Vorinostat

(vor in' oh stat)

Brand Name(s): , Zolinza^®

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WHY is this medicine prescribed?

Vorinostat is used to treat cutaneous T-cell lymphoma (CTCL, a type of cancer) in people whose disease has not improved, has gotten worse, or has come back after taking other medications. Vorinostat is in a class of medications called histone deacetylase (HDAC) inhibitors. It works by killing or stopping the growth of cancer cells.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Vorinostat comes as a capsule to take by mouth. It is usually taken once a day with food. Your doctor will tell you whether to take vorinostat every day or only on certain days of the week. Take vorinostat at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take vorinostat exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the capsules whole; do not open, chew, or crush them. If you are not able to swallow the capsules whole, call your doctor. If vorinostat capsules are accidentally opened or crushed, do not touch the capsules or the powder. If the powder from an open or crushed capsule gets on your skin or in your eyes or nose, wash the area well with plenty of water and call your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What SPECIAL PRECAUTIONS should I follow?

Before taking vorinostat,

• tell your doctor and pharmacist if you are allergic to vorinostat, any other medications, or any of the ingredients in vorinostat capsules. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven), belinostat (Beleodaq), and valproic acid (Depakene). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have nausea, vomiting, or diarrhea; and if you have or have ever had a blood clot in the lungs or a vein (blood vessel); high blood sugar or diabetes; arrhythmias (abnormal heartbeat or heart rhythm problems); low levels of potassium or magnesium, and heart, kidney, or liver disease.
• tell your doctor if you are pregnant or plan to become pregnant. You will have to take a pregnancy test at least 7 days before starting treatment. If you are a woman who is able to become pregnant, you must use effective birth control during your treatment and for 6 months after your final dose. If you are male with a female partner who could become pregnant, you must use effective birth control during your treatment and for 3 months after your final dose. If you become pregnant while taking vorinostat, call your doctor immediately. Vorinostat may harm the fetus.
• tell your doctor if you are breastfeeding or plan to breastfeed. You should not breastfeed while taking vorinostat and for 1 week after your final dose.
• you should know that vorinostat may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• you should know that vorinostat may cause an increase in blood glucose. If you have diabetes or high blood sugar, check your blood sugar as often as directed by your doctor. If your blood sugar is higher than usual, call your doctor. Tell your doctor immediately if you have any of the following symptoms while you are taking vorinostat: extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness. It is very important to call your doctor as soon as you have any of these symptoms, because high blood sugar that is not treated can cause a serious condition called ketoacidosis. Ketoacidosis may become life-threatening if it is not treated at an early stage. Symptoms of ketoacidosis include dry mouth, upset stomach and vomiting, shortness of breath, breath that smells fruity, and decreased consciousness. Call your doctor if you are unable to eat or drink normally due to nausea, vomiting, or diarrhea while you are taking vorinostat.Your doctor may need to change your diet or medication to help control your blood sugar while you are taking vorinostat.

What SPECIAL DIETARY instructions should I follow?

Make sure to drink at least eight 8-ounce (240-milliliter) cups of water or other liquids every day while taking vorinostat so you do not become dehydrated.

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Vorinostat may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• diarrhea
• nausea
• loss of appetite
• weight loss
• vomiting
• constipation
• extreme tiredness
• chills
• change in the way things taste
• dry mouth
• hair loss
• dizziness
• swelling of the legs, feet, or ankles
• itching
• cough
• fever
• headache
• muscle aches

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• unusual bleeding or bruising
• pale skin
• sudden swelling, redness, warmth, pain, and/or tenderness in a leg
• skin redness or change in skin color
• sudden sharp chest pain
• shortness of breath
• coughing up blood
• sweating
• fast heartbeat
• fainting
• feeling anxious

Vorinostat may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. [WEB]

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website ([WEB]) for more information if you do not have access to a take-back program.

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at [WEB]. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to vorinostat.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking vorinostat.

Do not let anyone else take your medication.Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2023. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: February 15, 2019.