vorinostat

Contraindicated in:

Severe hepatic impairment;
OB: Pregnancy;
Lactation: Lactation.

Use Cautiously in:

Renal impairment;
Mild or moderate hepatic impairment;
Pre-existing nausea, vomiting, or diarrhea (treat symptomatically before initiating therapy);
Rep: Women of reproductive potential and men with female partners of reproductive potential;
Pedi: Safety and effectiveness not established in children;
Geri: Older adults may be more sensitive to drug effects.

Adv. Reactions/Side Effects ⬆ ⬇

CV: DEEP VEIN THROMBOSIS, QT interval prolongation

Derm: alopecia, itching

Endo: hyperglycemia

GI: anorexia, constipation, diarrhea, dry mouth, nausea, vomiting

GU: ↓fertility (women), proteinuria

Hemat: anemia, thrombocytopenia

Metab: weight loss

MS: muscle spasms

Neuro: dysgeusia, dizziness, headache

Resp: cough, PULMONARY EMBOLISM

Misc: chills, fever

Interactions ⬆ ⬇

Drug-drug:

↑risk of thrombocytopenia and GI bleeding with valproic acid.
May ↑ risk of bleeding with warfarin.

Availability ⬆ ⬇

Capsules: 100 mg

Route/Dosage ⬆ ⬇

PO (Adults ): 400 mg once daily; if intolerance occurs, dose may be ↓ to 300 mg once daily or 300 mg once daily for 5 consecutive days/wk.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Acts as a histone deacetylase inhibitor, which decreases gene transcription resulting in cell cycle arrest.

Therapeutic effects:

Decreased progression of cutaneous T-cell lymphoma.

Classifications ⬆ ⬇

Therapeutic Classification: antineoplastics

Pharmacologic Classification: enzyme inhibitors

Pharmacokinetics ⬆ ⬇

Absorption: Well absorbed following oral administration.

Distribution: Unknown.

Metabolism/Excretion: Mostly metabolized, <1% excreted unchanged in urine.

Half-Life: 2 hr.

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
PO	unknown	4 hr	24 hr

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication to patient. Advise patient to read Patient Information before starting therapy. Instruct patient to take as directed. Take missed doses as soon as remembered. If almost time for next dose, skip dose and take next dose at regular time; do not double doses
Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken, and to consult health care professional before taking any new medications or herbal products.
Advise patient to drink >2 L of fluid/day to prevent dehydration and to report vomiting or diarrhea to health care professional promptly.
Instruct patient to notify health care professional immediately if signs of deep vein thrombosis (sudden swelling in leg, pain or tenderness in leg [may only be felt when standing or walking], ↑ warmth in the area of swelling, skin redness or change in skin color) or pulmonary embolus (sudden sharp chest pain, shortness of breath, cough with bloody secretions, sweating, rapid pulse, fainting, feeling anxious) occur. Also notify health care professional if unusual bleeding or bruising, or unusual tiredness occur.
Advise patients with diabetes to monitor blood glucose frequently as directed and notify health care professional if blood sugar is higher than normal.
May cause dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
Rep: May cause fetal harm. Advise women of reproductive potential to use effective contraception during and for >6 mo after last dose and to avoid breastfeeding during therapy and for >1 wk after last dose. Advise men with female partners of reproductive potential to use effective contraception during and for >3 mo after last dose. May impair female fertility. Advise patient to notify health care professional immediately if pregnancy is suspected.

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Indications ⬇

Contraind./Precautions ⬆ ⬇