Drug General Information (ID: DDIC2K18SO)
Drug Name			Clofibrate		Drug Info		Trabectedin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihyperammonia Agents				Alkylating Agents
Structure

Mechanism of Clofibrate-Trabectedin Interaction (Severity Level: Moderate)
Increased risk of hepatotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Clofibrate				Trabectedin
Mechanism 1		Hepatotoxicity				Hepatotoxicity
Key Mechanism Factor 1
		Factor Name		Hepatotoxicity
		Factor Description		Combination of drugs that can induce hepatotoxicity may increase the risk of liver injury. Symptoms vary depending on the level of exposure and the total extent of liver damage, and may cause few symptoms if the damage is mild, and eventually lead to liver failure in patients with severe damage.
Mechanism Description		Increased risk of hepatotoxicity by the combination of Clofibrate and Trabectedin
Increased risk of other adverse reactions (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Clofibrate				Trabectedin
Mechanism 2		Rhabdomyolysis				Rhabdomyolysis
Key Mechanism Factor 2
		Factor Name		Adverse reactions
		Factor Description		An adverse reaction is an unexpected negative reaction to a medication or treatment that happens even when it's used correctly.
Mechanism Description		Increased risk of adverse reactions by the combination of Clofibrate and Trabectedin

Recommended Action
Management		Caution is advised when trabectedin is used with other agents associated with rhabdomyolysis. Patients should be advised to seek medical attention if they experience unexplained muscle pain, tenderness or weakness, particularly if accompanied by fever, malaise and/or dark colored urine. Caution is advised when trabectedin is used with other agents that are potentially hepatotoxic. Patients should be advised to seek medical attention if they experience potential signs and symptoms of hepatotoxicity such as fever, rash, itching, anorexia, nausea, vomiting, fatigue, malaise, right upper quadrant pain, dark urine, pale stools, and jaundice. Monitoring of alkaline phosphatase, bilirubin, AST, and ALT should occur regularly during trabectedin treatment in accordance with the product labeling, or as often as necessary when clinical symptoms develop.

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2	Product Information. Yondelis (trabectedin). Janssen Pharmaceuticals, Titusville, NJ.