Romidepsin (Generic Name)

Other Names: Istodax®

About This Drug

Romidepsin is a drug used to treat cancer. This drug is given intravenously (IV).

Possible Side Effects (More Common)

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets.  Bone marrow depression usually occurs five to 14 days after the drug is given and may increase your risk of infection, fatigue, and bleeding.
  • Nausea and vomiting. These symptoms may occur within several hours after you receive the drug and may last up to 120 hours after the drug is given. Drugs are available to prevent and lessen these side effects.
  • Soreness of the mouth and throat. You may have red areas, white patches, or sores that are painful.
  • This drug may affect how your liver works. Your liver function will be checked as needed.
  • This drug may increase your blood sugar level. Your blood sugar will be checked as needed.
  • Rash
  • Diarrhea or constipation

Possible Side Effects (Less Common)

  • Changes in your heart function which could result in cardiac failure.  Your heart function will be monitored as needed.
  • Acute respiratory distress syndrome 
  • This drug may affect how your kidneys work. Your kidney function will be checked as needed.
  • Allergic reactions.  Signs of an allergic reaction are shortness of breath, rash, itching, dizziness,  lightheadedness, or feeling your heart beat rapidly (palpitations).

Sexual Problems and Reproduction Concerns

In men and women both, this drug may temporarily or permanently affect your ability to have children.  This cannot be determined before your therapy.  In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations.  In women, menstrual bleeding may become irregular or stop while you are receiving this drug.  Do not assume that you cannot become pregnant if you do not have a menstrual period.  

Speak with your doctor or nurse if  you plan to have children.  Ask for information on sperm or egg banking.

Pregnancy Warning:  This drug may have harmful effects on the unborn child, so effective methods of birth control should be used by both men and women during your cancer treatment and for at least 3 months after treatment. Ask your doctor or nurse about effective birth control measures.

Genetic counseling is available to you to discuss the effects of thisdoctor or nurse doctor or  drug therapy on future pregnancies.  In addition, a genetic counselor can review the potential risks of problems in the fetus due to this medication if an exposure during pregnancy has occurred.

Breast Feeding Warning:  It is not known if this drug passes into breast milk.  For this reason, women are advised to discuss with their doctor the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and seriously harm a breast feeding infant.

Women may experience signs of menopause like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.

 

Treating Side Effects

  • Drink 6 – 8 cups of fluids every day unless your doctor has told you to restrict your fluid intake due to another medical condition.  A cup is 8 ounces of fluid.  If you vomit or have diarrhea, you should drink more fluids so that you do not become dehydrated.
  • Mouth care is very important.  Your mouth care should consist of regular, gentle cleaning of your teeth and dentures and rinsing your mouth with a mixture of ½ teaspoon of salt in 8 ounces of water or ½ teaspoon of sodium bicarbonate (baking soda) in 8 ounces of water.  This should be done at least after every meal and at bedtime.
  • If you have mouth sores, avoid mouthwash that contains alcohol.  Avoid alcohol and smoking because they can irritate your mouth and throat.
  • Do not put anything on your rash unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if your rash is bothersome.

Food and Drug Interactions

  • Avoid grapefruit and grapefruit juice as it may increase the levels and side effects of romidepsin.
  • Avoid the use of St. John’s Wort while taking temsirolimus as this may decrease the levels of the drug making it less effective.  Check with your doctor before starting any other herbal medication, as there may be serious drug interactions.
  • Check with your doctor or pharmacist about all other prescription medications and dietary supplements you are taking before starting this medication as there are a lot of known drug interactions with temsirolimus.  In addition, if any new prescription, over-the-counter medication, or dietary supplement is started, check with your doctor or pharmacist to make sure that there are no known interactions

While you are receiving this drug by IV, tell your doctor or nurse immediately If you have any of the following symptoms of an allergic reaction:

  • Shortness of breath
  • Rash or itching
  • Dizziness or lightheadedness
  • Feeling your heart beat rapidly (palpitations)

When to call your doctor or nurse immediately if you have any of the following symptoms:

  • Fever of 100.5 F (38 C) or above
  • Chills
  • Chest pain or tightness. If this lasts 2 minutes or longer, call 911.
  • Rapid heart beat (palpitations)
  • Unusual bleeding or bruising
  • Wheezing or difficulty breathing
  • Cough
  • Dizziness
  • Uncontrolled nausea or vomiting that prevents you from eating or drinking
  • Vomiting more than three times a day
  • Abdominal pain
  • Severe rash or itching
  • Diarrhea or bloody stools
  • Skin wound that will not heal

When to call your doctor or nurse as soon as possible if you have any of the following symptoms:

  • Numbness or tingling
  • Extreme weakness or tiredness
  • Mild rash
  • Constipation not helped by recommended medications
  • Sores in your mouth or thorat that prevent you from eating or drinking
  • Weight loss of more than 5 pounds.
  • Increased urination

New January 2012

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