Drug General Information (ID: DDIWJHQM72)
Drug Name			Ifosfamide		Drug Info		Ziconotide		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antineoplastics				Analgesics
Structure

Mechanism of Ifosfamide-Ziconotide Interaction (Severity Level: Moderate)
Additive CNS depression effects Click to Show/Hide Mechanism Graph
Drug Name		Ifosfamide				Ziconotide
Mechanism		CNS depression effects (neurotoxic effects)				CNS depression effects
Key Mechanism Factor 1
		Factor Name		CNS depression effects
		Factor Description		CNS depressants are drugs that inhibit or suppress brain activity and can reduce mental and physical processes. Excessive CNS depression can lead to decreased heart rate, slow breathing (less than 10 breaths per minute), extreme confusion or loss of memory, nausea and vomiting, poor judgment, blue lips or fingertips, irritability and aggression, and clammy or cold skin.
Mechanism Description		Additive CNS depression effects by the combination of Ifosfamide and Ziconotide

Recommended Action
Management		Due to the potential for additive effects, centrally-acting agents should be used with caution in combination with ifosfamide. If ifosfamide-induced encephalopathy occurs, both ifosfamide and non-essential concomitant CNS agents should be discontinued. Supportive therapy should be initiated and maintained until complete resolution of neurotoxicity.

References
1	Product Information. Ifex (ifosfamide). Bristol-Myers Squibb, Princeton, NJ.
2	Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7. [PMID: 3725002]
3	Simonian NA, Gilliam FG, Chiappa KH "Ifosfamide causes a diazepam-sensitive encephalopathy." Neurology 43 (1993): 2700-2