Vorinostat (patient information)

# Why is this medication 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.

# 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 some 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.

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

# What special precautions should I follow
Before taking vorinostat
- tell your doctor and pharmacist if you are allergic to vorinostat or any other medications.
- 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: amiodarone (Cordarone), anticoagulants ('blood thinners') such as warfarin (Coumadin), cisapride (Propulsid) (no longer available in the US), disopyramide (Norpace), dofetilide (Tikosyn), erythromycin (E.E.S., E-Mycin, Erythrocin), medications to treat heart arrhythmias; moxifloxacin (Avelox), pimozide (Orap), procainamide (Procanbid, Pronestyl), quinidine (Quinidex), sotalol (Betapace, Betapace AF), sparfloxacin (Zagam), thioridazine (Mellaril), 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 heart beat or heart rhythm problems); and heart, kidney, or liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. Vorinostat may cause harm to the fetus. *If you become pregnant while taking vorinostat, call your doctor immediately.
- 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 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 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.

# Side Effects

## Mild side effects
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

## Severe side effects
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 storage conditions are needed for this medicine
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). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local 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.

# Brand names
- Zolinza