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Can you take Romidepsin with Sodium phenylbutyrate / taurursodiol?

2 drug interactions and 21 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

sodium phenylbutyrate romiDEPsin

Applies to: sodium phenylbutyrate / taurursodiol and romidepsin

Using sodium phenylbutyrate together with romiDEPsin may increase certain side effects of each medication. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact. 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.

Moderate:

romiDEPsin taurursodiol

Applies to: romidepsin and sodium phenylbutyrate / taurursodiol

Taurursodiol may increase the blood levels and effects of romiDEPsin. 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

20 potential interactions Applies to: 17 conditions, including Heart Failure, Peripheral Neuropathy, Arrhythmia, Gallbladder Disease, and Fluid Retention.

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.

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.

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.

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.

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.

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.

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.

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.

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:

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.

Peripheral Neuropathy

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:

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.

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:

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

romidepsin

A total of 543 drugs are known to interact with romidepsin.

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.