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Istodax Side Effects

Generic name: romidepsin

Medically reviewed by Last updated on Apr 23, 2022.

Note: This document contains side effect information about romidepsin. Some of the dosage forms listed on this page may not apply to the brand name Istodax.

For the Consumer

Applies to romidepsin: intravenous powder for solution, intravenous solution

Side effects requiring immediate medical attention

Along with its needed effects, romidepsin (the active ingredient contained in Istodax) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking romidepsin:

More common

  • Black, tarry stools
  • bleeding gums
  • blood in the urine or stools
  • blurred vision
  • bone pain
  • chest pain
  • chills
  • confusion
  • cough
  • decreased urine output
  • difficulty with breathing
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • drowsiness
  • dry mouth
  • fast or irregular heartbeat
  • fever
  • flushed, dry skin
  • fruit-like breath odor
  • headache
  • hoarseness
  • increased hunger
  • increased thirst
  • increased urination
  • joint pain, stiffness, or swelling
  • loss of appetite
  • lower back or side pain
  • muscle cramps in the hands, arms, feet, legs, or face
  • muscle spasms or twitching
  • nausea
  • numbness or tingling in the hands, fingertips, feet, or lips
  • painful or difficult urination
  • pale skin
  • pinpoint red spots on the skin
  • seizures
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stomach cramps or pain
  • sweating
  • swelling of the face, ankles, feet, lower legs, or hands
  • swollen glands
  • tremor
  • trouble breathing
  • unexplained weight loss
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting

Side effects not requiring immediate medical attention

Some side effects of romidepsin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Change in taste
  • constipation
  • cracks in the skin
  • diarrhea
  • itching
  • lack or loss of strength
  • loss of heat from the body
  • loss of taste
  • red, swollen skin
  • scaly skin
  • weight loss

For Healthcare Professionals

Applies to romidepsin: intravenous powder for injection, intravenous solution


Very common (10% or more): Nausea (86%), vomiting (52%), constipation (40%), diarrhea (36%), abdominal pain (14%)

Common (1% to 10%): Stomatitis[Ref]


The most commonly reported adverse events included neutropenia, lymphopenia, thrombocytopenia, infections, nausea, fatigue, vomiting, anorexia, anemia, and ECG T-wave changes.

The most commonly reported events leading to discontinuation included infection, fatigue, dyspnea, QT prolongation, and hypomagnesemia.[Ref]


Very common (10% or more): Anemia (72%), neutropenia (66%), leukopenia (46%), thrombocytopenia (65%), lymphopenia (57%)[Ref]


Very common (10% or more): ST-T wave changes on ECG (63%), hypotension (23%)

Common (1% to 10%): Tachycardia, supraventricular arrhythmia, ventricular arrhythmia, edema, deep vein thrombosis, chest pain

Frequency not reported: QT prolongation[Ref]


Very common (10% or more): Anorexia (54%), hypocalcemia (52%), hyperglycemia (51%), hypoalbuminemia (48%), hyperuricemia (33%), hypomagnesemia (28%), hypermagnesemia (27%), hypophosphatemia (27%), hypokalemia (20%), weight loss (15%), hyponatremia (20%),

Common (1% to 10%): Dehydration, hypoalbuminemia, hyperuricemia, tumor lysis syndrome[Ref]

Nervous system

Very common (10% or more): Dysgeusia (40%), headache (34%)

Common (1% to 10%): Syncope, dizziness[Ref]


Very common (10% or more): AST elevations (28%), ALT elevations (22%)

Common (1% to 10%): Hyperbilirubinemia[Ref]


Very common (10% or more): Pruritus (31%), dermatitis/exfoliative dermatitis (27%)

Common (1% to 10%): Rash[Ref]


Common (1% to 10%): Hypersensitivity


Very common (10% or more): Infections (54%)

Common (1% to 10%): Sepsis, upper respiratory infection, urinary tract infection, pneumonia, cellulitis, oral candidiasis, central line infection, catheter related infection


Very common (10% or more): Asthenia/fatigue (77%), pyrexia (47%), chills (17%)

Common (1% to 10%): Febrile neutropenia


Very common (10% or more): Cough (21%), dyspnea (21%)

Common (1% to 10%): Pulmonary embolism, pneumonitis


Common (1% to 10%): Muscle spasms, myalgia


1. "Product Information. Istodax (romidepsin)." Gloucester Pharmaceuticals (2009):

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.