Drug General Information (ID: DDIYDZ5J12)
Drug Name			Vancomycin		Drug Info		Clofarabine		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiinfective Agents				Antineoplastics
Structure

Mechanism of Vancomycin-Clofarabine Interaction (Severity Level: Moderate)
Increased risk of nephrotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Vancomycin				Clofarabine
Mechanism		Nephrotoxicity				Nephrotoxicity
Key Mechanism Factor 1
		Factor Name		Nephrotoxicity
		Factor Description		The combination of drugs that can induce nephrotoxicity may increase the risk of kidney injury. When kidney injury occurs, the inability to remove excess urine and waste from the body can lead to high levels of urea nitrogen, creatinine, and electrolytes (such as potassium and magnesium) in the blood.
Mechanism Description		Increased risk of nephrotoxicity by the combination of Vancomycin and Clofarabine

Recommended Action
Management		Drugs that are potentially nephrotoxic (e.g., aminoglycosides polypeptide, glycopeptide, and polymyxin antibiotics amphotericin B aminosalicylates antiviral/antiretroviral agents such as acyclovir, adefovir, cidofovir, foscarnet, ganciclovir, and tenofovir antineoplastics such as aldesleukin, carboplatin, cisplatin, ifosfamide, streptozocin, and high intravenous dosages of methotrexate chelating agents such as deferasirox, deferoxamine, edetate disodium, and edetate calcium disodium immunosuppressants such as cyclosporine, everolimus, sirolimus, and tacrolimus intravenous bisphosphonates intravenous pentamidine high dosages and/or chronic use of nonsteroidal anti-inflammatory agents gallium nitrate lithium penicillamine) should be avoided during the 5 days of clofarabine administration if possible. Renal function should be evaluated prior to and during therapy, and administration discontinued immediately if substantial increases (e.g., grade 3 or higher) in creatinine are noted.

References
1	Product Information. Clolar (clofarabine). sanofi-aventis, Bridgewater, NJ.