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Can you take Eribulin with Sodium phenylbutyrate / taurursodiol?

1 drug interaction and 22 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

eriBULin taurursodiol

Applies to: eribulin and sodium phenylbutyrate / taurursodiol

Taurursodiol may alter the blood levels and effects of eriBULin. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring 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.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

sodium phenylbutyrate Food/Lifestyle

Applies to: sodium phenylbutyrate / taurursodiol

Food may affect the absorption of sodium phenylbutyrate. A high-fat, high-calorie meal (approximately 800 to 1000 calories; 500 to 600 calories from fat, 250 calories from carbohydrate, 150 calories from protein) has been shown to reduce the absorption of sodium phenylbutyrate, although it is unknown what impact this may have on the overall effectiveness of the medication. The manufacturer recommends taking sodium phenylbutyrate before a meal or snack. This is especially important if you weigh less than 70 kg (approximately 154 pounds). Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.

Disease interactions

21 potential interactions Applies to: 17 conditions, including Heart Failure, Peripheral Neuropathy, Arrhythmia, Hypokalemia, and Gallbladder Disease.

Arrhythmia

Moderate:

eribulin

eriBULin has a moderate potential interaction with Arrhythmia.

In clinical trials, eribulin has caused QT prolongation independent of concentration. Close monitoring should be exercised in patients with congestive heart failure, bradyarrhythmias, those taking drugs known to prolong the QT interval, including Class Ia and III antiarrhythmics, and electrolyte abnormalities. It is recommended to correct hypokalemia or hypomagnesemia prior to starting therapy and monitor these electrolytes periodically during therapy. Avoid in patients with congenital long QT syndrome.

Biliary Obstruction

Moderate:

sodium phenylbutyrate / taurursodiol

The taurursodiol in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Biliary Obstruction.

Sodium phenylbutyrate-taurursodiol contains taurursodiol, a bile acid. In patients with disorders that interfere with bile acid circulation, there may be an increased risk for diarrhea and patients should be monitored appropriately. Other conditions such as pancreatic insufficiency, intestinal malabsorption, or intestinal diseases that may alter the concentration of bile acids, may also lead to decreased absorption of this drug and its components. Consider consulting with a GI specialists with experience managing these GI disorders. Patients with disorders of enterohepatic circulation (e.g., biliary infection, active cholecystitis, etc.), severe pancreatic disorders (e.g., pancreatitis), and intestinal disorders that may alter concentrations of bile acids (e.g., ileal resection, regional ileitis, etc.) were excluded from clinical studies and there is no experience in patients with these conditions. Caution is advised.

Central Nervous System Disorders

Moderate:

sodium phenylbutyrate / taurursodiol

The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Central Nervous System Disorders.

Sodium phenylbutyrate is a pro-drug and is rapidly metabolized to the active, phenylacetate. Neurotoxicity, including exacerbation of a preexisting neuropathy, has been reported with the use of intravenous phenylacetate. The acute onset and reversibility when the phenylacetate infusion was discontinued suggested a drug effect. Care should be exercised when prescribing sodium phenylbutyrate to patients at risk for neurotoxicity.

Electrolyte Abnormalities

Moderate:

eribulin

eriBULin has a moderate potential interaction with Electrolyte Abnormalities.

In clinical trials, eribulin has caused QT prolongation independent of concentration. Close monitoring should be exercised in patients with congestive heart failure, bradyarrhythmias, those taking drugs known to prolong the QT interval, including Class Ia and III antiarrhythmics, and electrolyte abnormalities. It is recommended to correct hypokalemia or hypomagnesemia prior to starting therapy and monitor these electrolytes periodically during therapy. Avoid in patients with congenital long QT syndrome.

Fluid Retention

Major:

sodium phenylbutyrate / taurursodiol

The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a major potential interaction with Fluid Retention.

The use of sodium phenylbutyrate may cause fluid retention in patients with congestive heart failure, renal dysfunction, or sodium retention with edema. Sodium phenylbutyrate is primarily excreted by the kidney and these patients may exhibit reduced excretion. Therapy with sodium phenylbutyrate should be administered cautiously in these patients. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.

Gallbladder Disease

Moderate:

sodium phenylbutyrate / taurursodiol

The taurursodiol in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Gallbladder Disease.

Sodium phenylbutyrate-taurursodiol contains taurursodiol, a bile acid. In patients with disorders that interfere with bile acid circulation, there may be an increased risk for diarrhea and patients should be monitored appropriately. Other conditions such as pancreatic insufficiency, intestinal malabsorption, or intestinal diseases that may alter the concentration of bile acids, may also lead to decreased absorption of this drug and its components. Consider consulting with a GI specialists with experience managing these GI disorders. Patients with disorders of enterohepatic circulation (e.g., biliary infection, active cholecystitis, etc.), severe pancreatic disorders (e.g., pancreatitis), and intestinal disorders that may alter concentrations of bile acids (e.g., ileal resection, regional ileitis, etc.) were excluded from clinical studies and there is no experience in patients with these conditions. Caution is advised.

Heart Failure

Major:

sodium phenylbutyrate / taurursodiol

The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a major potential interaction with Heart Failure.

The use of sodium phenylbutyrate may cause fluid retention in patients with congestive heart failure, renal dysfunction, or sodium retention with edema. Sodium phenylbutyrate is primarily excreted by the kidney and these patients may exhibit reduced excretion. Therapy with sodium phenylbutyrate should be administered cautiously in these patients. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.

Hypokalemia

Moderate:

eribulin

eriBULin has a moderate potential interaction with Hypokalemia.

In clinical trials, eribulin has caused QT prolongation independent of concentration. Close monitoring should be exercised in patients with congestive heart failure, bradyarrhythmias, those taking drugs known to prolong the QT interval, including Class Ia and III antiarrhythmics, and electrolyte abnormalities. It is recommended to correct hypokalemia or hypomagnesemia prior to starting therapy and monitor these electrolytes periodically during therapy. Avoid in patients with congenital long QT syndrome.

Infection

Major:

eribulin

eriBULin has a major potential interaction with Infection.

Because of their cytotoxic effects on rapidly proliferating tissues, antineoplastic agents frequently can, to varying extent, induce myelosuppression. The use of these drugs may be contraindicated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during antineoplastic therapy. Close clinical monitoring of hematopoietic function is recommended.

Liver Disease

Moderate:

eribulin

eriBULin has a moderate potential interaction with Liver Disease.

Pharmacokinetics studies to evaluate the effect of hepatic impairment in patients treated with eribulin demonstrated that patients with mild hepatic impairment (Child-Pugh A) and moderate hepatic impairment (Child-Pugh B) had higher eribulin exposures as compared to patients with normal hepatic function. It is recommended to reduce the starting dose of eribulin in patients with mild or moderate hepatic impairment according to the manufacturer recommendations. Eribulin has not been studied in patients with severe hepatic impairment (Child-Pugh C). Caution and close monitoring should be taken.

Moderate:

sodium phenylbutyrate / taurursodiol

The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Liver Disease.

Sodium phenylbutyrate is primarily metabolized in the liver and kidney. Therapy with sodium phenylbutyrate should be administered cautiously in patients with liver disease. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.

Magnesium Imbalance

Moderate:

eribulin

eriBULin has a moderate potential interaction with Magnesium Imbalance.

In clinical trials, eribulin has caused QT prolongation independent of concentration. Close monitoring should be exercised in patients with congestive heart failure, bradyarrhythmias, those taking drugs known to prolong the QT interval, including Class Ia and III antiarrhythmics, and electrolyte abnormalities. It is recommended to correct hypokalemia or hypomagnesemia prior to starting therapy and monitor these electrolytes periodically during therapy. Avoid in patients with congenital long QT syndrome.

Malabsorption Syndrome

Moderate:

sodium phenylbutyrate / taurursodiol

The taurursodiol in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Malabsorption Syndrome.

Sodium phenylbutyrate-taurursodiol contains taurursodiol, a bile acid. In patients with disorders that interfere with bile acid circulation, there may be an increased risk for diarrhea and patients should be monitored appropriately. Other conditions such as pancreatic insufficiency, intestinal malabsorption, or intestinal diseases that may alter the concentration of bile acids, may also lead to decreased absorption of this drug and its components. Consider consulting with a GI specialists with experience managing these GI disorders. Patients with disorders of enterohepatic circulation (e.g., biliary infection, active cholecystitis, etc.), severe pancreatic disorders (e.g., pancreatitis), and intestinal disorders that may alter concentrations of bile acids (e.g., ileal resection, regional ileitis, etc.) were excluded from clinical studies and there is no experience in patients with these conditions. Caution is advised.

Myoneural Disorder

Moderate:

sodium phenylbutyrate / taurursodiol

The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Myoneural Disorder.

Sodium phenylbutyrate is a pro-drug and is rapidly metabolized to the active, phenylacetate. Neurotoxicity, including exacerbation of a preexisting neuropathy, has been reported with the use of intravenous phenylacetate. The acute onset and reversibility when the phenylacetate infusion was discontinued suggested a drug effect. Care should be exercised when prescribing sodium phenylbutyrate to patients at risk for neurotoxicity.

Neutropenia

Moderate:

eribulin

eriBULin has a moderate potential interaction with Neutropenia.

Adverse hematologic effects including neutropenia, and febrile neutropenia (fever >=38.5°C with Grade 3 or 4 neutropenia) have been associated with the use of eribulin. It is recommended to monitor complete blood counts prior to each dose and increase the frequency of monitoring in patients who develop Grade 3 or 4 cytopenias. Delay administration of therapy and reduce subsequent doses in patients who experience febrile neutropenia or Grade 4 neutropenia lasting longer than 7 days. Do not administer therapy on Day 1 or Day 8 if ANC < 1,000/mm3, platelets < 75,000/mm3, or grade 3 or 4 non-hematological toxicities.

Peripheral Neuropathy

Moderate:

eribulin

eriBULin has a moderate potential interaction with Peripheral Neuropathy.

In clinical trials, eribulin caused peripheral neuropathy. Monitor patients closely for signs of peripheral motor and sensory neuropathy. It is recommended to withhold treatment in patients who experience Grade 3 or 4 peripheral neuropathy, until resolution to Grade 2 or less.

Moderate:

sodium phenylbutyrate / taurursodiol

The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Peripheral Neuropathy.

Sodium phenylbutyrate is a pro-drug and is rapidly metabolized to the active, phenylacetate. Neurotoxicity, including exacerbation of a preexisting neuropathy, has been reported with the use of intravenous phenylacetate. The acute onset and reversibility when the phenylacetate infusion was discontinued suggested a drug effect. Care should be exercised when prescribing sodium phenylbutyrate to patients at risk for neurotoxicity.

Renal Dysfunction

Major:

sodium phenylbutyrate / taurursodiol

The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a major potential interaction with Renal Dysfunction.

The use of sodium phenylbutyrate may cause fluid retention in patients with congestive heart failure, renal dysfunction, or sodium retention with edema. Sodium phenylbutyrate is primarily excreted by the kidney and these patients may exhibit reduced excretion. Therapy with sodium phenylbutyrate should be administered cautiously in these patients. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.

Moderate:

eribulin

eriBULin has a moderate potential interaction with Renal Dysfunction.

Pharmacokinetics studies to evaluate the effect of renal impairment in patients treated with eribulin demonstrated that patients with moderate and severe renal impairment had higher eribulin dose-normalized exposures compared to that in patients with normal renal function. It is recommended to reduce the starting dose of eribulin in patients with moderate or severe renal impairment (CrCL 15-49 mL/min) according to the manufacturer recommendations.

Moderate:

sodium phenylbutyrate / taurursodiol

The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Renal Dysfunction.

Sodium phenylbutyrate is primarily metabolized in the liver and kidney. Therapy with sodium phenylbutyrate should be administered cautiously in patients with liver disease. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.

Thrombocytopenia

Moderate:

eribulin

eriBULin has a moderate potential interaction with Thrombocytopenia.

Adverse hematologic effects including neutropenia, and febrile neutropenia (fever >=38.5°C with Grade 3 or 4 neutropenia) have been associated with the use of eribulin. It is recommended to monitor complete blood counts prior to each dose and increase the frequency of monitoring in patients who develop Grade 3 or 4 cytopenias. Delay administration of therapy and reduce subsequent doses in patients who experience febrile neutropenia or Grade 4 neutropenia lasting longer than 7 days. Do not administer therapy on Day 1 or Day 8 if ANC < 1,000/mm3, platelets < 75,000/mm3, or grade 3 or 4 non-hematological toxicities.

More resources

eribulin

A total of 527 drugs are known to interact with eribulin.

sodium phenylbutyrate / taurursodiol

A total of 590 drugs are known to interact with sodium phenylbutyrate / taurursodiol.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.