Drug Interaction Report

If you are currently being treated or have recently been treated with trabectedin, you should let your doctor know before using streptococcus salivarius. 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 streptococcus salivarius 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.

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.