Istodax Side Effects

Generic Name: romidepsin

Note: This page contains side effects data for the generic drug romidepsin. It is possible that some of the dosage forms included below may not apply to the brand name Istodax.

It is possible that some side effects of Istodax may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

For the Consumer

Applies to romidepsin: intravenous powder for solution

Along with its needed effects, romidepsin (the active ingredient contained in Istodax) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking romidepsin:

More common
  • Abdominal or stomach cramps or pain
  • black, tarry stools
  • bleeding gums
  • blood in the urine or stools
  • blurred vision
  • bone pain
  • chest pain
  • chills
  • coma
  • confusion
  • convulsions
  • cough or hoarseness
  • decreased urine output
  • difficulty with breathing
  • dizziness
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • drowsiness
  • dry mouth
  • fast or irregular heartbeat
  • fever
  • flushed, dry skin
  • fruit-like breath odor
  • headache
  • increased hunger
  • increased thirst
  • increased urination
  • joint pain, stiffness, or swelling
  • loss of appetite
  • lower back or side pain
  • mood or mental changes
  • muscle cramps in the hands, arms, feet, legs, or face
  • muscle pain
  • muscle spasms (tetany) or twitching seizures
  • nausea or vomiting
  • numbness or tingling in the hands, fingertips, feet, or lips
  • painful or difficult urination
  • pale skin
  • pinpoint red spots on the skin
  • shortness of breath
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • sweating
  • swelling of the face, ankles, feet, lower legs, or hands
  • swollen glands
  • trembling
  • tremor
  • troubled breathing
  • troubled breathing with exertion
  • unexplained weight loss
  • unusual bleeding or bruising
  • unusual tiredness or weakness
Less common
  • Fainting
  • fast, pounding, or irregular heartbeat or pulse
  • swelling

Some side effects of romidepsin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Change in taste
  • constipation
  • cracks in the skin
  • diarrhea
  • itching skin
  • lack or loss of strength
  • loss of appetite
  • loss of heat from the body
  • loss of taste
  • red, swollen skin
  • scaly skin
  • weight loss

For Healthcare Professionals

Applies to romidepsin: intravenous powder for injection


Gastrointestinal side effects including nausea (up to 86%), anorexia (up to 54%), vomiting (up to 52%), constipation (up to 39%), and diarrhea (up to 20%) have been reported.


General side effects including asthenia/fatigue (up to 77%), infections (up to 54%), and pyrexia (up to 23%) have been reported.


Hematologic side effects including anemia (up to 72%), thrombocytopenia (up to 65%), neutropenia (up to 57%), lymphopenia (up to 57%), hypoalbuminemia (up to 48%), and leukopenia (up to 46%) have been reported.


Cardiovascular side effects including electrocardiogram ST-T wave changes (up to 63%) and hypotension (up to 23%) have been reported.


Metabolic side effects including hypocalcemia (up to 52%), hyperglycemia (up to 51%), hyperuricemia (up to 33%), hypomagnesemia (up to 28%), hypermagnesemia (up to 27%), hypophosphatemia (up to 27%), hypokalemia (up to 20%), and hyponatremia (up to 20%) have been reported.

Nervous system

Nervous system side effects including dysgeusia (up to 40%) have been reported.


Hepatic side effects including increased aspartate aminotransferase (up to 28%) and increased alanine aminotransferase (up to 22%) have been reported.


Dermatologic side effects including pruritus (up to 31%) and dermatitis/exfoliative dermatitis (up to 27%) have been reported.

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