Vorinostat

ZOLINZA

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Pronunciation: vor-IN-oe-stat (zoe-LINZ-a)

Vorinostat ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Vorinostat ballicule

What it isHistone deacetylase inhibitor; cutaneous T-cell lymphoma.

Why this oneOral epigenetic therapy for a disease with few systemic options.

What limits itThrombocytopenia, fatigue and QT prolongation. Dehydration from GI losses is common.

Vorinostat molecular structure (skeletal formula) — Molecular structure: Vorinostat

Vorinostat prescription history

Animated chart of estimated U.S. prescriptions per year, Oral anticancer meds (1953–2026). Vorinostat enters in 2006 (estimated).

FDA-approved for

cutaneous T-cell lymphoma (2006)

Principal riskThrombocytopenia and QT prolongation

Classes and tags

Clinical profile

Therapeutic safety burden3 / 4

Overdose danger2 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk3 / 4

Legacy pregnancy categoryD

Defining liabilityMyelosuppression and agent-specific hepatic, cardiac, pulmonary, neurologic or reproductive toxicity require oncology monitoring.

FDA label

Read the full label on DailyMed ↗

NO BOXED WARNINGS

FDA dosing	Population	Start	Target	Max
Cutaneous T-cell lymphoma (CTCL)	adult	400 mg QD	400 mg QD	400 mg QD

Renal Undefined

Hepatic Mild-moderate (bilirubin 1-3×ULN or AST>ULN): reduce to 300 mg QD; severe: insufficient data

For intolerance, may reduce to 300 mg QD, then 300 mg QD for 5 consecutive days/week

Instructions

Take with food
Swallow whole; do not open or crush capsules
Effective contraception during and after treatment (females 6 mo, males 3 mo)
Drink ≥2 L/day fluids to prevent dehydration

Available strengths

cap 100 mg

Cautions

Thromboembolism (PE, DVT)
Myelosuppression (thrombocytopenia, anemia) — monitor CBC
GI toxicity (nausea, vomiting, diarrhea); prevent dehydration
Hyperglycemia — monitor glucose
Electrolyte/creatinine abnormalities — monitor and correct
Severe thrombocytopenia with concomitant HDAC inhibitors (e.g., valproic acid)
Embryo-fetal toxicity

Adverse reactions

Diarrhea
Fatigue
Nausea
Thrombocytopenia
Anorexia
Dysgeusia

Pregnancy Can cause fetal harm; advise of potential risk to fetus

Lactation Do not breastfeed during and for ≥1 week after last dose

Cost

Vorinostat (ZOLINZA)

Strength		#/mo	generic $/mo	CostPlus
100 mg	cap	30 qd		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Vorinostat is dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entry2027 est.

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Self-check

Which enzyme class does vorinostat inhibit?
Histone deacetylases.
What can cause dehydration during vorinostat treatment?
GI losses.