Details of the Drug

General Information of Drug (ID: DMCVJ86)

Drug Name
Clofarabine
Synonyms
CAFdA; CFB; Clofarabina; Clofarabinum; Clofarex; Clolar; Evoltra; Clofarabine [USAN]; Clolar (TN); Evoltra (TN); Clofarabine (USAN/INN); Clolar, Evoltra, Clofarabine; Cl-F-Ara-A; (2R,3R,4S,5R)-5-(6-amino-2-chloropurin-9-yl)-4-fluoro-2-(hydroxymethyl)oxolan-3-ol; 2-Chloro-9-(2-deoxy-2-fluoro-b-D-arabinofuranosyl)-9H-purin-6-amine; 2-Chloro-9-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl)-9H-purin-6-amine; 2-Chloro-9-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl)adenine; 2-Cl-2'-F-araA; 2-chloro-9-(2'-deoxy-2'-fluoro-beta-D-arabinofuranosyl)adenine; 3S211048
Indication
Disease Entry ICD 11 Status REF
Acute lymphoblastic leukaemia 2A85 Approved [1], [2], [3], [4]
Myelodysplastic syndrome 2A37 Approved [1], [2], [3], [4]
Therapeutic Class
Anticancer Agents
Drug Type
Small molecular drug
Structure
3D MOL 2D MOL
#Ro5 Violations (Lipinski): 0 Molecular Weight (mw) 303.68
Topological Polar Surface Area (xlogp) 0.9
Rotatable Bond Count (rotbonds) 2
Hydrogen Bond Donor Count (hbonddonor) 3
Hydrogen Bond Acceptor Count (hbondacc) 8
ADMET Property
BDDCS Class
Biopharmaceutics Drug Disposition Classification System (BDDCS) Class 3: high solubility and low permeability [5]
Clearance
The drug present in the plasma can be removed from the body at the rate of 7.7 mL/min/kg [6]
Elimination
55% of drug is excreted from urine in the unchanged form [5]
Half-life
The concentration or amount of drug in body reduced by one-half in 5.2 hours [6]
Metabolism
The drug is metabolized via the deoxycytidine kinase and mono- and di-phosphokinases [7]
MRTD
The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 4.234 micromolar/kg/day [8]
Unbound Fraction
The unbound fraction of drug in plasma is 0.53% [6]
Vd
Fluid volume that would be required to contain the amount of drug present in the body at the same concentration as in the plasma 1.75 L/kg [6]
Water Solubility
The ability of drug to dissolve in water is measured as 1 mg/mL [5]
Chemical Identifiers
Formula
C10H11ClFN5O3
IUPAC Name
(2R,3R,4S,5R)-5-(6-amino-2-chloropurin-9-yl)-4-fluoro-2-(hydroxymethyl)oxolan-3-ol
Canonical SMILES
C1=NC2=C(N=C(N=C2N1[C@H]3[C@H]([C@@H]([C@H](O3)CO)O)F)Cl)N
InChI
InChI=1S/C10H11ClFN5O3/c11-10-15-7(13)5-8(16-10)17(2-14-5)9-4(12)6(19)3(1-18)20-9/h2-4,6,9,18-19H,1H2,(H2,13,15,16)/t3-,4+,6-,9-/m1/s1
InChIKey
WDDPHFBMKLOVOX-AYQXTPAHSA-N
Cross-matching ID
PubChem CID
119182
ChEBI ID
CHEBI:681569
CAS Number
123318-82-1
DrugBank ID
DB00631
TTD ID
D0R5RR
VARIDT ID
DR01330
INTEDE ID
DR1773

Molecular Interaction Atlas of This Drug


Drug Therapeutic Target (DTT)
DTT Name DTT ID UniProt ID MOA REF
Bacterial Penicillin binding protein (Bact PBP) TTJP4SM NOUNIPROTAC Binder [9]
Ribonucleotide reductase (RIR) TTX09M4 RIR1_HUMAN; RIR2_HUMAN; RIR2B_HUMAN Inhibitor [9]

Drug Transporter (DTP)
DTP Name DTP ID UniProt ID MOA REF
Equilibrative nucleoside transporter 2 (SLC29A2) DTW78DQ S29A2_HUMAN Substrate [10]
Equilibrative nucleoside transporter 1 (SLC29A1) DTXD1TQ S29A1_HUMAN Substrate [10]
Concentrative Na(+)-nucleoside cotransporter 3 (SLC28A3) DT4YL5R S28A3_HUMAN Substrate [10]
Breast cancer resistance protein (ABCG2) DTI7UX6 ABCG2_HUMAN Substrate [11]

Drug-Metabolizing Enzyme (DME)
DME Name DME ID UniProt ID MOA REF
Deoxycytidine kinase (DCK)
Main DME 		DE9FGNK DCK_HUMAN Substrate [12]
Molecular Interaction Atlas (MIA) Jump to Detail Molecular Interaction Atlas of This Drug

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Clofarabine
DDI Drug Name DDI Drug ID Severity Mechanism Disease REF
Blinatumomab DMGECIJ Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Blinatumomab. Mature B-cell lymphoma [2A85] [48]
Mercaptopurine DMTM2IK Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Mercaptopurine. Mature B-cell lymphoma [2A85] [48]
Cytarabine DMZD5QR Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Cytarabine. Mature B-cell lymphoma [2A85] [48]
Coadministration of a Drug Treating the Disease Different from Clofarabine (Comorbidity)
DDI Drug Name DDI Drug ID Severity Mechanism Comorbidity REF
Remdesivir DMBFZ6L Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Remdesivir. 1D6YCoronavirus Disease 2019 [1D6YCoronavirus Disease 2019] [49]
Tretinoin DM49DUI Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Tretinoin. Acne vulgaris [ED80] [48]
Isotretinoin DM4QTBN Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Isotretinoin. Acne vulgaris [ED80] [48]
Nicotinamide DMUPE07 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Nicotinamide. Acquired cutaneous blood vessel malformation [EF20] [48]
Pioglitazone DMKJ485 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Pioglitazone. Acute diabete complication [5A2Y] [48]
Tagraxofusp DM9HQ5U Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Tagraxofusp. Acute myeloid leukaemia [2A60] [48]
Framycetin DMF8DNE Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Framycetin. Alcoholic liver disease [DB94] [48]
Inotersen DMJ93CT Major Increased risk of nephrotoxicity by the combination of Clofarabine and Inotersen. Amyloidosis [5D00] [50]
Dronedarone DMA8FS5 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Dronedarone. Angina pectoris [BA40] [48]
Bedaquiline DM3906J Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Bedaquiline. Antimicrobial drug resistance [MG50-MG52] [51]
Oxymetholone DMFXUT8 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Oxymetholone. Aplastic anaemia [3A70] [48]
Posaconazole DMUL5EW Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Posaconazole. Aspergillosis [1F20] [48]
Roflumilast DMPGHY8 Moderate Additive immunosuppressive effects by the combination of Clofarabine and Roflumilast. Asthma [CA23] [50]
Zileuton DMVRIC2 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Zileuton. Asthma [CA23] [48]
Ofloxacin DM0VQN3 Minor Decreased absorption of Clofarabine due to intestinal mucosa variation caused by Ofloxacin. Bacterial infection [1A00-1C4Z] [52]
Kanamycin DM2DMPO Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Kanamycin. Bacterial infection [1A00-1C4Z] [48]
Clavulanate DM2FGRT Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Clavulanate. Bacterial infection [1A00-1C4Z] [48]
Clarithromycin DM4M1SG Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Clarithromycin. Bacterial infection [1A00-1C4Z] [48]
Trovafloxacin DM6AN32 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Trovafloxacin. Bacterial infection [1A00-1C4Z] [48]
Sulfamethoxazole DMB08GE Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Sulfamethoxazole. Bacterial infection [1A00-1C4Z] [48]
Sparfloxacin DMB4HCT Minor Decreased absorption of Clofarabine due to intestinal mucosa variation caused by Sparfloxacin. Bacterial infection [1A00-1C4Z] [52]
Streptomycin DME1LQN Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Streptomycin. Bacterial infection [1A00-1C4Z] [48]
Gemifloxacin DMHT34O Minor Decreased absorption of Clofarabine due to intestinal mucosa variation caused by Gemifloxacin. Bacterial infection [1A00-1C4Z] [52]
Norfloxacin DMIZ6W2 Minor Decreased absorption of Clofarabine due to intestinal mucosa variation caused by Norfloxacin. Bacterial infection [1A00-1C4Z] [52]
ABT-492 DMJFD2I Minor Decreased absorption of Clofarabine due to intestinal mucosa variation caused by ABT-492. Bacterial infection [1A00-1C4Z] [52]
Gentamicin DMKINJO Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Gentamicin. Bacterial infection [1A00-1C4Z] [48]
Netilmicin DMRD1QK Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Netilmicin. Bacterial infection [1A00-1C4Z] [48]
Levofloxacin DMS60RB Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Levofloxacin. Bacterial infection [1A00-1C4Z] [48]
Tobramycin DMUI0CH Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Tobramycin. Bacterial infection [1A00-1C4Z] [48]
Troleandomycin DMUZNIG Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Troleandomycin. Bacterial infection [1A00-1C4Z] [48]
Minocycline DMVN5OH Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Minocycline. Bacterial infection [1A00-1C4Z] [48]
Lomefloxacin DMVRH9C Minor Decreased absorption of Clofarabine due to intestinal mucosa variation caused by Lomefloxacin. Bacterial infection [1A00-1C4Z] [52]
Telithromycin DMZ4P3A Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Telithromycin. Bacterial infection [1A00-1C4Z] [48]
Etidronic acid DM1XHYJ Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Etidronic acid. Bone paget disease [FB85] [48]
Pexidartinib DMS2J0Z Major Increased risk of hepatotoxicity by the combination of Clofarabine and Pexidartinib. Bone/articular cartilage neoplasm [2F7B] [53]
Temozolomide DMKECZD Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Temozolomide. Brain cancer [2A00] [48]
Lomustine DMMWSUL Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Lomustine. Brain cancer [2A00] [48]
Lapatinib DM3BH1Y Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Lapatinib. Breast cancer [2C60-2C6Y] [48]
LY2835219 DM93VBZ Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and LY2835219. Breast cancer [2C60-2C6Y] [48]
Pralatrexate DMAO80I Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Pralatrexate. Breast cancer [2C60-2C6Y] [48]
Tucatinib DMBESUA Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Tucatinib. Breast cancer [2C60-2C6Y] [48]
Tamoxifen DMLB0EZ Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Tamoxifen. Breast cancer [2C60-2C6Y] [48]
Bosutinib DMTI8YE Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Bosutinib. Breast cancer [2C60-2C6Y] [48]
Trastuzumab Emtansine DMU1LXS Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Trastuzumab Emtansine. Breast cancer [2C60-2C6Y] [48]
Fluoxymesterone DMUHCF1 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Fluoxymesterone. Breast cancer [2C60-2C6Y] [48]
Atorvastatin DMF28YC Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Atorvastatin. Cardiovascular disease [BA00-BE2Z] [48]
Fenofibric acid DMGO2MC Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Fenofibric acid. Cardiovascular disease [BA00-BE2Z] [48]
Macitentan DMP79A1 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Macitentan. Cardiovascular disease [BA00-BE2Z] [48]
Chenodiol DMQ8JIK Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Chenodiol. Cholelithiasis [DC11] [48]
Iodipamide DMXIQYS Major Increased risk of nephrotoxicity by the combination of Clofarabine and Iodipamide. Cholelithiasis [DC11] [54]
Phenylbutazone DMAYL0T Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Phenylbutazone. Chronic pain [MG30] [50]
Ketoprofen DMRKXPT Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Ketoprofen. Chronic pain [MG30] [50]
Regorafenib DMHSY1I Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Regorafenib. Colorectal cancer [2B91] [48]
Intedanib DMSTA36 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Intedanib. Colorectal cancer [2B91] [48]
Methoxyflurane DML0RAE Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Methoxyflurane. Corneal disease [9A76-9A78] [48]
Pasireotide DMHM7JS Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Pasireotide. Cushing syndrome [5A70] [48]
Ivacaftor DMZC1HS Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Ivacaftor. Cystic fibrosis [CA25] [48]
Ethanol DMDRQZU Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Ethanol. Cystitis [GC00] [48]
Milnacipran DMBFE74 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Milnacipran. Depression [6A70-6A7Z] [48]
Polatuzumab vedotin DMF6Y0L Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Polatuzumab vedotin. Diffuse large B-cell lymphoma [2A81] [48]
Felbamate DM1V5ZS Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Felbamate. Epilepsy/seizure [8A61-8A6Z] [48]
Fosphenytoin DMOX3LB Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Fosphenytoin. Epilepsy/seizure [8A61-8A6Z] [48]
Ethotoin DMXWOCP Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Ethotoin. Epilepsy/seizure [8A61-8A6Z] [48]
Cannabidiol DM0659E Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Cannabidiol. Epileptic encephalopathy [8A62] [48]
Mefenamic acid DMK7HFI Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Mefenamic acid. Female pelvic pain [GA34] [50]
Dantrolene DM1D8XY Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Dantrolene. Fever [MG26] [48]
Itraconazole DMCR1MV Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Itraconazole. Fungal infection [1F29-1F2F] [48]
Pentamidine DMHZJCG Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Pentamidine. Fungal infection [1F29-1F2F] [48]
Terbinafine DMI6HUW Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Terbinafine. Fungal infection [1F29-1F2F] [48]
Ketoconazole DMPZI3Q Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Ketoconazole. Fungal infection [1F29-1F2F] [48]
Amphotericin B DMTAJQE Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Amphotericin B. Fungal infection [1F29-1F2F] [48]
Atovaquone DMY4UMW Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Atovaquone. Fungal infection [1F29-1F2F] [48]
Sunitinib DMCBJSR Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Sunitinib. Gastrointestinal stromal tumour [2B5B] [48]
Lamivudine DMI347A Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Lamivudine. Hepatitis virus infection [1E50-1E51] [48]
Daclatasvir DMSFK9V Moderate Decreased clearance of Clofarabine due to the transporter inhibition by Daclatasvir. Hepatitis virus infection [1E50-1E51] [50]
177Lu-DOTATATE DMT8GVU Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and 177Lu-DOTATATE. Hepatitis virus infection [1E50-1E51] [48]
Isoniazid DM5JVS3 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Isoniazid. HIV-infected patients with tuberculosis [1B10-1B14] [48]
Rifampin DMA8J1G Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Rifampin. HIV-infected patients with tuberculosis [1B10-1B14] [48]
Brentuximab vedotin DMWLC57 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Brentuximab vedotin. Hodgkin lymphoma [2B30] [48]
Stavudine DM6DEK9 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Stavudine. Human immunodeficiency virus disease [1C60-1C62] [48]
Tipranavir DM8HJX6 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Tipranavir. Human immunodeficiency virus disease [1C60-1C62] [48]
Emtricitabine DMBMUWZ Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Emtricitabine. Human immunodeficiency virus disease [1C60-1C62] [48]
Didanosine DMI2QPE Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Didanosine. Human immunodeficiency virus disease [1C60-1C62] [48]
Rilpivirine DMJ0QOW Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Rilpivirine. Human immunodeficiency virus disease [1C60-1C62] [48]
Abacavir DMMN36E Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Abacavir. Human immunodeficiency virus disease [1C60-1C62] [48]
Darunavir DMN3GCH Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Darunavir. Human immunodeficiency virus disease [1C60-1C62] [48]
Maraviroc DMTL94F Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Maraviroc. Human immunodeficiency virus disease [1C60-1C62] [48]
Simvastatin DM30SGU Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Simvastatin. Hyper-lipoproteinaemia [5C80] [48]
Fluvastatin DM4MDJY Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Fluvastatin. Hyper-lipoproteinaemia [5C80] [48]
Fenofibrate DMFKXDY Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Fenofibrate. Hyper-lipoproteinaemia [5C80] [48]
Mipomersen DMGSRN1 Major Increased risk of hepatotoxicity by the combination of Clofarabine and Mipomersen. Hyper-lipoproteinaemia [5C80] [55]
Rosuvastatin DMMIQ7G Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Rosuvastatin. Hyper-lipoproteinaemia [5C80] [48]
Teriflunomide DMQ2FKJ Major Increased risk of hepatotoxicity by the combination of Clofarabine and Teriflunomide. Hyper-lipoproteinaemia [5C80] [56]
BMS-201038 DMQTAGO Major Increased risk of hepatotoxicity by the combination of Clofarabine and BMS-201038. Hyper-lipoproteinaemia [5C80] [57]
Moexipril DM26E4B Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Moexipril. Hypertension [BA00-BA04] [48]
Captopril DM458UM Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Captopril. Hypertension [BA00-BA04] [48]
Methyldopa DM5I621 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Methyldopa. Hypertension [BA00-BA04] [48]
Quinapril DMR8H31 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Quinapril. Hypertension [BA00-BA04] [48]
Lisinopril DMUOK4C Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Lisinopril. Hypertension [BA00-BA04] [48]
Tolvaptan DMIWFRL Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Tolvaptan. Hypo-osmolality/hyponatraemia [5C72] [48]
Pirfenidone DM6VZFQ Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Pirfenidone. Idiopathic interstitial pneumonitis [CB03] [48]
Givosiran DM5PFIJ Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Givosiran. Inborn porphyrin/heme metabolism error [5C58] [48]
Febuxostat DMDEXQ0 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Febuxostat. Inborn purine/pyrimidine/nucleotide metabolism error [5C55] [48]
Balsalazide DMO091F Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Balsalazide. Indeterminate colitis [DD72] [48]
Meclofenamic acid DM05FXR Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Meclofenamic acid. Inflammatory spondyloarthritis [FA92] [50]
Ibandronate DM0QZBN Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Ibandronate. Low bone mass disorder [FB83] [48]
Denosumab DMNI0KO Moderate Additive immunosuppressive effects by the combination of Clofarabine and Denosumab. Low bone mass disorder [FB83] [58]
Crizotinib DM4F29C Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Crizotinib. Lung cancer [2C25] [48]
Ceritinib DMB920Z Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Ceritinib. Lung cancer [2C25] [48]
Lurbinectedin DMEFRTZ Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Lurbinectedin. Lung cancer [2C25] [48]
Alectinib DMP1I6Y Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Alectinib. Lung cancer [2C25] [48]
BIBW 2992 DMTKD7Q Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and BIBW 2992. Lung cancer [2C25] [48]
Pralsetinib DMWU0I2 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Pralsetinib. Lung cancer [2C25] [48]
Capmatinib DMYCXKL Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Capmatinib. Lung cancer [2C25] [48]
Selpercatinib DMZR15V Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Selpercatinib. Lung cancer [2C25] [48]
Sulphadoxine DMZI2UF Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Sulphadoxine. Malaria [1F40-1F45] [48]
Calaspargase pegol DMQZBXI Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Calaspargase pegol. Malignant haematopoietic neoplasm [2B33] [48]
Idelalisib DM602WT Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Idelalisib. Mature B-cell leukaemia [2A82] [59]
Moxetumomab pasudotox DMN63DZ Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Moxetumomab pasudotox. Mature B-cell leukaemia [2A82] [48]
IPI-145 DMWA24P Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and IPI-145. Mature B-cell leukaemia [2A82] [48]
Vemurafenib DM62UG5 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Vemurafenib. Melanoma [2C30] [48]
Ipilimumab DMJTIYK Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Ipilimumab. Melanoma [2C30] [48]
Dacarbazine DMNPZL4 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Dacarbazine. Melanoma [2C30] [48]
Danazol DML8KTN Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Danazol. Menstrual cycle bleeding disorder [GA20] [48]
Exjade DMHPRWG Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Exjade. Mineral absorption/transport disorder [5C64] [48]
Gallium nitrate DMF9O6B Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Gallium nitrate. Mineral excesses [5B91] [48]
Riluzole DMECBWN Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Riluzole. Motor neuron disease [8B60] [48]
Carfilzomib DM48K0X Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Carfilzomib. Multiple myeloma [2A83] [48]
Panobinostat DM58WKG Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Panobinostat. Multiple myeloma [2A83] [48]
Thalidomide DM70BU5 Major Additive thrombogenic effects by the combination of Clofarabine and Thalidomide. Multiple myeloma [2A83] [60]
Tecfidera DM2OVDT Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Tecfidera. Multiple sclerosis [8A40] [48]
Siponimod DM2R86O Major Additive immunosuppressive effects by the combination of Clofarabine and Siponimod. Multiple sclerosis [8A40] [49]
Fingolimod DM5JVAN Major Additive immunosuppressive effects by the combination of Clofarabine and Fingolimod. Multiple sclerosis [8A40] [61]
Ozanimod DMT6AM2 Major Additive immunosuppressive effects by the combination of Clofarabine and Ozanimod. Multiple sclerosis [8A40] [50]
Fedratinib DM4ZBK6 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Fedratinib. Myeloproliferative neoplasm [2A20] [48]
Omacetaxine mepesuccinate DMPU2WX Moderate Additive immunosuppressive effects by the combination of Clofarabine and Omacetaxine mepesuccinate. Myeloproliferative neoplasm [2A20] [62]
Bupropion DM5PCS7 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Bupropion. Nicotine use disorder [6C4A] [48]
Entrectinib DMMPTLH Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Entrectinib. Non-small cell lung cancer [2C25] [48]
Orlistat DMRJSP8 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Orlistat. Obesity [5B80-5B81] [48]
Naproxen DMZ5RGV Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Naproxen. Osteoarthritis [FA00-FA05] [50]
Carboplatin DMG281S Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Carboplatin. Ovarian cancer [2C73] [48]
Etodolac DM6WJO9 Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Etodolac. Pain [MG30-MG3Z] [50]
Diflunisal DM7EN8I Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Diflunisal. Pain [MG30-MG3Z] [50]
Ibuprofen DM8VCBE Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Ibuprofen. Pain [MG30-MG3Z] [50]
ABIRATERONE DM8V75C Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and ABIRATERONE. Prostate cancer [2C82] [48]
Nilutamide DMFN07X Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Nilutamide. Prostate cancer [2C82] [48]
Bicalutamide DMZMSPF Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Bicalutamide. Prostate cancer [2C82] [48]
Ambrisentan DMD1QXW Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Ambrisentan. Pulmonary hypertension [BB01] [48]
Everolimus DM8X2EH Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Everolimus. Renal cell carcinoma [2C90] [48]
Axitinib DMGVH6N Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Axitinib. Renal cell carcinoma [2C90] [48]
Gatifloxacin DMSL679 Minor Decreased absorption of Clofarabine due to intestinal mucosa variation caused by Gatifloxacin. Respiratory infection [CA07-CA4Z] [52]
Colistimethate DMZ9BMU Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Colistimethate. Respiratory infection [CA07-CA4Z] [48]
Salsalate DM13P4C Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Salsalate. Rheumatoid arthritis [FA20] [50]
Meloxicam DM2AR7L Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Meloxicam. Rheumatoid arthritis [FA20] [50]
Penicillamine DM40EF6 Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Penicillamine. Rheumatoid arthritis [FA20] [48]
Tocilizumab DM7J6OR Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Tocilizumab. Rheumatoid arthritis [FA20] [48]
Canakinumab DM8HLO5 Moderate Additive immunosuppressive effects by the combination of Clofarabine and Canakinumab. Rheumatoid arthritis [FA20] [63]
Oxaprozin DM9UB0P Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Oxaprozin. Rheumatoid arthritis [FA20] [50]
Rilonacept DMGLUQS Moderate Additive immunosuppressive effects by the combination of Clofarabine and Rilonacept. Rheumatoid arthritis [FA20] [63]
Flurbiprofen DMGN4BY Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Flurbiprofen. Rheumatoid arthritis [FA20] [50]
Golimumab DMHZV7X Major Additive immunosuppressive effects by the combination of Clofarabine and Golimumab. Rheumatoid arthritis [FA20] [64]
Sulfasalazine DMICA9H Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Sulfasalazine. Rheumatoid arthritis [FA20] [48]
Sarilumab DMOGNXY Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Sarilumab. Rheumatoid arthritis [FA20] [48]
Leflunomide DMR8ONJ Major Additive immunosuppressive effects by the combination of Clofarabine and Leflunomide. Rheumatoid arthritis [FA20] [56]
Anthrax vaccine DM9GSWY Moderate Antagonize the effect of Clofarabine when combined with Anthrax vaccine. Sepsis [1G40-1G41] [65]
Larotrectinib DM26CQR Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Larotrectinib. Solid tumour/cancer [2A00-2F9Z] [48]
PDX-101 DM6OC53 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and PDX-101. Solid tumour/cancer [2A00-2F9Z] [48]
Ifosfamide DMCT3I8 Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Ifosfamide. Solid tumour/cancer [2A00-2F9Z] [48]
Trabectedin DMG3Y89 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Trabectedin. Solid tumour/cancer [2A00-2F9Z] [48]
Methyltestosterone DMWLFGO Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Methyltestosterone. Solid tumour/cancer [2A00-2F9Z] [48]
Pitolisant DM8RFNJ Moderate Decreased clearance of Clofarabine due to the transporter inhibition by Pitolisant. Somnolence [MG42] [50]
Telavancin DM58VQX Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Telavancin. Staphylococcal/streptococcal disease [1B5Y] [48]
Disulfiram DMCL2OK Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Disulfiram. Substance abuse [6C40] [48]
Naltrexone DMUL45H Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Naltrexone. Substance abuse [6C40] [48]
Fostamatinib DM6AUHV Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Fostamatinib. Thrombocytopenia [3B64] [48]
Eltrombopag DMOGFIX Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Eltrombopag. Thrombocytopenia [3B64] [48]
Lenvatinib DMB1IU4 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Lenvatinib. Thyroid cancer [2D10] [48]
Methimazole DM25FL8 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Methimazole. Thyrotoxicosis [5A02] [48]
Tizanidine DMR2IQ4 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Tizanidine. Tonus and reflex abnormality [MB47] [48]
Azathioprine DMMZSXQ Moderate Additive myelosuppressive effects by the combination of Clofarabine and Azathioprine. Transplant rejection [NE84] [49]
Tacrolimus DMZ7XNQ Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Tacrolimus. Transplant rejection [NE84] [48]
Olsalazine DMZW9HA Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Olsalazine. Ulcerative colitis [DD71] [48]
Cinoxacin DM4EWNS Minor Decreased absorption of Clofarabine due to intestinal mucosa variation caused by Cinoxacin. Urinary tract infection [GC08] [52]
Nitrofurantoin DM7PQIK Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Nitrofurantoin. Urinary tract infection [GC08] [48]
Plazomicin DMKMBES Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Plazomicin. Urinary tract infection [GC08] [48]
Nalidixic acid DMRM0JV Minor Decreased absorption of Clofarabine due to intestinal mucosa variation caused by Nalidixic acid. Urinary tract infection [GC08] [52]
Elagolix DMB2C0E Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Elagolix. Uterine fibroid [2E86] [48]
Amiodarone DMUTEX3 Moderate Increased risk of hepatotoxicity by the combination of Clofarabine and Amiodarone. Ventricular tachyarrhythmia [BC71] [48]
Ganciclovir DM1MBYQ Moderate Additive myelosuppressive effects by the combination of Clofarabine and Ganciclovir. Virus infection [1A24-1D9Z] [49]
Valganciclovir DMS2IUH Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Valganciclovir. Virus infection [1A24-1D9Z] [49]
Aciclovir DMYLOVR Moderate Increased risk of nephrotoxicity by the combination of Clofarabine and Aciclovir. Virus infection [1A24-1D9Z] [48]
⏷ Show the Full List of 191 DDI Information of This Drug

References

1 URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 6802).
2 2004 approvals: the demise of the blockbuster. Nat Rev Drug Discov. 2005 Feb;4(2):93-4.
3 Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services. 2015
4 Natural products as sources of new drugs over the last 25 years. J Nat Prod. 2007 Mar;70(3):461-77.
5 BDDCS applied to over 900 drugs
6 Trend Analysis of a Database of Intravenous Pharmacokinetic Parameters in Humans for 1352 Drug Compounds
7 FDA approval: ado-trastuzumab emtansine for the treatment of patients with HER2-positive metastatic breast cancer. Clin Cancer Res. 2014 Sep 1;20(17):4436-41.
8 Estimating the safe starting dose in phase I clinical trials and no observed effect level based on QSAR modeling of the human maximum recommended daily dose
9 Clofarabine: past, present, and future. Leuk Lymphoma. 2007 Oct;48(10):1922-30.
10 Cytarabine-resistant leukemia cells are moderately sensitive to clofarabine in vitro. Anticancer Res. 2014 Apr;34(4):1657-62.
11 Contribution of the drug transporter ABCG2 (breast cancer resistance protein) to resistance against anticancer nucleosides. Mol Cancer Ther. 2008 Sep;7(9):3092-102.
12 FDA label of Belinostat. The 2020 official website of the U.S. Food and Drug Administration.
13 Potential mechanisms of action related to the efficacy and safety of cladribine. Mult Scler Relat Disord. 2019 May;30:176-186.
14 Doxorubicin transport by RALBP1 and ABCG2 in lung and breast cancer. Int J Oncol. 2007 Mar;30(3):717-25.
15 Wild-type breast cancer resistance protein (BCRP/ABCG2) is a methotrexate polyglutamate transporter. Cancer Res. 2003 Sep 1;63(17):5538-43.
16 The effect of low pH on breast cancer resistance protein (ABCG2)-mediated transport of methotrexate, 7-hydroxymethotrexate, methotrexate diglutamate, folic acid, mitoxantrone, topotecan, and resveratrol in in vitro drug transport models. Mol Pharmacol. 2007 Jan;71(1):240-9.
17 Role of BCRP as a biomarker for predicting resistance to 5-fluorouracil in breast cancer. Cancer Chemother Pharmacol. 2009 May;63(6):1103-10.
18 Inhibiting the function of ABCB1 and ABCG2 by the EGFR tyrosine kinase inhibitor AG1478. Biochem Pharmacol. 2009 Mar 1;77(5):781-93.
19 Sterol transport by the human breast cancer resistance protein (ABCG2) expressed in Lactococcus lactis. J Biol Chem. 2003 Jun 6;278(23):20645-51.
20 The phytoestrogen genistein enhances multidrug resistance in breast cancer cell lines by translational regulation of ABC transporters. Cancer Lett. 2016 Jun 28;376(1):165-72.
21 Curcumin inhibits the activity of ABCG2/BCRP1, a multidrug resistance-linked ABC drug transporter in mice. Pharm Res. 2009 Feb;26(2):480-7.
22 Imatinib mesylate (STI571) is a substrate for the breast cancer resistance protein (BCRP)/ABCG2 drug pump. Blood. 2004 Nov 1;104(9):2940-2.
23 Involvement of the concentrative nucleoside transporter 3 and equilibrative nucleoside transporter 2 in the resistance of T-lymphoblastic cell lines to thiopurines. Biochem Biophys Res Commun. 2006 Apr 28;343(1):208-15.
24 Multiple SLC and ABC Transporters Contribute to the Placental Transfer of Entecavir. Drug Metab Dispos. 2017 Mar;45(3):269-278.
25 Kinetic study of anti-viral ribavirin uptake mediated by hCNT3 and hENT1 in Xenopus laevis oocytes. Biophys Chem. 2010 Mar;147(1-2):59-65.
26 Human equilibrative nucleoside transporter 1, as a predictor of 5-fluorouracil resistance in human pancreatic cancer. Anticancer Res. 2007 Jul-Aug;27(4B):2241-9.
27 PharmGKB: A worldwide resource for pharmacogenomic information. Wiley Interdiscip Rev Syst Biol Med. 2018 Jul;10(4):e1417. (ID: PA2040)
28 FLT3 is implicated in cytarabine transport by human equilibrative nucleoside transporter 1 in pediatric acute leukemia. Oncotarget. 2016 Aug 2;7(31):49786-49799.
29 Effects of dipyridamole coadministration on the pharmacokinetics of ribavirin in healthy volunteers. Drug Metab Pharmacokinet. 2013;28(5):406-10.
30 Lonsurf, INN-trifluridine/tipiracil.
31 Nitric oxide reduces adenosine transporter ENT1 gene (SLC29A1) promoter activity in human fetal endothelium from gestational diabetes. J Cell Physiol. 2006 Aug;208(2):451-60.
32 Transport of A1 adenosine receptor agonist tecadenoson by human and mouse nucleoside transporters: evidence for blood-brain barrier transport by murine equilibrative nucleoside transporter 1 mENT1. Drug Metab Dispos. 2013 Apr;41(4):916-22.
33 Effects of amino acid alterations in penicillin-binding proteins (PBPs) 1a, 2b, and 2x on PBP affinities of penicillin, ampicillin, amoxicillin, cefditoren, cefuroxime, cefprozil, and cefaclor in 18 clinical isolates of penicillin-susceptible, -intermediate, and -resistant pneumococci. Antimicrob Agents Chemother. 2002 May;46(5):1273-80.
34 Bacteriological characteristics of Staphylococcus aureus isolates from humans and bulk milk. J Dairy Sci. 2008 Feb;91(2):564-9.
35 Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services.
36 Activities of antibiotics against methicillin-resistant Staphylococcus aureus with particular reference to synergetic effect between ticarcillin and fosfomycin on penicillinase non-producing methicillin-resistant S. aureus. Jpn J Antibiot. 1993 Jun;46(6):421-7.
37 Emerging drugs for bacterial urinary tract infections. Expert Opin Emerg Drugs. 2005 May;10(2):275-98.
38 Penicillin-binding protein sensitive to cephalexin in sporulation of Bacillus cereus. Microbiol Res. 1997 Sep;152(3):227-32.
39 Relationship between penicillin-binding protein patterns and beta-lactamases in clinical isolates of Bacteroides fragilis with different susceptibility to beta-lactam antibiotics. J Med Microbiol. 2004 Mar;53(Pt 3):213-21.
40 Resistance of Pseudomonas aeruginosa to cefsulodin: modification of penicillin-binding protein 3 and mapping of its chromosomal gene. J Antimicrob Chemother. 1990 Apr;25(4):513-23.
41 In vitro antienterococcal activity explains associations between exposures to antimicrobial agents and risk of colonization by multiresistant enter... J Infect Dis. 2004 Dec 15;190(12):2162-6.
42 Preclinical Pharmacokinetics of Fosciclopirox, a Novel Treatment of Urothelial Cancers, in Rats and Dogs. J Pharmacol Exp Ther. 2019 Aug;370(2):148-159.
43 Anti-tumor effect of oncolytic herpes simplex virus G47delta on human nasopharyngeal carcinoma. Chin J Cancer. 2011 Dec;30(12):831-41.
44 Clinical pipeline report, company report or official report of the Pharmaceutical Research and Manufacturers of America (PhRMA)
45 Didox (a novel ribonucleotide reductase inhibitor) overcomes Bcl-2 mediated radiation resistance in prostate cancer cell line PC-3. Cancer Biol Ther. 2002 Sep-Oct;1(5):539-45.
46 Suppression of retrovirus-induced immunodeficiency disease (murine AIDS) by trimidox and didox: novel ribonucleotide reductase inhibitors with less bone marrow toxicity than hydroxyurea. Antiviral Res. 2002 Nov;56(2):167-81.
47 Metabolism of the new ribonucleotide reductase inhibitor amidox in the isolated perfused rat liver. Anticancer Res. 2000 Sep- Oct;20(5B):3521-6.
48 Product Information. Clolar (clofarabine). sanofi-aventis, Bridgewater, NJ.
49 Cerner Multum, Inc. "Australian Product Information.".
50 Cerner Multum, Inc. "UK Summary of Product Characteristics.".
51 Product Information. Sirturo (bedaquiline). Janssen Pharmaceuticals, Titusville, NJ.
52 Johnson EJ, MacGowan AP, Potter MN, et al "Reduced absorption of oral ciprofloxacin after chemotherapy for haematological malignancy." J Antimicrob Chemother 25 (1990): 837-42. [PMID: 2373666]
53 Product Information. Turalio (pexidartinib). Daiichi Sankyo, Inc., Parsippany, NJ.
54 Wong GT, Lee EY, Irwin MG. Contrast induced nephropathy in vascular surgery.?Br J Anaesth. 2016;117 Suppl 2:ii63-ii73. [PMID: 27566809]
55 Product Information. Kynamro (mipomersen). Genzyme Corporation, Cambridge, MA.
56 Product Information. Arava (leflunomide). Hoechst Marion-Roussel Inc, Kansas City, MO.
57 Product Information. Juxtapid (lomitapide). Aegerion Pharmaceuticals Inc, Cambridge, MA.
58 Product Information. Prolia (denosumab). Amgen USA, Thousand Oaks, CA.
59 Product Information. Zydelig (idelalisib). Gilead Sciences, Foster City, CA.
60 Bennett CL, Nebeker JR, Samore MH, et al "The Research on Adverse Drug Events and Reports (RADAR) project." JAMA 293 (2005): 2131-40. [PMID: 15870417]
61 Product Information. Gilenya (fingolimod). Novartis Pharmaceuticals, East Hanover, NJ.
62 Product Information. Synribo (omacetaxine). Teva Pharmaceuticals USA, North Wales, PA.
63 Product Information. Arcalyst (rilonacept). Regeneron Pharmaceuticals Inc, Tarrytown, NY.
64 Product Information. Cimzia (certolizumab). UCB Pharma Inc, Smyrna, GA.
65 CDC. Centers for Disease Control and Prevention/ "Recommendations of the advisory committtee on immunization practices (ACIP): use of vaccines and immune globulins in persons with altered immunocompetence." MMWR Morb Mortal Wkly Rep 42(RR-04) (1993): 1-18. [PMID: 20300058]