Can you take Risa-Bid with Trabectedin?
1 drug interaction and 7 additional warnings found for the following 2 drugs:
- Risa-Bid (lactobacillus acidophilus)
- trabectedin
Drug interactions
Moderate drug interactions
Moderate:
lactobacillus acidophilus trabectedin
Applies to: Risa-Bid (lactobacillus acidophilus) and trabectedin
If you are currently being treated or have recently been treated with trabectedin, you should let your doctor know before using lactobacillus acidophilus. Depending on the dose and length of time you have been on trabectedin, you may be at risk for developing rare infections from exposure to products containing live bacteria or yeast. Depending on your overall health and medical condition, it may be advisable to avoid using lactobacillus acidophilus until your immune system has recovered from the effects of trabectedin. Talk to your doctor 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.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
trabectedin Food/Lifestyle
Applies to: trabectedin
Do not consume grapefruit or grapefruit juice during treatment with trabectedin, as it may increase blood levels of the medication. This can increase the risk and/or severity of side effects such as nausea, vomiting, constipation, diarrhea, liver problems, heart muscle problems (e.G., heart failure), and impaired bone marrow function resulting in low numbers of different types of blood cells. You may be more likely to develop anemia, bleeding problems, and infections because of low blood cell counts. In addition, your may have an increased risk of developing a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. Talk to your doctor if you have any questions or concerns. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment with trabectedin, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. Avoid excessive use of alcohol, as it may add to the effects of trabectedin on the liver. 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
6 potential interactions Applies to: 6 conditions, including Heart Disease, Liver Disease, Immunodeficiency, Neutropenia, and Renal Dysfunction.
Heart Disease
Moderate:
trabectedin
Trabectedin has a moderate potential interaction with Heart Disease.
Cardiomyopathy including cardiac failure, congestive heart failure, ejection fraction decreased, diastolic dysfunction, or right ventricular dysfunction can occur with the use of trabectedin. Care should be taken when using this agent in patients with heart disease. Assess LVEF before initiation of therapy and at 2- to 3-month intervals thereafter. It is recommended to withhold therapy for LVEF below lower limit of normal and permanently discontinue treatment for symptomatic cardiomyopathy or persistent left ventricular dysfunction that does not recover to lower limit of normal within 3 weeks.
Immunodeficiency
Moderate:
Risa-Bid
The lactobacillus acidophilus in Risa-Bid has a moderate potential interaction with Immunodeficiency.
Probiotics, especially those containing lactobacillus, should be used with caution in immunosuppressed patients.
Liver Disease
Moderate:
trabectedin
Trabectedin has a moderate potential interaction with Liver Disease.
Hepatotoxicity, including hepatic failure, can occur with the use of trabectedin. It is recommended to assess liver function test (LFTs) prior to each administration of trabectedin and as deem appropriately based on the severity of preexisting hepatic impairment. Dose interruption, reduction, or discontinuation of treatment might be appropriate based on severity and duration of LFTs abnormality. The use of trabectedin in patients with mild hepatic impairment is not expected to cause clinically significant effects on its pharmacokinetics. Reduce dose in patients with moderate hepatic impairment as clinically appropriate and do not administer trabectedin to patients with severe hepatic impairment (bilirubin levels above 3 times to 10 times the upper limit of normal, and any AST and ALT). Close monitoring of LFTs is recommended.
Myopathy
Moderate:
trabectedin
Trabectedin has a moderate potential interaction with Myopathy.
Rhabdomyolysis and musculoskeletal toxicity can occur with the use of trabectedin. It is recommended to obtain baseline serum creatine phosphokinase (CPK) and creatinine levels prior to initiating therapy with trabectedin and periodically during treatment as clinically indicated. Withhold trabectedin for serum CPK levels more than 2.5 times the upper limit of normal. If CPK is elevated, evaluate for signs and symptoms of rhabdomyolysis or other causes. Permanently discontinue treatment for rhabdomyolysis. Care should be taken when using this agent in patients at risk for rhabdomyolysis.
Neutropenia
Moderate:
trabectedin
Trabectedin has a moderate potential interaction with Neutropenia.
The use of trabectedin has been associated with neutropenic sepsis, including fatal cases. It is recommended to monitor neutrophil count before each dose of trabectedin and periodically during treatment. Withhold treatment if the neutrophil count is less than 1,500 cells/microliter on the treatment day and permanently reduce the dose for life-threatening or prolonged, severe neutropenia in the preceding cycle. Therapy with trabectedin should be administered cautiously in patients predisposed to neutropenia. Patients should be warned to report any febrile illness.
Renal Dysfunction
Moderate:
trabectedin
Trabectedin has a moderate potential interaction with Renal Dysfunction.
The use of trabectedin in patients with mild or moderate renal impairment is not expected to cause clinically significant effects on its pharmacokinetics. No dose adjustment is recommended in patients with mild or moderate renal impairment. The effects of severe renal impairment or end-stage renal disease on trabectedin exposure are unknown. Hemodialysis is not expected to enhance the elimination of trabectedin as the product is highly bound to plasma proteins (97%) and not significantly excreted by the kidneys.
More resources
Risa-Bid
A total of 370 drugs are known to interact with Risa-Bid.
- Risa-bid is in the following drug classes: antidiarrheals, probiotics.
- Risa-bid is used to treat the following conditions:
trabectedin
A total of 691 drugs are known to interact with trabectedin.
- Trabectedin is in the drug class alkylating agents.
- Trabectedin is used to treat Soft Tissue Sarcoma.
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.