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Panobinostat and Zorvolex

Determining the interaction of Panobinostat and Zorvolex and the possibility of their joint administration.

Check result:
Panobinostat <> Zorvolex
Relevance: 17.08.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using panobinostat together with diclofenac may increase the risk of bleeding. In clinical studies, treatment with panobinostat alone has been associated with severe and sometimes fatal hemorrhage. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as dizziness, lightheadedness, red or black tarry stools, coughing up or vomiting fresh or dried blood that looks like coffee grounds, severe headache, and weakness. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR CLOSELY: Coadministration of panobinostat and drugs that interfere with platelet function or coagulation may potentiate the risk of bleeding complications. Treatment with panobinostat has been associated with severe thrombocytopenia and hemorrhage (including gastrointestinal and pulmonary hemorrhage) with fatal outcomes. The risk may be increased in patients with coagulation disorders or those on chronic anticoagulation therapy. In a phase III clinical trial in patients with relapsed multiple myeloma, treatment-emergent grade 3 to 4 (CTCAE) thrombocytopenia and hemorrhage was reported in 67% and 4.2% of panobinostat-treated patients, respectively. In the same phase III clinical trial, there were 5 patients treated with panobinostat who died due to a hemorrhagic event, compared to 1 in the control arm. The patients with fatal bleeding events reported in the clinical trial had at least grade 3 (CTCAE) thrombocytopenia at the time of the event.

MANAGEMENT: Concomitant use of other medications that interfere with platelet function or coagulation should be considered cautiously in patients treated with panobinostat. Close clinical and laboratory observation for bleeding complications is recommended during therapy. A complete blood cell count should be performed prior to and at least weekly during treatment according to treatment protocols, including monitoring for thrombocytopenia. Dose modifications may be required based on individual patient tolerability. Patients should be advised to promptly report any signs of bleeding to their doctor, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools. Since panobinostat is indicated in combination with bortezomib and dexamethasone, the manufacturer labeling for these products should also be consulted for additional information.

References
  • Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  • Cerner Multum, Inc. "Australian Product Information." O 0
  • "Product Information. Farydak (panobinostat)." Novartis Pharmaceuticals, East Hanover, NJ.
Panobinostat

Generic Name: panobinostat

Brand name: Farydak

Synonyms: n.a.

Zorvolex

Generic Name: diclofenac

Brand name: Cambia, Cataflam, Voltaren-XR, Zipsor, Zorvolex, Voltaren, Dyloject, also Cambia

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle
Disease interaction