Can you take Revuforj with Topotecan?
1 drug interaction and 15 additional warnings found for the following 2 drugs:
- Revuforj (revumenib)
- topotecan
Drug interactions
Moderate drug interactions
Moderate:
topotecan revumenib
Applies to: topotecan and Revuforj (revumenib)
Using topotecan together with revumenib may increase the risk of side effects that affect your bone marrow function, resulting in low numbers of different types of blood cells. You may be more likely to develop anemia, bleeding problems, or infections due to low blood cell counts.
You should seek medical attention if you develop:
- paleness
- fatigue
- dizziness
- fainting
- unusual bruising or bleeding
- fever
- chills
- diarrhea
- sore throat
- muscle aches
- shortness of breath
- blood in phlegm
- weight loss
- red or inflamed skin
- body sores
- pain or burning during urination
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.
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:
revumenib Food/Lifestyle
Applies to: Revuforj (revumenib)
High fat content meals may affect the absorption of revumenib. It is recommended that revumenib be taken while fasting or with a low fat meal (approximately 400 calories, with 25% of calories from fat).
Grapefruit juice may also increase the blood levels of revumenib which can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening.
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)
Increased levels of revumenib may also increase the risk of developing a serious and potentially life-threatening condition called differentiation syndrome.
Symptoms of differentiation syndrome include:
- fever
- cough
- shortness of breath
- severe headache
- confusion
- dizziness
- rapid weight gain
- swelling
- decreased urination
You should seek immediate medical attention if you develop any of these symptoms and/or symptoms of QT prolongation such as sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with revumenib.
The risk and/or severity of other side effects may also increase, including nausea, vomiting, diarrhea, fever or infections. You may need additional monitoring if grapefruit or grapefruit juice are consumed during treatment with revumenib.
Talk to a healthcare provider if you have any questions or concerns. 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
14 potential interactions Applies to: 13 conditions, including Heart Failure, Diarrhea, Arrhythmia, Hypokalemia, and Fever.
Arrhythmia
Moderate:
Revuforj
The revumenib in Revuforj has a moderate potential interaction with Arrhythmia.
Revumenib can cause QTc interval prolongation. Correct electrolyte imbalances such as hypokalemia and hypomagnesemia, prior to treatment, and perform a baseline ECG. This drug should not be initiated in patients with QTcF greater than 450 msec. Monitor with ECG during treatment (once a week during the first 4 weeks and then monthly). More frequent ECG monitoring may be necessary in patients with congenital long QTc syndrome, congestive heart failure, electrolyte abnormalities, or those taking other medications that can prolong the QTc interval.
Bleeding Disorder
Major:
topotecan
Topotecan has a major potential interaction with Bleeding Disorder.
Topotecan induces myelosuppression. Severe thrombocytopenia (< 25,000/mm3) has been reported during topotecan therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bleeding such as petechiae, purpura, hematuria, or melena. Close clinical monitoring of hematopoietic function is recommended. Therapy with topotecan should not be initiated in patients with platelet counts < 100,000/mm3. Subsequent courses of topotecan should be withheld until platelet counts exceed 100,000/mm3.
Bone Marrow Depression/Low Blood Counts
Major:
topotecan
Topotecan has a major potential interaction with Bone Marrow Depression/Low Blood Counts.
Topotecan induces myelosuppression. Severe neutropenia (< 500/mm3), severe thrombocytopenia (< 25,000/mm3), and severe anemia (< 8 g/dl) have been reported frequently. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended. Therapy with topotecan should not be initiated in patients with neutrophil counts < 1500/mm3 and/or platelet counts < 100,000/mm3. Subsequent courses of topotecan should be withheld until neutrophil counts exceed 1000/mm3, platelet counts exceed 100,000/mm3, and/or hemoglobin levels are at least 9 g/dl.
Diarrhea
Moderate:
topotecan
Topotecan has a moderate potential interaction with Diarrhea.
Topotecan capsules can cause severe and life-threatening diarrhea that may require hospitalization. It is recommended to withhold treatment for severe diarrhea. Manage diarrhea caused by topotecan aggressively and do no administer topotecan capsules to patients with Grade 3 or 4 diarrhea. Reduce the dose of therapy after recovery to Grade 1 or less. Close monitoring is recommended.
Fever
Major:
topotecan
Topotecan has a major potential interaction with Fever.
Topotecan induces myelosuppression. Severe neutropenia (< 500/mm3), severe thrombocytopenia (< 25,000/mm3), and severe anemia (< 8 g/dl) have been reported frequently. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression such as fever, sore throat, local infection, or bleeding. Close clinical monitoring of hematopoietic function is recommended. Therapy with topotecan should not be initiated in patients with neutrophil counts < 1500/mm3 and/or platelet counts < 100,000/mm3. Subsequent courses of topotecan should be withheld until neutrophil counts exceed 1000/mm3, platelet counts exceed 100,000/mm3, and/or hemoglobin levels are at least 9 g/dl.
Heart Failure
Moderate:
Revuforj
The revumenib in Revuforj has a moderate potential interaction with Heart Failure.
Revumenib can cause QTc interval prolongation. Correct electrolyte imbalances such as hypokalemia and hypomagnesemia, prior to treatment, and perform a baseline ECG. This drug should not be initiated in patients with QTcF greater than 450 msec. Monitor with ECG during treatment (once a week during the first 4 weeks and then monthly). More frequent ECG monitoring may be necessary in patients with congenital long QTc syndrome, congestive heart failure, electrolyte abnormalities, or those taking other medications that can prolong the QTc interval.
Hypokalemia
Moderate:
Revuforj
The revumenib in Revuforj has a moderate potential interaction with Hypokalemia.
Revumenib can cause QTc interval prolongation. Correct electrolyte imbalances such as hypokalemia and hypomagnesemia, prior to treatment, and perform a baseline ECG. This drug should not be initiated in patients with QTcF greater than 450 msec. Monitor with ECG during treatment (once a week during the first 4 weeks and then monthly). More frequent ECG monitoring may be necessary in patients with congenital long QTc syndrome, congestive heart failure, electrolyte abnormalities, or those taking other medications that can prolong the QTc interval.
Infection
Major:
topotecan
Topotecan 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:
Revuforj
The revumenib in Revuforj has a moderate potential interaction with Liver Disease.
Revumenib has not been studied in patients with severe liver or renal impairment.
Long QT Syndrome
Moderate:
Revuforj
The revumenib in Revuforj has a moderate potential interaction with Long QT Syndrome.
Revumenib can cause QTc interval prolongation. Correct electrolyte imbalances such as hypokalemia and hypomagnesemia, prior to treatment, and perform a baseline ECG. This drug should not be initiated in patients with QTcF greater than 450 msec. Monitor with ECG during treatment (once a week during the first 4 weeks and then monthly). More frequent ECG monitoring may be necessary in patients with congenital long QTc syndrome, congestive heart failure, electrolyte abnormalities, or those taking other medications that can prolong the QTc interval.
Magnesium Imbalance
Moderate:
Revuforj
The revumenib in Revuforj has a moderate potential interaction with Magnesium Imbalance.
Revumenib can cause QTc interval prolongation. Correct electrolyte imbalances such as hypokalemia and hypomagnesemia, prior to treatment, and perform a baseline ECG. This drug should not be initiated in patients with QTcF greater than 450 msec. Monitor with ECG during treatment (once a week during the first 4 weeks and then monthly). More frequent ECG monitoring may be necessary in patients with congenital long QTc syndrome, congestive heart failure, electrolyte abnormalities, or those taking other medications that can prolong the QTc interval.
Pulmonary Impairment
Moderate:
topotecan
Topotecan has a moderate potential interaction with Pulmonary Impairment.
Fatal cases of interstitial lung disease (ILD) have occurred with the use of topotecan. Risk factors include a history of ILD, pulmonary fibrosis, lung cancer, thoracic radiation, and use of pneumotoxic drugs and/or colony stimulating factors. It is recommended to monitor patients for pulmonary symptoms indicative of ILD and permanently discontinue treatment for confirmed ILD.
Renal Dysfunction
Major:
topotecan
Topotecan has a major potential interaction with Renal Dysfunction.
Topotecan is partially eliminated by the kidney. Approximately 30% of topotecan is excreted in the urine. Plasma clearance of topotecan was reduced 33% in patients with mild renal impairment (creatinine clearance of 40 to 60 mL/min) and 66% in patients with moderate renal impairment (creatinine clearance of 20 to 40 mL/min). Therapy with topotecan should be administered cautiously and at a reduced dosage in patients with moderate to severe renal dysfunction.
Moderate:
Revuforj
The revumenib in Revuforj has a moderate potential interaction with Renal Dysfunction.
Revumenib has not been studied in patients with severe liver or renal impairment.
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More resources
Revuforj
A total of 583 drugs are known to interact with Revuforj.
- Revuforj is in the drug class miscellaneous antineoplastics.
- Revuforj is used to treat the following conditions:
topotecan
A total of 455 drugs are known to interact with topotecan.
- Topotecan is in the drug class miscellaneous antineoplastics.
- Topotecan 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.