Panobinostat (Farydak®)

About This Drug

Panobinostat is used to treat cancer. It is given orally (by mouth).

Possible Side Effects

  • Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding
  • Fever
  • Tiredness
  • Decreased appetite (decreased hunger)
  • Nausea and throwing up (vomiting)
  • Loose bowel movements (diarrhea)
  • Swelling of your legs, ankles and/or feet
  • Changes in your electrolytes
  • Changes in your kidney function
  • Changes in your liver function

Note: Each of the side effects above was reported in 20% or greater of patients treated with panobinostat. Not all possible side effects are included above.

Warnings and Precautions

  • Severe bone marrow depression
  • Severe infections, including viral, bacterial and fungal, which can be life-threatening
  • Changes in the tissue of the heart, which can belife-threatening. Some changes may happen that can cause your heart to have less ability to pump blood or cause heart attack. You may have abnormal heartbeat.
  • Abnormal bleeding, which can be life-threatening– symptoms may be coughing up blood, throwing up blood (may look like coffee grounds), red or black tarry bowel movements, abnormally heavy menstrual flow, nosebleeds or any other unusual bleeding.
  • Changes in your liver function
  • Severe diarrhea

How to Take Your Medication

  • Swallow the medicine whole with or without food at the same time each day.Do not chew, crush or open it.
  • If any of the capsules are broken, do not touch them with bare hands. Carefully throw away the capsules and wash your hands after handling.
  • If you get any of the content of a broken capsules on your skin or in your eyes, you should wash the area of the skin well with soap and water right away. Call your doctor if you get a skin reaction
  • Missed dose: If you miss a dose, take it as soon as you think about it.If it is within 12 hours of your next dose, then skip the missed dose and contact your physician.
  • If you vomit a dose, take your next dose at the regular time. Do not take 2 doses at the same time
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • Storage: Store this medicine in the original container at room temperature. Discuss with your nurse or your doctor how to dispose of unused medicine

Treating Side Effects

  • Manage tiredness by pacing your activities for the day.
  • Be sure to include periods of rest between energy-draining activities.
  • To decrease infection, wash your hands regularly.
  • Avoid close contact with people who have a cold, the flu, or other infections.
  • Take your temperature as your doctor or nurse tells you, and whenever you feel like you may have a fever.
  • To help decrease bleeding, use a soft toothbrush. Check with your nurse before using dental floss.
  • Be very careful when using knives or tools.
  • Use an electric shaver instead of a razor.
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • To help with decreased appetite, eat small, frequent meals.
  • Eat high caloric food such as pudding, ice cream, yogurt and milkshakes.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.

Food and Drug Interactions

  • Do not eat grapefruit, starfruit, and pomegranate or drink grapefruit juice or pomegranate juice while taking this medicine.Grapefruit and grapefruit juice may raise the levels of panobinostat in your body. This could make side effects worse.
  • Check with your doctor or pharmacist about all other prescription medicines and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are known drug interactions with panobinostat. Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.
  • Avoid the use of St. John’s Wort while taking panobinostat as this may lower the levels of the drug in your body, which can make it less effective

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Fatigue that interferes with your daily activities
  • Feeling dizzy or lightheaded
  • Easy bleeding or bruising
  • Blood in your urine, vomit (bright red or coffee-ground) and/or stools ( bright red, or black/tarry)
  • Coughing up blood
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back or it can be constant. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Loose bowel movements (diarrhea) 4 times or loose bowel movements with lack of strength or a feeling of being dizzy
  • Weight gain of 5 pounds in one week (fluid retention)
  • Decreased urine, or very dark urine
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • If you think you may be pregnant or may have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of childbearing potential should use effective methods of birth control during your cancer treatment and for at least 3 months after treatment. Men with female partners of childbearing potential should use condoms during your cancer treatment and for at least 6 months after your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
  • Breastfeeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breastfeeding during treatment with this drug because this drug may enter the breast milk and cause harm to a breastfeeding baby.
  • Fertility warning: In men and women both, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children.Ask for information on sperm or egg banking.

Revised March 2018

This information is intended to provide helpful health information to the general public and is not to be used in place of any medical, health, psychological, or any other kind of personal professional services. The information herein does not cover all possible uses, actions, precautions, side effects, or interactions of the medicines mentioned, nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular medication. The dose, method of administration and contraindications for any administered medication should be confirmed before use. UPMC specifically disclaims all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any medication mentioned herein.