Wechselwirkungen von Cyclophosphamid

It is uncertain whether the occurrence of HSTCL is related to use of a TNF blocker or a TNF blocker in combination with these other immunosuppressants [see Warnings and Precautions (5.2) ] . (Fachinformation zu Adalimumab, Boxed Warning (umrahmter Warnhinweis))

Alcohol Content The alcohol content in a dose of FRINDOVYX may affect the central nervous system and should be taken into account for patients in whom alcohol intake should be avoided or minimized. (Fachinformation zu Cyclophosphamid, Warnhinweise und Vorsichtsmaßnahmen)

Patients with rheumatoid arthritis previously treated with alkylating agents (cyclophosphamide, chlorambucil, melphalan, or others) may have a prohibitive risk of malignancy if treated with IMURAN. (Fachinformation zu Azathioprin, Gegenanzeigen)

Hepatic veno-occlusive disease, which may be life threatening, has been reported in patients receiving busulfan, usually in combination with cyclophosphamide or other chemotherapeutic agents prior to bone marrow transplantation. (Fachinformation zu Busulfan, Warnhinweise)

About 13 percent of the cases of neutropenia have ended fatally, but almost all fatalities were in patients with serious illness, having collagen vascular disease, renal failure, heart failure or immunosuppressant therapy, or a combination of these complicating factors. (Fachinformation zu Captopril, Warnhinweise)

In kidney, liver, and heart transplant patients Neoral may be administered with other immunosuppressive agents. (Fachinformation zu Ciclosporin, Boxed Warning (umrahmter Warnhinweis))

Prevention or Management Concomitant use with myelosuppressive or other immunosuppressive drugs is not recommended. (Fachinformation zu Cladribin, Arzneimittelwechselwirkungen)

Cases of cardiomyopathy with subsequent death have been reported following experimental high dose therapy with cytarabine in combination with cyclophosphamide when used for bone marrow transplant preparation. (Fachinformation zu Cytarabin, Warnhinweise)

Immunosuppressant/neoplastic: everolimus Co-administration of everolimus and PREZISTA/ritonavir is not recommended. irinotecan Discontinue PREZISTA/ritonavir at least 1 week prior to starting irinotecan therapy. (Fachinformation zu Darunavir, Arzneimittelwechselwirkungen)

Cyclophosphamide – Not recommended for use with Enbrel. (Fachinformation zu Etanercept, Arzneimittelwechselwirkungen)

Chicken pox and measles, for example, can have a more serious or even fatal course in children on immunosuppressant corticosteroids. (Fachinformation zu Fludrocortison, Warnhinweise)

Persons who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chickenpox or measles. (Fachinformation zu Flunisolid, Vorsichtsmaßnahmen)

Immunosuppressants Everolimus Sirolimus Temsirolimus (IV) Not recommended during and 2 weeks after TOLSURA treatment. (Fachinformation zu Itraconazol, Arzneimittelwechselwirkungen)

…methylergonovine • HMG-CoA reductase inhibitors: lovastatin, simvastatin (these drugs can be temporarily discontinued to allow PAXLOVID use [see Table 2 , Drug Interactions (7.3) ] ) • Immunosuppressants: voclosporin • Microsomal triglyceride transfer protein inhibitor: lomitapide • Migraine medications: eletriptan, ubrogepant • Mineralocorticoid receptor antagonists:… (Fachinformation zu Nirmatrelvir und Ritonavir, Gegenanzeigen)

…IN TRANSPLANT PATIENTS; AND INCREASED MORTALITY IN FEMALE LIVER TRANSPLANT PATIENTS • Increased risk for developing serious infections and malignancies with ASTAGRAF XL ® or other immunosuppressants that may lead to hospitalization or death. [see Warnings and Precautions ( 5.1 , 5.2 )] • Increased mortality in female liver transplant patients with ASTAGRAF XL. (Fachinformation zu Tacrolimus, Boxed Warning (umrahmter Warnhinweis))

AC Anthracycline (doxorubicin) and cyclophosphamide. → Paclitaxel+Trastuzumab 3.2% (64/2000) Includes 1 patient with fatal cardiomyopathy and 1 patient with sudden death without documented etiology. (Fachinformation zu Trastuzumab, Warnhinweise und Vorsichtsmaßnahmen)

…inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity ● Amiodarone… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Cyclophosphamide and Other Cytotoxic Agents Clinical Impact Concomitant use of allopurinol with cyclophosphamide and other cytotoxic agents (doxorubicin, bleomycin, procarbazine, mechloroethamine) increases bone marrow suppression among patients with neoplastic disease, except leukemia. (Fachinformation zu Allopurinol, Arzneimittelwechselwirkungen)

…inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity ● Amiodarone… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity ● Amiodarone ● G-CSF, GM-CSF (granulocyte colony-stimulating factor, granulocyte macrophage colony-stimulating factor) Increased nephrotoxicity ● Amphotericin B ● Indomethacin: Acute… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Fachinformation zu Amlodipin, Arzneimittelwechselwirkungen)

Impact of Amlodipine on Other Drugs Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Fachinformation zu Amlodipin und Atorvastatin, Arzneimittelwechselwirkungen)

Table 2: Drugs that Potentiate Cyclophosphamide Toxicities Toxicity Drugs Increased hematotoxicity and/or immunosuppression ● ACE inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Immunosuppressants: Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Fachinformation zu Amlodipin und Olmesartan, Arzneimittelwechselwirkungen)

Immunosuppressants Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when coadministered. (Fachinformation zu Amlodipin und Valsartan, Arzneimittelwechselwirkungen)

…Trastuzumab Increased pulmonary toxicity ● Amiodarone ● G-CSF, GM-CSF (granulocyte colony-stimulating factor, granulocyte macrophage colony-stimulating factor) Increased nephrotoxicity ● Amphotericin B ● Indomethacin: Acute water intoxication has been reported with concomitant use of indomethacin Increase in other toxicities: ● Azathioprine: Increased risk of hepatotoxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Monitor anticoagulant activity closely in patients receiving warfarin or other coumarins. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Monitor anticoagulant activity closely in patients receiving warfarin or other coumarins. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…nitroglycerin, nitroprusside, nitrous oxide Local anesthetics articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants… (Fachinformation zu Articain und Adrenalin, Arzneimittelwechselwirkungen)

Effect of Other Drugs on Cyclophosphamide Exposure Protease Inhibitors Concomitant use of protease inhibitors may increase the concentration of cytotoxic metabolites and may enhance the toxicities of cyclophosphamide, including higher incidence of infections, neutropenia, and mucositis. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Prolonged apnea may occur with concurrent depolarizing muscle relaxants (e.g., succinylcholine). (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Table 2: Drugs that Potentiate Cyclophosphamide Toxicities Toxicity Drugs Increased hematotoxicity and/or immunosuppression ● ACE inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Consider discontinuation or reduction of any concomitant chemotherapy or immunosuppressive therapy in patients who develop PML. (Fachinformation zu Bendamustin, Warnhinweise und Vorsichtsmaßnahmen)

Monitor for neurologic toxicities in patients receiving metronidazole. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Monitor anticoagulant activity closely in patients receiving warfarin or other coumarins. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity ● Amiodarone… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…nitroglycerin, nitroprusside, nitrous oxide Local anesthetics articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants… (Fachinformation zu Bupivacain und Adrenalin, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

The rate of metabolism and the leukopenic activity of cyclophosphamide are reportedly increased by chronic co-administration of CYP3A4 inducers. (Fachinformation zu Carbamazepin, Arzneimittelwechselwirkungen)

Prolonged apnea may occur with concurrent depolarizing muscle relaxants (e.g., succinylcholine). (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…nitroglycerin, nitroprusside, nitrous oxide Local anesthetics articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants… (Fachinformation zu Chloroprocain, Vorsichtsmaßnahmen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Prolonged apnea may occur with concurrent depolarizing muscle relaxants (e.g., succinylcholine). (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Venous Occlusive Disease of the Liver Patients who have previously received a hematopoietic stem cell transplant (HSCT) are at higher risk for veno-occlusive disease (VOD) of the liver following treatment with clofarabine (40 mg/m 2 ) when used in combination with etoposide (100 mg/m 2 ) and cyclophosphamide (440 mg/m 2 ). (Fachinformation zu Clofarabin, Warnhinweise und Vorsichtsmaßnahmen)

Prolonged apnea may occur with concurrent depolarizing muscle relaxants (e.g., succinylcholine). (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Monitor anticoagulant activity closely in patients receiving warfarin or other coumarins. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Prolonged apnea may occur with concurrent depolarizing muscle relaxants (e.g., succinylcholine). (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Effect of Other Drugs on Cyclophosphamide Exposure Protease Inhibitors Concomitant use of protease inhibitors may increase the concentration of cytotoxic metabolites and may enhance the toxicities of cyclophosphamide, including higher incidence of infections, neutropenia, and mucositis. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Cyclophosphamide used concurrently with daunorubicin hydrochloride may also result in increased cardiotoxicity. (Fachinformation zu Daunorubicin, Arzneimittelwechselwirkungen)

Other risk factors for the development of ONJ include immunosuppressive therapy, treatment with angiogenesis inhibitors, systemic corticosteroids, diabetes, and gingival infections. (Fachinformation zu Denosumab, Warnhinweise und Vorsichtsmaßnahmen)

There is an additive or potentially synergistic increase in the risk of cardiomyopathy in patients who have received radiotherapy to the mediastinum or concomitant therapy with other known cardiotoxic agents, such as cyclophosphamide and trastuzumab. (Fachinformation zu Doxorubicin, Warnhinweise und Vorsichtsmaßnahmen)

Monitor anticoagulant activity closely in patients receiving warfarin or other coumarins. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Arzneimittelwechselwirkungen)

Immunosuppressants: Cyclosporine, tacrolimus, sirolimus, and others metabolized by CYP3A ↓ immunosuppressant Dose adjustments of the immunosuppressant may be required. (Fachinformation zu Efavirenz, Lamivudin und Tenofovir, Arzneimittelwechselwirkungen)

Immuno-suppressants: e.g., cyclosporine (CsA) sirolimus tacrolimus ↑ immuno-suppressants ↑ elvitegravir (with CsA) ↑ cobicistat (with CsA) Therapeutic monitoring of the immunosuppressive agents is recommended upon coadministration with GENVOYA. (Fachinformation zu Elvitegravir, Cobicistat, Emtricitabin und Tenofovir, Arzneimittelwechselwirkungen)

Table 2: Drugs that Potentiate Cyclophosphamide Toxicities Toxicity Drugs Increased hematotoxicity and/or immunosuppression ● ACE inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Table 2: Drugs that Potentiate Cyclophosphamide Toxicities Toxicity Drugs Increased hematotoxicity and/or immunosuppression ● ACE inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Monitor anticoagulant activity closely in patients receiving warfarin or other coumarins. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity ● Amiodarone… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity ● Amiodarone… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Immunosuppressants : cyclosporine sirolimus tacrolimus ↓ immunosuppressant Etravirine and systemic immunosuppressants should be co-administered with caution because plasma concentrations of cyclosporine, sirolimus, or tacrolimus may be affected. (Fachinformation zu Etravirin, Arzneimittelwechselwirkungen)

Immunosuppressants Clinical Impact: Immunosuppressants such as cyclosporine and tacrolimus can produce nephrotoxicity with decreases in creatinine clearance and rises in serum creatinine, and because renal excretion is the primary elimination route of fibrate drugs including fenofibrate, there is a risk that an interaction will lead to deterioration of renal… (Fachinformation zu Fenofibrat, Arzneimittelwechselwirkungen)

Frequent PT/INR determinations are advisable until it has been definitely determined that the PT/INR has stabilized Immunosuppressants Clinical Impact: Immunosuppressants such as cyclosporine and tacrolimus can produce nephrotoxicity with decreases in creatinine clearance and rises in serum creatinine, and because renal excretion is the primary elimination route… (Fachinformation zu Fenofibrinsäure, Arzneimittelwechselwirkungen)

(See CLINICAL PHARMACOLOGY: Drug Interaction Studies . ) Cyclophosphamide Combination therapy with cyclophosphamide and fluconazole results in an increase in serum bilirubin and serum creatinine. (Fachinformation zu Fluconazol, Arzneimittelwechselwirkungen)

Monitor anticoagulant activity closely in patients receiving warfarin or other coumarins. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Effect of Other Drugs on Cyclophosphamide Exposure Protease Inhibitors Concomitant use of protease inhibitors may increase the concentration of cytotoxic metabolites and may enhance the toxicities of cyclophosphamide, including higher incidence of infections, neutropenia, and mucositis. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Table 2: Drugs that Potentiate Cyclophosphamide Toxicities Toxicity Drugs Increased hematotoxicity and/or immunosuppression ● ACE inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity ● Amiodarone… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…acetate, insulin, angiotensin converting enzyme (ACE) inhibitors, H 2 receptor antagonists, fibrates, propoxyphene, pentoxifylline, somatostatin analogs, anabolic steroids and androgens, cyclophosphamide, phenyramidol, guanethidine, fluconazole, sulfinpyrazone, tetracyclines, clarithromycin, disopyramide, quinolones, and those drugs that are highly protein-bound, such… (Fachinformation zu Glimepirid, Arzneimittelwechselwirkungen)

Monitor anticoagulant activity closely in patients receiving warfarin or other coumarins. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…pulmonary toxicity ● Amiodarone ● G-CSF, GM-CSF (granulocyte colony-stimulating factor, granulocyte macrophage colony-stimulating factor) Increased nephrotoxicity ● Amphotericin B ● Indomethacin: Acute water intoxication has been reported with concomitant use of indomethacin Increase in other toxicities: ● Azathioprine: Increased risk of hepatotoxicity (liver necrosis)… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

When treating patients, consideration of whether to use RENFLEXIS alone or in combination with other immunosuppressants such as azathioprine or 6-mercaptopurine should take into account a possibility that there is a higher risk of HSTCL with combination therapy versus an observed increased risk of immunogenicity and hypersensitivity reactions with infliximab… (Fachinformation zu Infliximab, Warnhinweise und Vorsichtsmaßnahmen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Immunosuppressants everolimus, rapamycin (also known as sirolimus), temsirolimus budesonide, ciclesonide, cyclosporine, dexamethasone, fluticasone, methylprednisolone, tacrolimus Rapamycin (sirolimus): Ketoconazole tablets 200 mg daily for 10 days increased the C max and AUC of a single 5 mg dose of sirolimus by 4.3 fold and 10.9 fold, respectively in 23 healthy… (Fachinformation zu Ketoconazol, Arzneimittelwechselwirkungen)

Plasma cholinesterase activity may be decreased by chronic administration of certain monoamine oxidase inhibitors, oral contraceptives, glucocorticoids, antimyasthenics (neostigmine), cyclophosphamide, and possibly thiotepa. (Fachinformation zu Kokain, Arzneimittelwechselwirkungen)

…can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity ● Amiodarone ● G-CSF,… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressants or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Ledipasvir und Sofosbuvir, Warnhinweise und Vorsichtsmaßnahmen)

If used with concomitant methotrexate and/or other potential immunosuppressive agents, chronic monitoring should be monthly. (Fachinformation zu Leflunomid, Warnhinweise und Vorsichtsmaßnahmen)

In patients who received more than 4 cycles of a REVLIMID-containing treatment or for whom inadequate numbers of CD 34+ cells have been collected with G-CSF alone, G-CSF with cyclophosphamide or the combination of G-CSF with a CXCR4 inhibitor may be considered. (Fachinformation zu Lenalidomid, Warnhinweise und Vorsichtsmaßnahmen)

…nitroglycerin, nitroprusside, nitrous oxide Local anesthetics articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, isofamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants… (Fachinformation zu Lidocain und Adrenalin, Arzneimittelwechselwirkungen)

…nitroglycerin, nitroprusside, nitrous oxide Local anesthetics articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, isofamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sufonamides Antimalarials chloroquine, primaquine Anticonvulsants… (Fachinformation zu Lidocain und Prilocain, Arzneimittelwechselwirkungen)

Table 2: Drugs that Potentiate Cyclophosphamide Toxicities Toxicity Drugs Increased hematotoxicity and/or immunosuppression ● ACE inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Effect of Other Drugs on Cyclophosphamide Exposure Protease Inhibitors Concomitant use of protease inhibitors may increase the concentration of cytotoxic metabolites and may enhance the toxicities of cyclophosphamide, including higher incidence of infections, neutropenia, and mucositis. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…nitroprusside, nitric oxide, nitrous oxide Local anesthetics articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants… (Fachinformation zu Mepivacain, Arzneimittelwechselwirkungen)

A treatment regimen containing multiple immunosuppressants (including thiopurines) should therefore be used with caution as this could lead to lymphoproliferative disorders, some with reported fatalities. (Fachinformation zu Mercaptopurin, Warnhinweise und Vorsichtsmaßnahmen)

Mesna has been used to prevent severe bladder toxicity. (Fachinformation zu Cyclophosphamid, Warnhinweise und Vorsichtsmaßnahmen)

Prolonged apnea may occur with concurrent depolarizing muscle relaxants (e.g., succinylcholine). (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Prolonged apnea may occur with concurrent depolarizing muscle relaxants (e.g., succinylcholine). (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Monitor for neurologic toxicities in patients receiving metronidazole. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Table 2: Drugs that Potentiate Cyclophosphamide Toxicities Toxicity Drugs Increased hematotoxicity and/or immunosuppression ● ACE inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Lymphoma and Other Malignancies Patients receiving immunosuppressants, including mycophenolate mofetil, are at increased risk of developing lymphomas and other malignancies, particularly of the skin [see Adverse Reactions ( 6.1 )]. (Fachinformation zu Mycophenolat, Warnhinweise und Vorsichtsmaßnahmen)

Table 2: Drugs that Potentiate Cyclophosphamide Toxicities Toxicity Drugs Increased hematotoxicity and/or immunosuppression ● ACE inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Immunosuppressive Agents There have been reports of increased blood concentrations of cyclosporine and tacrolimus into toxic ranges when patients received these drugs concomitantly with nefazodone. (Fachinformation zu Nefazodon, Arzneimittelwechselwirkungen)

Cancer Chemotherapy: Cyclophosphamide Plasma concentrations may be decreased. (Fachinformation zu Nevirapin, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Prolonged apnea may occur with concurrent depolarizing muscle relaxants (e.g., succinylcholine). (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Prolonged apnea may occur with concurrent depolarizing muscle relaxants (e.g., succinylcholine). (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…that Potentiate Cyclophosphamide Toxicities Toxicity Drugs Increased hematotoxicity and/or immunosuppression ● ACE inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ●… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Treatment has consisted of high doses of corticosteroids alone or, in some cases, concomitantly with an immunosuppressant. (Fachinformation zu Penicillamin, Warnhinweise)

Table 2: Drugs that Potentiate Cyclophosphamide Toxicities Toxicity Drugs Increased hematotoxicity and/or immunosuppression ● ACE inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…acetate, insulin, angiotensin converting enzyme (ACE) inhibitors, H2 receptor antagonists, fibrates, propoxyphene, pentoxifylline, somatostatin analogs, anabolic steroids and androgens, cyclophosphamide, phenyramidol, guanethidine, fluconazole, sulfinpyrazone, tetracyclines, clarithromycin, disopyramide, quinolones, and those drugs that are highly protein-bound, such… (Fachinformation zu Pioglitazon und Glimepirid, Arzneimittelwechselwirkungen)

…nitroglycerin, nitroprusside, nitrous oxide Local anesthetics articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine Antineoplastic Agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants… (Fachinformation zu Prilocain und Adrenalin, Arzneimittelwechselwirkungen)

Table 2: Drugs that Potentiate Cyclophosphamide Toxicities Toxicity Drugs Increased hematotoxicity and/or immunosuppression ● ACE inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Table 2: Drugs that Potentiate Cyclophosphamide Toxicities Toxicity Drugs Increased hematotoxicity and/or immunosuppression ● ACE inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Glipizide Decrease exposure Immunosuppressive Agents Cyclosporine Decrease exposure Tacrolimus Prevention or Management: Monitoring of whole blood concentrations and appropriate dosage adjustments of tacrolimus are recommended when rifampin and tacrolimus are used concomitantly. (Fachinformation zu Rifampicin, Arzneimittelwechselwirkungen)

…Digoxin Corticosteroids Prednisone Fibrates Clofibrate Oral Hypoglycemics Sulfonylureas (e.g., glyburide, glipizide) Hormonal Contraceptives/Progestins Ethinyl estradiol, levonorgestrel Immunosuppressants Cyclosporine, tacrolimus Methylxanthines Theophylline Narcotic analgesics Methadone Phosphodiesterase-5 (PDE-5) Inhibitors Sildenafil Thyroid preparations Levothyroxine… (Fachinformation zu Rifapentin, Arzneimittelwechselwirkungen)

Effect of Other Drugs on Cyclophosphamide Exposure Protease Inhibitors Concomitant use of protease inhibitors may increase the concentration of cytotoxic metabolites and may enhance the toxicities of cyclophosphamide, including higher incidence of infections, neutropenia, and mucositis. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Monitor anticoagulant activity closely in patients receiving warfarin or other coumarins. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…nitroglycerin, nitroprusside, nitrous oxide Local anesthetics articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine Antineoplastic agents cyclophosphamide, flutamide, hydroxyurea, ifosfamide, rasburicase Antibiotics dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides Antimalarials chloroquine, primaquine Anticonvulsants… (Fachinformation zu Ropivacain, Arzneimittelwechselwirkungen)

HBV reactivation has also been reported in patients receiving certain immunosuppressant or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV direct-acting antivirals may be increased in these patients. (Fachinformation zu Sofosbuvir und Velpatasvir, Warnhinweise und Vorsichtsmaßnahmen)

…inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity ● Amiodarone… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Prolonged apnea may occur with concurrent depolarizing muscle relaxants (e.g., succinylcholine). (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Tamoxifen Concomitant use of tamoxifen and a cyclophosphamide-containing chemotherapy regimen may increase the risk of thromboembolic complications. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Immunosuppressants: Amlodipine may increase the systemic exposure of cyclosporine or tacrolimus when co-administered. (Fachinformation zu Telmisartan und Amlodipin, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Prophylaxis of PJP should be considered when concomitant use of corticosteroids or other immunosuppressive agents are required. (Fachinformation zu Temsirolimus, Warnhinweise und Vorsichtsmaßnahmen)

Hepatic Veno-Occlusive Disease Hepatic veno-occlusive disease may occur in patients who have received high-dose TEPADINA in conjunction with busulfan and cyclophosphamide [ see Adverse Reactions (6.1) ]. (Fachinformation zu Thiotepa, Warnhinweise und Vorsichtsmaßnahmen)

Cyclosporine, tacrolimus: Monitor for toxicities of these immunosuppressive drugs ( 7.1 ) (Fachinformation zu Tinidazol, Arzneimittelwechselwirkungen)

Prolonged apnea may occur with concurrent depolarizing muscle relaxants (e.g., succinylcholine). (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity ● Amiodarone… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Table 2: Drugs that Potentiate Cyclophosphamide Toxicities Toxicity Drugs Increased hematotoxicity and/or immunosuppression ● ACE inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity ● Amiodarone… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…inhibitors: ACE inhibitors can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

Drugs Suspected of Causing SIADH Use with drugs suspected of causing SIADH (e.g., SSRIs, tricyclic antidepressants, haloperidol, chlorpropamide, enalapril, methyldopa, pentamidine, vincristine, cyclophosphamide, ifosfamide, felbamate) may increase the pressor effect in addition to the antidiuretic effect of Vasostrict ® . (Fachinformation zu Vasopressin, Arzneimittelwechselwirkungen)

The absorption of verapamil can be reduced by the cyclophosphamide, oncovin, procarbazine, prednisone (COPP) and the vindesine, adriamycin, cisplatin (VAC) cytotoxic drug regimens. (Fachinformation zu Verapamil, Arzneimittelwechselwirkungen)

Coumarins Both increased and decreased warfarin effect have been reported in patients receiving warfarin and cyclophosphamide. (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

…can cause leukopenia. ● Natalizumab ● Paclitaxel: Increased hematotoxicity has been reported when cyclophosphamide was administered after paclitaxel infusion. ● Thiazide diuretics ● Zidovudine Increased cardiotoxicity ● Anthracyclines ● Cytarabine ● Pentostatin ● Radiation therapy of the cardiac region ● Trastuzumab Increased pulmonary toxicity ● Amiodarone ● G-CSF,… (Fachinformation zu Cyclophosphamid, Arzneimittelwechselwirkungen)

IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persists despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (Fachinformation zu Atorvastatin, Warnhinweise und Vorsichtsmaßnahmen)

Thirty-four patients were treated with corticosteroids and one patient was treated with a non-steroidal immunosuppressant. (Fachinformation zu Axitinib, Warnhinweise und Vorsichtsmaßnahmen)

…* A baseline platelet count of 50,000/μL was required for study eligibility ‡ Data were missing at baseline for one patient In the combination study of bortezomib with rituximab, cyclophosphamide, doxorubicin and prednisone (BR-CAP) in previously untreated mantle cell lymphoma patients, the incidence of thrombocytopenia (≥ Grade 4) was 32% vs 1% for the rituximab,… (Fachinformation zu Bortezomib, Warnhinweise und Vorsichtsmaßnahmen)

In a trial conducted in patients with metastatic breast cancer who were treated with fluorouracil, doxorubicin, and cyclophosphamide (FAC) with or without dexrazoxane starting with their first cycle of FAC therapy, patients who were randomized to receive dexrazoxane had a lower response rate (48% vs. 63%) and shorter time to progression than patients who were… (Fachinformation zu Dexrazoxan, Warnhinweise und Vorsichtsmaßnahmen)

Treatment-related AML or MDS has occurred in patients given anthracyclines and/or cyclophosphamide, including use in adjuvant therapy for breast cancer. (Fachinformation zu Docetaxel, Warnhinweise und Vorsichtsmaßnahmen)

Administer prophylaxis for PJP when concomitant use of corticosteroids or other immunosuppressive agents are required. (Fachinformation zu Everolimus, Warnhinweise und Vorsichtsmaßnahmen)

IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy without significant inflammation; and improvement with immunosuppressive agents. (Fachinformation zu Ezetimib und Simvastatin, Warnhinweise und Vorsichtsmaßnahmen)

IMNM is characterized by proximal muscle weakness and elevated serum CK, which persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody, muscle biopsy showing necrotizing myopathy, and improvement with immunosuppressive agents. (Fachinformation zu Fluvastatin, Warnhinweise und Vorsichtsmaßnahmen)

Secondary malignancies (urinary tract cancer, myelodysplasia, acute leukemias, lymphomas, thyroid cancer, and sarcomas) have been reported in patients treated with cyclophosphamide-containing regimens . (Fachinformation zu Cyclophosphamid, Warnhinweise und Vorsichtsmaßnahmen)

Secondary malignancies (urinary tract cancer, myelodysplasia, acute leukemias, lymphomas, thyroid cancer, and sarcomas) have been reported in patients treated with cyclophosphamide-containing regimens . (Fachinformation zu Cyclophosphamid, Warnhinweise und Vorsichtsmaßnahmen)

Secondary malignancies (urinary tract cancer, myelodysplasia, acute leukemias, lymphomas, thyroid cancer, and sarcomas) have been reported in patients treated with cyclophosphamide-containing regimens . (Fachinformation zu Cyclophosphamid, Warnhinweise und Vorsichtsmaßnahmen)

IMNM is characterized by: proximal muscle weakness and elevated serum creatine kinase, which persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (Fachinformation zu Lovastatin, Warnhinweise)

Immunosuppressive Drugs Tacrolimus: Tacrolimus has been shown to be metabolized via the CYP3A system. (Fachinformation zu Nifedipin, Vorsichtsmaßnahmen)

IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (Fachinformation zu Pitavastatin, Warnhinweise und Vorsichtsmaßnahmen)

CYP3A Substrates Immunosuppressants that are CYP3A4 Substrates Mechanism and Clinical Effect(s) Posaconazole is a strong CYP3A4 inhibitor. (Fachinformation zu Posaconazol, Arzneimittelwechselwirkungen)

IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (Fachinformation zu Pravastatin, Warnhinweise und Vorsichtsmaßnahmen)

Secondary malignancies (urinary tract cancer, myelodysplasia, acute leukemias, lymphomas, thyroid cancer, and sarcomas) have been reported in patients treated with cyclophosphamide-containing regimens . (Fachinformation zu Cyclophosphamid, Warnhinweise und Vorsichtsmaßnahmen)

IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy; and improvement with immunosuppressive agents. (Fachinformation zu Rosuvastatin, Warnhinweise und Vorsichtsmaßnahmen)

IMNM is characterized by proximal muscle weakness and elevated serum creatine kinase that persist despite discontinuation of statin treatment; positive anti-HMG CoA reductase antibody; muscle biopsy showing necrotizing myopathy without significant inflammation; and improvement with immunosuppressive agents. (Fachinformation zu Simvastatin, Warnhinweise und Vorsichtsmaßnahmen)

Secondary malignancies (urinary tract cancer, myelodysplasia, acute leukemias, lymphomas, thyroid cancer, and sarcomas) have been reported in patients treated with cyclophosphamide-containing regimens . (Fachinformation zu Cyclophosphamid, Warnhinweise und Vorsichtsmaßnahmen)

Secondary malignancies (urinary tract cancer, myelodysplasia, acute leukemias, lymphomas, thyroid cancer, and sarcomas) have been reported in patients treated with cyclophosphamide-containing regimens . (Fachinformation zu Cyclophosphamid, Warnhinweise und Vorsichtsmaßnahmen)

…Repaglinide, Rosiglitazone: [See Warnings and Precautions ( 5.4 ) and Adverse Reactions ( 6.2 )] Insulin Insulin: [See Warnings and Precautions ( 5.4 ) and Adverse Reactions ( 6.2 )] Immunosuppressants: Cyclosporine Use With Caution Cyclosporine: There have been spontaneous or published reports of CYP3A based interactions of clarithromycin with cyclosporine. (Fachinformation zu Clarithromycin, Arzneimittelwechselwirkungen)

In patients with CLL, rituximab did not alter systemic exposure to fludarabine or cyclophosphamide. (Fachinformation zu Rituximab, Arzneimittelwechselwirkungen)