What are the precautions for taking Vorinostat?

During clinical studies of vorinostat (Vorinostat), warnings and precautions such asthromboembolism, thromboembolism, gastrointestinal toxicity, hyperglycemia, clinical chemistry abnormalities, embryonic-fetal toxicity have emerged. Patients should use drugs to treat cutaneous T-cell lymphoma under the guidance of a doctor.

1. Thromboembolism: Pulmonary embolism occurs in 5% of patients treated with vorinostat, and deep vein thrombosis has also been reported. Monitor for signs and symptoms of these events, especially in patients with a history of thromboembolic events.

2. Myelosuppression: Treatment with vorinostat can cause dose-related thrombocytopenia and anemia. Monitor blood cell counts every two weeks for the first two months of treatment and monthly thereafter. Adjust dose or discontinue treatment with vorinostat based on clinical circumstances.

3. Gastrointestinal toxicity: including nausea, vomiting and diarrhea, which may require the use of antiemetics and antidiarrheals. Fluids and electrolytes should be replenished to prevent dehydration. Preexisting nausea, vomiting, and diarrhea should be adequately controlled before initiating treatment with vorinostat.

4. Hyperglycemia: In clinical trials, 5% of patients treated with vorinostat developed severe hyperglycemia. Patients need to monitor their blood sugar every two weeks for the first two months of treatment, and monthly thereafter.

5. Clinical chemistry abnormalities: Patients undergo chemical tests every two weeks during the first two months of treatment, including serum electrolytes, creatinine, magnesium and calcium, and monthly thereafter. Correct hypokalemia and hypomagnesemia before use5%. Monitor potassium and magnesium more frequently in symptomatic patients (e.g., patients with nausea, vomiting, diarrhea, fluid imbalance, or cardiac symptoms).

6. Severe thrombocytopenia occurs when the drug is combined: It has been reported that severe thrombocytopenia leading to gastrointestinal bleeding may occur in 5% of patients when combined with other HDAC inhibitors (such as valproic acid). Patients should have their platelet counts monitored more frequently.

7. Embryo -Fetal Toxicity: According to the results of animal studies and its mechanism of action, vorinostat taken by pregnant women may cause harm to the fetus. In animal reproduction studies, vorinostat crossed the placenta and caused adverse developmental outcomes at exposures approximately 0.5 times the human exposure based on AUC 0-24 hours. Therefore it is recommended that women of reproductive potential use effective contraceptive methods during treatment and for at least 6 months after the last dose. It is recommended that men who are sexual partners of women of reproductive potential use effective contraceptive methods during treatment and for at least 3 months after the last dose.

The original drug of vorinostat is not currently on the market in China, and therefore cannot be included in the national medical insurance coverage. Overseas, there is an American version of the original drug, specifications100mg*120 pills per box, which may cost around 100,000 yuan (the price may fluctuate due to exchange rate effects). It is very expensive, and there is currently no generic version of vorinostat produced and launched. For more drug information and specific prices, please consult a medical consultant.