Can you take Bitolterol with Romidepsin?
1 drug interaction and 16 additional warnings found for the following 2 drugs:
- bitolterol
- romidepsin
Drug interactions
Moderate drug interactions
Moderate:
bitolterol romiDEPsin
Applies to: bitolterol and romidepsin
Using bitolterol together with romiDEPsin can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a rare side effect.
You may be more susceptible if you have:
- a heart condition called congenital long QT syndrome
- other cardiac diseases
- conduction abnormalities
- electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting)
The risk may exist even when bitolterol or similar medications are given by oral inhalation directly into the lungs, and more so if these products are overused. Do not exceed the dose and frequency of use recommended on the product label or prescribed by your doctor.
Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications.
You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
bitolterol Caffeine
Applies to: bitolterol
Both bitolterol and caffeine can increase blood pressure and heart rate, and combining them may enhance these effects.
Talk to your doctor before using these medications, especially if you have a history of high blood pressure or heart disease. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications.
Contact your doctor if your condition changes or you experience increased side effects.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
15 potential interactions Applies to: 15 conditions, including High Blood Pressure, Seizures, Arrhythmia, Hypokalemia, and Hyperthyroidism.
Arrhythmia
Moderate:
romidepsin
romiDEPsin has a moderate potential interaction with Arrhythmia.
The use of romidepsin may cause changes in ECG. It is recommended to consider cardiovascular monitoring of ECG prior to starting therapy and periodically during treatment in patients with congenital long QT syndrome, history of significant cardiovascular disease, and in patients taking anti-arrhythmic medicines or medicinal products that lead to significant QT prolongation. Confirm that potassium and magnesium levels are within normal range before administration of romidepsin. Care and close monitoring is recommended.
Bone Marrow Depression/Low Blood Counts
Moderate:
romidepsin
romiDEPsin has a moderate potential interaction with Bone Marrow Depression/Low Blood Counts.
Cases of fatal and serious infections, including pneumonia, sepsis, and viral reactivation, including Epstein Barr and hepatitis B viruses have been reported with the use of romidepsin. The risk of life threatening infections may be greater in patients with a history of prior treatment with monoclonal antibodies directed against lymphocyte antigens and in patients with disease involvement of the bone marrow. Monitor reactivation in patients with evidence of prior hepatitis B infection as recommended and consider antiviral prophylaxis as clinically indicated.
Cardiovascular Conditions and Disorders
Moderate:
romidepsin
romiDEPsin has a moderate potential interaction with Cardiovascular Conditions and Disorders.
The use of romidepsin may cause changes in ECG. It is recommended to consider cardiovascular monitoring of ECG prior to starting therapy and periodically during treatment in patients with congenital long QT syndrome, history of significant cardiovascular disease, and in patients taking anti-arrhythmic medicines or medicinal products that lead to significant QT prolongation. Confirm that potassium and magnesium levels are within normal range before administration of romidepsin. Care and close monitoring is recommended.
Diabetes Mellitus
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with Diabetes Mellitus.
Adrenergic bronchodilators may cause increases in blood glucose concentrations. These effects are usually transient and slight, but may be significant with dosages higher than those normally recommended. Large doses of IV albuterol (not commercially available in the U.S.) and terbutaline sulfate have been reported to cause exacerbation of preexisting diabetes mellitus and ketoacidosis. Therapy with adrenergic bronchodilators should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.
Heart Disease
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with Heart Disease.
Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.
High Blood Pressure
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with High Blood Pressure.
Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.
Hyperthyroidism
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with Hyperthyroidism.
Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.
Hypokalemia
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with Hypokalemia.
Adrenergic bronchodilators may cause decreases in serum potassium concentrations, primarily when given by nebulization or intravenous administration. Although this effect is usually transient and does not require supplementation, clinically significant hypokalemia may occur in some patients, with the potential to induce cardiovascular adverse effects. The relevance of these observations to oral or oral aerosol/powder for inhalation therapy is unknown. Therapy with adrenergic bronchodilators should be administered cautiously in patients with or predisposed to hypokalemia.
Infection
Moderate:
romidepsin
romiDEPsin has a moderate potential interaction with Infection.
Cases of fatal and serious infections, including pneumonia, sepsis, and viral reactivation, including Epstein Barr and hepatitis B viruses have been reported with the use of romidepsin. The risk of life threatening infections may be greater in patients with a history of prior treatment with monoclonal antibodies directed against lymphocyte antigens and in patients with disease involvement of the bone marrow. Monitor reactivation in patients with evidence of prior hepatitis B infection as recommended and consider antiviral prophylaxis as clinically indicated.
Liver Disease
Moderate:
romidepsin
romiDEPsin has a moderate potential interaction with Liver Disease.
Romidepsin population pharmacokinetic analysis indicated that mild hepatic impairment had no significant influence on romidepsin pharmacokinetics. A dose reduction and close monitoring is recommended in patients with moderate and severe hepatic impairment.
Lymphocytopenia
Moderate:
romidepsin
romiDEPsin has a moderate potential interaction with Lymphocytopenia.
The use of romidepsin may cause thrombocytopenia, leukopenia (neutropenia and lymphopenia), and anemia. It is recommended to monitor blood counts regularly during treatment, and if necessary to modify the dose of romidepsin according to clinical practices.
Neutropenia
Moderate:
romidepsin
romiDEPsin has a moderate potential interaction with Neutropenia.
The use of romidepsin may cause thrombocytopenia, leukopenia (neutropenia and lymphopenia), and anemia. It is recommended to monitor blood counts regularly during treatment, and if necessary to modify the dose of romidepsin according to clinical practices.
Renal Dysfunction
Moderate:
romidepsin
romiDEPsin has a moderate potential interaction with Renal Dysfunction.
Romidepsin population pharmacokinetic analysis indicated that romidepsin pharmacokinetics were not affected by renal impairment. Care and close monitoring is recommended when prescribing this agent to patients with end-stage renal disease as the pharmacokinetics of romidepsin have not been studied in these patients.
Seizures
Moderate:
bitolterol
Bitolterol has a moderate potential interaction with Seizures.
Adrenergic bronchodilators may cause CNS stimulation. Therapy with adrenergic bronchodilators should be administered cautiously in patients with seizure disorders. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.
Thrombocytopenia
Moderate:
romidepsin
romiDEPsin has a moderate potential interaction with Thrombocytopenia.
The use of romidepsin may cause thrombocytopenia, leukopenia (neutropenia and lymphopenia), and anemia. It is recommended to monitor blood counts regularly during treatment, and if necessary to modify the dose of romidepsin according to clinical practices.
More resources
bitolterol
A total of 396 drugs are known to interact with bitolterol.
- Bitolterol is in the drug class adrenergic bronchodilators.
- Bitolterol is used to treat the following conditions:
romidepsin
A total of 547 drugs are known to interact with romidepsin.
- Romidepsin is in the drug class histone deacetylase inhibitors.
- Romidepsin is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.