Vorinostat (Oral)

Vorinostat is used to treat cutaneous T-cell lymphoma (CTCL). Vorinostat works by interfering with the growth of cancer cells, preventing their spread and helping to control the disease.

Overview

The US brand name of Vorinostat is Zolinza.

Vorinostat is a chemotherapy drug used in the treatment of T-cell lymphoma (CTCL), a form of cancer that attacks certain white blood cells, causing lesions to form on the sufferer's skin.

Vorinostat works by disrupting the growth of the cancerous cells, allowing the body to destroy and remove them. Unfortunately, Vorinostat can also affect the growth of the body's normal, healthy cells and is known to cause some unwanted side effects. Some of these side effects can be serious and should be reported immediately to your health professional. Other effects are more of a nuisance than a concern, and may not become evident until some months or years following the use of the medicine.

Before beginning treatment with Vorinostat, it is advisable to discuss the pros and cons of using Vorinostat with your doctor. Vorinostat is only available in capsule form through a prescription from your medical professional.

Conditions treated

  • T-cell lymphoma (CTCL)

Type of medicine

  • chemotherapy

Side effects

Together with its desired effects, some medicines can cause some unwanted effects too. Not all of these side-effects will affect every patient, but if they occur, they may require medical attention.

The side effects commonly experienced by patients taking Vorinostat include cracks in the skin, scaliness, and itching. Your skin may also become reddened and swollen in patches. You may also find that your sense of taste has changed, and you could find that you are no longer able to register the flavor of certain foods, and your mouth may become unusually dry.

You may become constipated, and you could find that you experience some hair loss or thinning of your hair. It is not uncommon for people taking Vorinostat to find that they suffer from a loss of physical strength and intermittent muscle spasms. Some people find that they struggle to keep warm.

These effects are quite common and should not be a cause for immediate alarm, although you should mention them to your doctor.

Other, less common side effects can sometimes include feelings of anxiety and confusion accompanied by dizziness and fainting. You may find that you experience bloating of your face and extremities, chest pain or coughing. You could feel as though you have the flu, with head and muscle aches, pains, chills or a fever. Some people suffer from diarrhea or black, tarry stools, and urination may become very frequent and painful. You could feel that your heart is beating too fast or irregularly. You may feel unusually thirsty and find that you have a reduced appetite. Swellings can appear on your face, extremities, and sexual organs, and you may experience a tingling feeling or numbness in these areas.

There are a number of more serious side effects that are more rarely experienced. If you find that you are suffering from any of the following effects, consult your medical professional immediately:

  • sudden shortness of breath and problems breathing
  • tiny red spots on your skin
  • a sore throat or swollen glands
  • ulceration around the mouth
  • problems with coordination of movement and walking
  • feeling unusually tired or sleepy
  • unusual bruising or bleeding
  • persistent sores or spots that will not heal
  • areas on your skin that appear waxy, yellow or form a shiny bump
  • severe nausea and vomiting
  • vomiting blood or matter that looks like coffee grounds
  • extreme pain or discomfort in the arms, back, neck or jaw

Many of the milder side effects that you may experience when you begin taking Vorinostat will disappear without further medical attention, as your body adjusts to the new drug. Your doctor will be able to advise you on ways to reduce or prevent many of the side effects. However, if you find that the unpleasant effects persist and are causing you problems, always consult your medical professional. Not all the recognized side-effects of Vorinostat affect patients, and some people may experience other unpleasant effects. If you notice any other effects, always check with your doctor or seek medical advice from another health professional.

If you have ever had any unusual or allergic reactions to any medication, including Vorinostat, be sure to tell your doctor or the prescribing physician who is treating you. You must also remember to tell your health care professional if you are allergic to any form of food additives, including:

  • food dyes
  • preservatives
  • food types
  • animals

It is also important to mention any non-prescription products, including herbal supplements or vitamins.

Dosage

You should note that the dosage of this medicine will vary between patients. Be sure to take the dose as directed by your doctor or follow the directions given on the product label. Never alter the dose that you are taking unless you are instructed to do so by your treating physician or doctor.

The dose of medicine that you are prescribed varies depending on the strength of the preparation. It also depends on the number of doses that you are required to take each day, the time elapsed between doses, and the time period over which you take the medicine. You should not stop taking the medicine until your doctor or medical team instruct you to do so.

When used as a treatment for cutaneous T-cell lymphoma and dispensed in oral, capsule form, Vorinostat should be prescribed as follows:

  • adults - 400mg once per day
  • children - dose will be determined by your treating physician

Your doctor may adjust the dose of this medicine as required, depending on the progression of your condition and the efficacy of the drug.

If you miss a dose of your medication, always take it as soon as possible. However, if you take multiple doses across the day and your next dose is nearly due, skip the dose you have omitted and just go back to your usual dosing schedule. Never take a double dose.

Vorinostat comes in capsule form. You must swallow the capsule whole and with food. Do not break the capsule open, chew it or crush it. If the capsule becomes damaged and the powder it contains comes into contact with your skin, wash it off immediately with soap and water.

One of the more common side effects of Vorinostat is nausea. If you are badly affected, you may vomit. However, it is very important that you continue to take your medication as per the instructions of your doctor, even if you begin to feel unwell. It is possible that these side effects will resolve on their own as your body gets used to the medication. Alternatively, your doctor may be able to suggest ways in which you can reduce the side effects of the medication.

You should try to drink at least two pints of water or other fluids each day while you are taking Vorinostat. This is important to stop you from becoming dehydrated and to keep your kidneys working efficiently. Vorinostat is provided with a patient information insert. Be sure to read the instructions on the insert and follow them carefully. If you have any questions, ask your medical team for advice.

Drug interactions

In many cases, it is perfectly safe to use a combination of different medications together. However, there are some drugs that should not be used with Vorinostat. In these cases, your doctor may change the dose or alter the drug regime you are currently on. You must inform your health professional if you are taking any of the drugs listed below if you are also prescribed Vorinostat. These interactions are listed because of their potential significance, but the list is not necessarily substantive.

It is not recommended that you take Vorinostat if you are already taking any of the medications listed below. Your medical team may decide not to prescribe Vorinostat, or they may change some of the other drugs you take instead:

  • Amisulpride
  • Bepridil
  • Amifampridine
  • Mesoridazine
  • Pimozide
  • Sparfloxacin
  • Cisapride
  • Dronedarone
  • Piperaquine
  • Saquinavir
  • Terfenadine
  • Thioridazine
  • Ziprasidone

The following medications are not usually recommended for use together with Vorinostat, although your doctor may decide that mutual use is appropriate in some cases. If both medicines are prescribed together, your dosage may be altered or the frequency of use of one or both of the medicines may be changed.

  • Arsenic Trioxide
  • Anagrelide
  • Amiodarone
  • Buserelin
  • Aripiprazole
  • Dabrafenib
  • Clarithromycin
  • Degarelix
  • Deslorelin
  • Crizotinib
  • Delamanid
  • Domperidone
  • Donepezil
  • Efavirenz
  • Escitalopram
  • Goserelin
  • Fluoxetine
  • Gonadorelin
  • Hydroxychloroquine
  • Histrelin
  • Hydroxyzine
  • Ivabradine
  • Ketoconazole
  • Leuprolide
  • Levofloxacin
  • Metronidazole
  • Moxifloxacin
  • Nafarelin
  • Ondansetron
  • Panobinostat
  • Pasireotide
  • Pazopanib
  • Pimavanserin
  • Pitolisant
  • Quetiapine
  • Sevoflurane
  • Sotalol
  • Sulpiride
  • Tacrolimus
  • Triptorelin
  • Valproic Acid
  • Vandetanib
  • Vemurafenib
  • Vinflunine
  • Zuclopenthixol

The use of any of the following listed medications can cause an increased risk of some of the side effects previously listed. However, using both drugs may be the most effective treatment for your condition. If both the medicines are prescribed together, your medical professional may alter the dose or change how frequently you use one or both of the drugs.

  • Warfarin
  • Acenocoumarol
  • Phenprocoumon
  • Dicumarol

It is the case that some medications, including Vorinostat, should not be used when you are consuming certain types of food or when using tobacco or alcohol, as to do so could cause interactions and side effects to occur. If you use alcohol or tobacco, you should discuss this with your doctor.

There are some other medical conditions that can affect the use of Vorinostat. You must be sure to inform your medical professional if you suffer from any of the following medical conditions:

The use of Vorinostat in patients suffering from any of the aforementioned conditions can make these illnesses worse.

Warnings

Vorinostat can lower the number of white cells in your blood, and this increases your chances of getting an infection. It can also reduce the number of platelets, which your body needs for efficient blood clotting. However, there are a number of precautions that you can take when your blood count is low to reduce the risk of bleeding or infection.

Try to avoid interaction with people who have infections, such as colds or flu. If you do feel that you are getting a fever, chills, hoarseness or a cough, check with your doctor straight away. Similarly, if you experience painful or difficult urination, back or side pain, speak to your doctor; this could be symptomatic of a kidney or urinary tract infection.

Take extra care when brushing or flossing your teeth and when using a toothpick so that you don't accidentally cause your gums to bleed. Ask your doctor or dentist for alternative ways of cleaning your teeth and gums. If you need any dental work, always check with your doctor first.

Avoid touching the inside of your nose and your eyes, unless you have just washed your hands and have not touched anything else subsequently.

When using sharp objects such as nail clippers or a safety razor, take extra care not to cut yourself.

Do not play contact sports or undertake activities that could result in injury until you have stopped taking the medication and your doctor has given you the all-clear to resume your normal activities.

This medicine can affect your blood sugar levels. If you become aware of any changes in your urine or blood sugar tests, always check with your doctor.

It is not known whether Vorinostat can be used safely in children or whether its use would be effective in their treatment. For more advice, consult a medical specialist. Studies carried out on the use of Vorinostat in the elderly have not shown any geriatric-specific problems that would preclude its use.

If you are pregnant and your medical team recommends Vorinostat for the treatment of your cutaneous T-cell lymphoma, you should be aware that the drug can present a risk to the fetus in some pregnant women across all trimesters. However, if your life is at risk from your condition, the benefits of this drug therapy regime may outweigh the potential risks to your unborn baby.

It has not been established through research whether there is a risk to infants when using Vorinostat while breastfeeding. You should ask your doctor for more advice when weighing the potential benefits against the possible risks before breastfeeding while taking this medication.

It should also be noted that using Vorinostat in patients with hypoglycemia (high blood sugar) can cause blood sugar levels to rise. If you are suffering from bowel or stomach problems, such as vomiting, nausea or diarrhea, these problems should be treated and resolved first, before you begin using Vorinostat.

Vorinostat can be harmful to unborn babies. If you are prescribed this medication, be sure to use an effective method of birth control to avoid becoming pregnant. If you think that you have become pregnant while you are taking Vorinostat, you must inform your doctor immediately.

Drugs formulated for the treatment of cancer are very strong and can cause many side effects. It is therefore important that you fully understand the benefits and risks of taking Vorinostat before you begin your treatment. You should also work closely with your medical team throughout your treatment.

Storage

Always store this medication at room temperature and in a sealed container. Keep the medication away from direct sunlight and heat sources, and do not allow the packaging to get wet. Do not freeze the medication.

Keep the medication well out of the reach of children and pets.

If you have medication that is out of date or is no longer required, do not dispose of it by flushing it down the toilet or putting it in your trash. Ask your doctor or hospital physician how you should safely dispose of any unwanted medication.

Summary

Vorinostat is used in the treatment of T-cell lymphoma (CTCL), a form of cancer. After you have been prescribed this medication, be sure to attend your doctor for regular progress checks to make sure that the treatment is working correctly. You may have to undergo blood and urine tests in order to screen for any unwanted effects.

Vorinostat can cause blood clotting problems in some patients. If you begin to experience chest, groin or leg pain, especially in your calves, consult your doctor without delay. Similarly, if you experience problems breathing, shortness of breath, sudden headaches, loss of coordination, weakness or numbness in your arms or legs, slurred speech or visual impairment, contact your doctor immediately; these may be signs of blood clotting problems. Prior to undergoing any medical tests, be sure to tell the doctor in charge that you are taking Vorinostat. This is important as some test results can be affected by this drug.

This drug can be extremely effective in the treatment of cutaneous T-cell lymphoma. Patients should work closely with their medical team to determine the best dosage and to combat any side-effects that present during treatment.

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Last Reviewed:
December 23, 2017
Last Updated:
April 05, 2018
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