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No in-vivo interaction studies have been performed.
When Ribomustin is combined with myelosuppressive agents, the effect of Ribomustin and/or the co-administered medicinal products on the bone marrow may be potentiated. Any treatment reducing the patient's performance status or impairing bone marrow function can increase the toxicity of Ribomustin.
Combination of Ribomustin with cyclosporine or tacrolimus may result in excessive immunosuppression with risk of lymphoproliferation.
Cytostatics can reduce antibody formation following live-virus vaccination and increase the risk of infection which may lead to fatal outcome. This risk is increased in subjects who are already immunosuppressed by their underlying disease.
Bendamustine metabolism involves cytochrome P450 (CYP) 1A2 isoenzyme (see Pharmacology: Pharmacokinetics under Actions). Therefore, potential for interaction with CYP1A2 inhibitors (such as fluvoxamine, ciprofloxacin, acyclovir, cimetidine) exists.
