Vorinostat Disease Interactions

The use of vorinostat may cause pulmonary embolism and deep vein thrombosis. It is recommended to monitor for signs and symptoms of these events, particularly in patients with a prior history of thromboembolic events.

The use of vorinostat may cause hyperglycemia. It is recommended to monitor serum glucose every 2 weeks during the first 2 months of therapy and monthly thereafter. Care should be exercised when using this agent in diabetic patients.

The use of vorinostat may cause gastrointestinal disturbances. It is recommended to adequately control any preexisting nausea, vomiting, and diarrhea prior to beginning treatment with vorinostat. Fluid and electrolytes should be replaced to prevent dehydration and the use of antiemetic and antidiarrheal medications may be appropriate. Correct hypokalemia and hypomagnesemia prior to administration of vorinostat. Monitor potassium and magnesium more frequently in symptomatic patients.

Compared to patients with normal liver function, AUC increases of 50 to 66% were observed in patients with hepatic impairment. It is recommended to reduce the starting dose of vorinostat to 300 mg orally once daily with food in patients with mild to moderate hepatic impairment (bilirubin 1 to 3 × ULN or AST greater than ULN). There is insufficient evidence to recommend a starting dose for patients with severe hepatic impairment (bilirubin greater than 3 × ULN). Precautions should be instituted when using this agent in patients with liver dysfunction.

The use of vorinostat can cause dose-related thrombocytopenia and anemia. It is recommended to monitor blood counts every 2 weeks during the first 2 months of therapy and monthly thereafter. Adjust dosage or discontinue treatment as clinically appropriate. Care should be exercised when using this agent in patients with bone marrow suppression.