Drug Interaction Report

Imatinib may increase the blood levels of trabectedin in some patients. 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. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. 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. 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.

Grapefruit juice may increase the blood levels of certain medications such as imatinib. You should avoid consumption of grapefruit and grapefruit juice during treatment with imatinib. However, if you have been regularly consuming grapefruit or grapefruit juice with the medication, then it is advisable for you to talk with your doctor before changing the amounts of these products in your diet, as this may alter the effects of your medication. Contact your doctor if your condition changes or you experience increased side effects. Orange juice is not expected to interact.

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.