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Medically reviewed by Holevn.org. Last updated on May 24, 2019.
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
- Powder for Solution
Therapeutic Class: Antineoplastic Agent
Pharmacologic Class: Histone Deacetylase Inhibitor
Uses for romidepsin
Romidepsin injection is used to treat certain types of cancer of the white blood cells called cutaneous T-cell lymphoma (CTCL) and peripheral T-cell lymphoma (PTCL). Romidepsin is used in patients who have already been treated with at least 1 previous treatment.
Romidepsin interferes with the growth of cancer cells, which are eventually destroyed by the body. Since the growth of normal body cells may also be affected, other unwanted effects will also occur. Some of these may be serious and must be reported to your doctor. Before you begin treatment with romidepsin, you and your doctor should talk about the benefits of romidepsin as well as the risks of receiving it.
Romidepsin is to be given only by or under the direct supervision of a doctor.
Before using romidepsin
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For romidepsin, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to romidepsin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of romidepsin injection in the pediatric population. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of romidepsin injection in the elderly. However, elderly patients are more sensitive to the effects of romidepsin than younger adults.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving romidepsin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using romidepsin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using romidepsin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- St John’s Wort
Interactions with food/tobacco/alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other medical problems
The presence of other medical problems may affect the use of romidepsin. Make sure you tell your doctor if you have any other medical problems, especially:
- Anemia (low red blood cells) or
- Blood or bone marrow problems or
- Epstein Barr infection (mononucleosis), history of or
- Hepatitis B infection, history of or
- Kidney disease or
- Leukopenia (low white blood cells) or
- Thrombocytopenia (low platelets)—Use with caution. May make these conditions worse.
- Congenital long QT syndrome (heart rhythm problem) or
- Heart or blood vessel disease or
- Heart rhythm problems, history of—Use with caution. May make side effects become worse.
- Hypokalemia (low potassium in the blood) or
- Hypomagnesemia (low magnesium in the blood)—Use with caution. These conditions must be corrected first before receiving romidepsin.
- Infection—May decrease your body’s ability to fight an infection.
- Liver disease, moderate or severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
Proper use of romidepsin
A nurse or other trained health professional will give you romidepsin in a medical facility. It is given through a needle placed into one of your veins.
Romidepsin is usually given on days 1, 8, and 15 of a 28-day cycle of treatment. Each treatment takes at least 4 hours.
Romidepsin comes with a patient information leaflet. Read and follow these instructions carefully. Ask your doctor if you have any questions.
Precautions while using romidepsin
It is very important that your doctor check your progress at regular visits to make sure romidepsin is working properly. Blood and urine tests may be needed to check for unwanted effects.
Receiving romidepsin while you are pregnant can harm your unborn baby. Birth control pills may not work as well to prevent pregnancy when used with romidepsin. Use another form of birth control (eg, condoms, IUD, spermicide) along with your pills. Women should use an effective form of birth control during treatment and for at least 1 month after the last dose. Men should use an effective form of birth control during treatment and for at least 1 month after the last dose to prevent pregnancy in a sexual partner. If you think you have become pregnant while receiving the medicine, tell your doctor right away.
Your doctor will give you a pregnancy test within 7 days before starting romidepsin to make sure you are not pregnant.
Romidepsin can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. It can also lower the number of platelets, which are necessary for proper blood clotting. If this occurs, there are certain precautions you can take, especially when your blood count is low, to reduce the risk of infection or bleeding:
- If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.
- Check with your doctor immediately if you notice any unusual bleeding or bruising, black, tarry stools, blood in the urine or stools, or pinpoint red spots on your skin.
- Be careful when using a regular toothbrush, dental floss, or toothpick. Your medical doctor, dentist, or nurse may recommend other ways to clean your teeth and gums. Check with your medical doctor before having any dental work done.
- Do not touch your eyes or the inside of your nose unless you have just washed your hands and have not touched anything else in the meantime.
- Be careful not to cut yourself when you are using sharp objects such as a safety razor or fingernail or toenail cutters.
- Avoid contact sports or other situations where bruising or injury could occur.
You may get infections more easily while using romidepsin. These can occur during treatment and within 30 days after the last dose. Tell your doctor right away if you have a fever, cough, burning sensation on urination, flu-like symptoms, muscle aches, or worsening skin problems.
Romidepsin may cause heart rhythm changes, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting or serious side effects. Contact your doctor right away if you have a fast, pounding, or uneven heartbeat, chest pain, or troubled breathing.
Romidepsin may cause a serious type of reaction called tumor lysis syndrome. Your doctor may give you a medicine to help prevent this. Call your doctor right away if you have a decrease or change in urine amount, joint pain, stiffness, or swelling, lower back, side, or stomach pain, rapid weight gain, swelling of the feet or lower legs, or unusual tiredness or weakness.
If you plan to have children, talk with your doctor before receiving romidepsin. Some men and women receiving romidepsin have become infertile (unable to have children).
Cancer medicines can cause nausea or vomiting even after receiving medicines to prevent it. Ask your doctor or nurse about other ways to control these side effects.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John’s wort) or vitamin supplements.
Romidepsin side effects
Along with its needed effects, a medicine 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:
- Black, tarry stools
- bleeding gums
- blood in the urine or stools
- blurred vision
- bone pain
- chest pain
- decreased urine output
- difficulty with breathing
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- dry mouth
- fast or irregular heartbeat
- flushed, dry skin
- fruit-like breath odor
- 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
- numbness or tingling in the hands, fingertips, feet, or lips
- painful or difficult urination
- pale skin
- pinpoint red spots on the skin
- sore throat
- sores, ulcers, or white spots on the lips or in the mouth
- stomach cramps or pain
- swelling of the face, ankles, feet, lower legs, or hands
- swollen glands
- troubled breathing
- unexplained weight loss
- unusual bleeding or bruising
- unusual tiredness or weakness
Some side effects 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:
- Change in taste
- cracks in the skin
- lack or loss of strength
- loss of heat from the body
- loss of taste
- red, swollen skin
- scaly skin
- weight loss
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Seek emergency medical attention or call 115
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