, live vaccines, methotrexate, montelukast, omeprazole, oral contraceptives, pancuronium, phenobarbital, phenytoin, ranitidine, rifampicin, rifampin, timolol, tolbutamide, vitamin A... 

Amitriptyline, barbiturates, chlorproguanil, citalopram, clomipramine, clozapine, cyclophosphamide, diazepam, hexobarbital, imipramine, pentamidine, phenobarbital, phenytoin, propranolol, quinine, (S)- and (Jf)-warfarin, zidovudine... 

CYP2A6 <5 1-2 Acetaminophen Carbamazepi ne Cyclophosphamide Selegiline Flunitrazepam Nicotine Clotrimazole Isoniazid Methoxypsoralen Valproic acid Dexamethasone Phenobarbital Rifampin... 

CYP2B6 <5 1-2 Bupropion Carbamazepi ne Cyclophosphamide Selegiline Flunitrazepam Meperidine Bupropion Selegiline Ethinylestradiol Phencyclidine Tamoxifen Ticlopidine Clotrimazole Carbamazepine Phenobarbital Phenytoin Pioglitazone Rifampin Troglitazone Valproic acid Ritonavir... 

Pretreatment with cytochrome (CYP) inducers such as phenobarbital enhances the rate of activation of the azoxyphosphorenes but does not alter total exposure to active metabolites over time and does not affect toxicity or efficacy. Cyclophosphamide is eliminated by hepatic metabolism and can be used at full doses in patients with renal insufficiency. Maximal concentrations in plasma are achieved 1 hour after oral administration the tj of parent drug in plasma is -7 hours. 

Evidence suggests that neither the toxicity nor the therapeutic effects of cyclophosphamide and ifosfamide are significantly altered by the concurrent use of barbiturates. However, an isolated report describes a girl taking phenobarbital who developed encephalopathy when given ifosfamide. 

Cyclophosphamide was reported to inhibit the clearance and increase the effects of pentobarbital in a study in rats. Another study found auto-in-duction of cyclophosphamide clearance in a patient taking phenobarbital with subsequent chemotherapy courses similar to that in patients not taking phenobarbital. ... 

The relationship between the case of encephalopathy and the use of ifosfamide with phenobarbital is not established, but it serves to emphasise the need for particular caution and good monitoring if concurrent use is undertaken. More study is needed. Although barbiturates can cause an increase in the rate of metabolism of cyclophosphamide, this does not appear to alter the AUC and the efficacy of this drug. 

Noninterfering metabolites, acetaminophen, aspirin, cyclophosphamide, dextropropo -phene, diamorphine, dihydrocodeine, doxorubicin, methotrexate, metoclopramide, morphine, phenobarbital, prednisone, procarbazine, prochlorperazine, vincristine... 

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