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Drug Interactions between panobinostat and PosiFlush

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

heparin flush panobinostat

Applies to: PosiFlush (heparin flush) and panobinostat

MONITOR: Concomitant use of heparin flush and drugs that interfere with platelet function or coagulation or drugs that commonly cause thrombocytopenia may potentiate the risk of bleeding complications. Although uncommon, inadvertent anticoagulation resulting in hemorrhagic events may occur with heparin flushes, particularly during repeated or excessive use or administration of higher concentration flush solutions.

MANAGEMENT: Caution and monitoring (e.g., platelet counts, hematocrits, tests for occult blood in stools) are advised when heparin flushes are given to patients receiving systemic anticoagulants, platelet inhibitors, antithrombotic agents, thrombolytics, or drugs with known risks of thrombocytopenia or bleeding. An unexplained fall in hematocrit, fall in blood pressure, or any other unexplained symptom should lead to serious consideration of a hemorrhagic event.

References (4)
  1. Passannante A, Macik BG (1988) "The heparin flush syndrome: a cause of iatrogenic hemorrhage." Am J Med Sci, 296, p. 71-3
  2. (2022) "Product Information. Heparin Sodium in Sodium Chloride (heparin flush)." Baxter Healthcare Corporation
  3. (2018) "Product Information. Canusal (heparin flush)." Wockhardt UK Ltd
  4. (2022) "Product Information. Heparinised Saline (Pfizer) (heparinised saline)." Pfizer Australia Pty Ltd, pfphepsi10922

Drug and food interactions

Moderate

panobinostat food

Applies to: panobinostat

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of panobinostat. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Increased exposure to panobinostat may increase the risk of adverse effects such as nausea, vomiting, diarrhea, anorexia, peripheral edema, cardiotoxicity, ECG abnormalities, electrolyte disturbances, bleeding complications, hepatotoxicity, and myelosuppression.

Food may delay the rate of absorption of panobinostat, but does not significantly affect the overall extent of absorption. When a single oral dose of panobinostat was administered to 36 patients with advanced cancer 30 minutes after a high-fat meal, panobinostat peak plasma concentration (Cmax) and systemic exposure (AUC) were approximately 44% and 16% lower, respectively, compared to administration under fasting conditions. The median time to maximum concentration (Tmax) was prolonged by 2.5 hours.

MANAGEMENT: Patients should avoid consumption of grapefruit or grapefruit juice during treatment with panobinostat. The manufacturer also recommends avoiding star fruit, Seville oranges, pomegranate, and pomegranate juice. Panobinostat may be administered with or without food.

References (3)
  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. Cerner Multum, Inc. "Australian Product Information."
  3. (2015) "Product Information. Farydak (panobinostat)." Novartis Pharmaceuticals

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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