For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines? It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while having treatment with this one, to ensure that the combination is safe.

There may be an increased risk of side effects on the liver or blood cells if this medicine is used in combination with other medicines that can have these kinds of side effects, or with medicines that can prevent the breakdown of trabectedin in the body (see below for examples).

There may be an increased risk of side effects on the muscles if Yondelis is used in combination with any of the following medicines:

statins for lowering cholesterol, eg simvastatin, atorvastatin
fibrates for lowering cholesterol, eg bezafibrate, gemfibrozil
ezetimibe
nicotinic acid (niacin)
medicines that can prevent the breakdown of trabectedin in the body (see below for examples).
The following medicines may prevent the breakdown of trabectedin by the body and so may increase the risk of side effects:

azole antifungals, eg ketoconazole, fluconazole
ciclosporin
macrolide antibiotics, eg clarithromycin.
protease inhibitors for HIV infection, eg ritonavir
verapamil.
Trabectedin may decrease the blood level of phenytoin used to treat epilepsy, and this could increase the risk of convulsions. The use of phenytoin in combination with Yondelis is not recommended.

The following medicines may decrease the amount of trabectedin in the blood and could therefore make it less effective:

phenobarbital
rifampicin
the herbal remedy St. John's wort.
Vaccines may be less effective in people receiving chemotherapy. This is because chemotherapy medicines reduce the activity of the immune system and can prevent the body forming adequate antibodies. Live vaccines should be postponed until at least six months after finishing chemotherapy because they may cause serious infections. Live vaccines include: measles, mumps, rubella, MMR, BCG, oral polio, oral typhoid and yellow fever.

Other medicines containing the same active ingredient There are currently no other medicines available in the UK that contain trabectedin as the active ingredient.