Drug General Information (ID: DDIQ1REYB6)
Drug Name			Chlorambucil		Drug Info		Nalidixic acid		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antineoplastics				Antibiotics
Structure

Mechanism of Chlorambucil-Nalidixic acid Interaction (Severity Level: Major)
Increased risk of GI mucosal injury/bleeding risk Click to Show/Hide Mechanism Graph
Drug Name		Chlorambucil				Nalidixic acid
Mechanism		GI mucosal injury/bleeding risk				GI mucosal injury/bleeding risk
Key Mechanism Factor 1
		Factor Name		Gastrointestinal toxicity
		Factor Description		The risk and severity of gastrointestinal toxicity, including inflammation, bleeding, ulceration, and perforation, increases when drugs with gastrointestinal mucosal irritant effects are combined.
Mechanism Description		Increased risk of GI mucosal injury/bleeding risk by the combination of Chlorambucil and Nalidixic acid

Recommended Action
Management		The concomitant use of nalidixic acid in patients undergoing therapy with melphalan or other related cancer chemotherapeutic alkylating agents is considered contraindicated.

References
1	Product Information. NegGram (nalidixic acid). Sanofi Winthrop Pharmaceuticals, New York, NY.