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Can you take Romidepsin with Sporanox?

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

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Drug interactions

Moderate drug interactions

Moderate:

itraconazole romiDEPsin

Applies to: Sporanox (itraconazole) and romidepsin

Itraconazole may increase the blood levels and effects of romiDEPsin. You may be more likely to experience side effects such as anemia, bleeding problems, infections, or an irregular heart rhythm that may be serious or life-threatening. Contact your doctor 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, and pain or burning during urination. You should seek immediate medical attention if you experience sudden dizziness, lightheadedness, fainting, shortness of breath, or fast or pounding heartbeats 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:

itraconazole Food/Lifestyle

Applies to: Sporanox (itraconazole)

Food increases the absorption of itraconazole capsules but decreases the absorption of itraconazole oral solution. Capsules should be taken immediately after a full meal and the solution be taken on an empty stomach to ensure best results.

Disease interactions

21 potential interactions Applies to: 16 conditions, including COPD, Arrhythmia, Heart Disease, Fluid Retention, and Liver Disease.

Achlorhydria

Moderate:

Sporanox

The itraconazole in Sporanox has a moderate potential interaction with Achlorhydria.

Itraconazole 100-mg capsules should be administered after a full meal. Under fasted conditions, absorption of itraconazole from the 100-mg capsule formulation was diminished with decreased gastric acidity. Studies conducted under fasted conditions showed that taking the 100-mg capsule formulation with 8 ounces of a non-diet cola beverage enhanced absorption of itraconazole in AIDS patients with relative or absolute achlorhydria; this increase relative to the effects of a full meal is unknown.

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.

Moderate:

Sporanox

The itraconazole in Sporanox has a moderate potential interaction with Arrhythmia.

Some azole antifungals have been associated with prolongation of the QT interval on the ECG. Rare cases of QT prolongation and torsade de pointes have been reported during postmarketing experience; such reports usually involved seriously ill patients with multiple confounding risk factors, such as structural heart disease, electrolyte abnormalities, and concomitant medications. These drugs should be administered with caution to patients with potentially proarrhythmic conditions, such as congenital/acquired QT prolongation, cardiomyopathy (especially when heart failure is present), sinus bradycardia, and existing symptomatic arrhythmias. Concomitant use with other medications that have potential to increase the risk of cardiotoxicity should be avoided.

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.

COPD

Major:

Sporanox

The itraconazole in Sporanox has a major potential interaction with COPD.

Itraconazole may possess a dose-related negative inotropic effect. Transient, asymptomatic decreases in left ventricular ejection fraction were observed with IV administration in healthy volunteers; these resolved before the next infusion. Additionally, cases of congestive heart failure (CHF), peripheral edema, and pulmonary edema have been reported during postmarketing experience in patients treated for onychomycosis and/or systemic fungal infections. Itraconazole should not be used to treat onychomycosis in patients with evidence of ventricular dysfunction such as CHF or history of CHF; itraconazole should not be used for other indications in such patients unless the benefit clearly outweighs the risk. The risks and benefits of itraconazole therapy should be reviewed carefully in patients with risk factors for CHF (including cardiac disease [e.g., ischemic and valvular disease], significant pulmonary disease [e.g., chronic obstructive pulmonary disease], renal failure and other edematous disorders). Patients with risk factors for CHF should be advised of the signs/symptoms of CHF, treated with caution, and monitored for signs/symptoms of CHF during therapy.

Cystic Fibrosis

Moderate:

Sporanox

The itraconazole in Sporanox has a moderate potential interaction with Cystic Fibrosis.

In a study using itraconazole oral solution in cystic fibrosis patients, therapeutic drug levels varied and were not reached in some patients. Alternative therapy should be considered for patients who do not respond to itraconazole oral solution or itraconazole 100-mg capsules.

Fluid Retention

Major:

Sporanox

The itraconazole in Sporanox has a major potential interaction with Fluid Retention.

Itraconazole may possess a dose-related negative inotropic effect. Transient, asymptomatic decreases in left ventricular ejection fraction were observed with IV administration in healthy volunteers; these resolved before the next infusion. Additionally, cases of congestive heart failure (CHF), peripheral edema, and pulmonary edema have been reported during postmarketing experience in patients treated for onychomycosis and/or systemic fungal infections. Itraconazole should not be used to treat onychomycosis in patients with evidence of ventricular dysfunction such as CHF or history of CHF; itraconazole should not be used for other indications in such patients unless the benefit clearly outweighs the risk. The risks and benefits of itraconazole therapy should be reviewed carefully in patients with risk factors for CHF (including cardiac disease [e.g., ischemic and valvular disease], significant pulmonary disease [e.g., chronic obstructive pulmonary disease], renal failure and other edematous disorders). Patients with risk factors for CHF should be advised of the signs/symptoms of CHF, treated with caution, and monitored for signs/symptoms of CHF during therapy.

Heart Disease

Major:

Sporanox

The itraconazole in Sporanox has a major potential interaction with Heart Disease.

Itraconazole may possess a dose-related negative inotropic effect. Transient, asymptomatic decreases in left ventricular ejection fraction were observed with IV administration in healthy volunteers; these resolved before the next infusion. Additionally, cases of congestive heart failure (CHF), peripheral edema, and pulmonary edema have been reported during postmarketing experience in patients treated for onychomycosis and/or systemic fungal infections. Itraconazole should not be used to treat onychomycosis in patients with evidence of ventricular dysfunction such as CHF or history of CHF; itraconazole should not be used for other indications in such patients unless the benefit clearly outweighs the risk. The risks and benefits of itraconazole therapy should be reviewed carefully in patients with risk factors for CHF (including cardiac disease [e.g., ischemic and valvular disease], significant pulmonary disease [e.g., chronic obstructive pulmonary disease], renal failure and other edematous disorders). Patients with risk factors for CHF should be advised of the signs/symptoms of CHF, treated with caution, and monitored for signs/symptoms of CHF during therapy.

Immunodeficiency

Moderate:

Sporanox

The itraconazole in Sporanox has a moderate potential interaction with Immunodeficiency.

The oral bioavailability of itraconazole 100-mg capsules may be decreased in some immunocompromised patients (e.g., neutropenic patients, AIDS patients, organ transplant recipients); in addition, since hypochlorhydria has been reported in HIV-infected patients, the absorption of itraconazole may be reduced in these patients. The dose of itraconazole 100-mg capsules should be adjusted based on the clinical response of such patients.

Itraconazole oral solution is not recommended for initial treatment in severely neutropenic patients at immediate risk of systemic candidiasis.

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

Major:

Sporanox

The itraconazole in Sporanox has a major potential interaction with Liver Disease.

Limited data are available on the use of oral itraconazole in patients with liver dysfunction. Itraconazole has been associated with rare cases of serious hepatotoxicity (including liver failure and death). Caution is recommended when this drug is used in patients with liver dysfunction; such patients should be carefully monitored during therapy. Treatment with itraconazole is strongly discouraged in patients with elevated or abnormal liver enzymes, with active liver disease, or who had liver toxicity with other drugs unless the situation is serious or life-threatening and the expected benefit exceeds the risk. Liver function monitoring is recommended for patients with preexisting hepatic function abnormalities or those who had liver toxicity with other drugs.

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.

Moderate:

Sporanox

The itraconazole in Sporanox has a moderate potential interaction with Neutropenia.

The oral bioavailability of itraconazole 100-mg capsules may be decreased in some immunocompromised patients (e.g., neutropenic patients, AIDS patients, organ transplant recipients); in addition, since hypochlorhydria has been reported in HIV-infected patients, the absorption of itraconazole may be reduced in these patients. The dose of itraconazole 100-mg capsules should be adjusted based on the clinical response of such patients.

Itraconazole oral solution is not recommended for initial treatment in severely neutropenic patients at immediate risk of systemic candidiasis.

Organ Transplant

Moderate:

Sporanox

The itraconazole in Sporanox has a moderate potential interaction with Organ Transplant.

The oral bioavailability of itraconazole 100-mg capsules may be decreased in some immunocompromised patients (e.g., neutropenic patients, AIDS patients, organ transplant recipients); in addition, since hypochlorhydria has been reported in HIV-infected patients, the absorption of itraconazole may be reduced in these patients. The dose of itraconazole 100-mg capsules should be adjusted based on the clinical response of such patients.

Itraconazole oral solution is not recommended for initial treatment in severely neutropenic patients at immediate risk of systemic candidiasis.

Renal Dysfunction

Major:

Sporanox

The itraconazole in Sporanox has a major potential interaction with Renal Dysfunction.

Itraconazole may possess a dose-related negative inotropic effect. Transient, asymptomatic decreases in left ventricular ejection fraction were observed with IV administration in healthy volunteers; these resolved before the next infusion. Additionally, cases of congestive heart failure (CHF), peripheral edema, and pulmonary edema have been reported during postmarketing experience in patients treated for onychomycosis and/or systemic fungal infections. Itraconazole should not be used to treat onychomycosis in patients with evidence of ventricular dysfunction such as CHF or history of CHF; itraconazole should not be used for other indications in such patients unless the benefit clearly outweighs the risk. The risks and benefits of itraconazole therapy should be reviewed carefully in patients with risk factors for CHF (including cardiac disease [e.g., ischemic and valvular disease], significant pulmonary disease [e.g., chronic obstructive pulmonary disease], renal failure and other edematous disorders). Patients with risk factors for CHF should be advised of the signs/symptoms of CHF, treated with caution, and monitored for signs/symptoms of CHF during therapy.

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:

Sporanox

The itraconazole in Sporanox has a moderate potential interaction with Renal Dysfunction.

Limited data are available on the use of oral itraconazole in patients with renal dysfunction; itraconazole exposure may be lower in some of these patients. Caution is advised when using itraconazole in patients with renal dysfunction and dose adjustment may be needed. Patients with renal dysfunction should be carefully monitored when using the 65-mg capsule formulation.

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.

Sporanox

A total of 597 drugs are known to interact with Sporanox.

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.