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The following information outlines crucial safety warnings and risks associated with the use of Zolinza (vorinostat). Patients and healthcare professionals should review this carefully and consult with a healthcare provider if any concerns arise.

• Blood Clots: Although infrequent, some individuals using Zolinza may develop blood clots, such as deep vein thrombosis (DVT) or pulmonary embolism (PE). Immediate medical attention is required if there is swelling in one limb, sudden chest pain, or difficulty breathing, as these could indicate a blood clot. Patients with a history of blood clots should be particularly cautious.

• Reduced Blood Cell Counts: This medication may lower red blood cell (RBC) and platelet levels, potentially causing fatigue and breathing difficulties due to the reduced oxygen-carrying capacity of the blood.

• Gastrointestinal Issues: Nausea, vomiting, and diarrhea are reported side effects. Healthcare providers may prescribe antiemetics like ondansetron (Zofran) or prochlorperazine (Compazine) to alleviate these symptoms. Consultation with a dietician may also be recommended to manage dietary habits to minimize stomach discomfort.

• Increased Blood Sugar Levels: Some patients may experience elevated blood sugar (hyperglycemia), which is generally mild but can be severe in about 5% of cases. Blood sugar monitoring is advised every two weeks during the initial two months of treatment. Patients with diabetes or a history of high blood sugar should monitor their levels at home and report any symptoms of excessive thirst and frequent urination to their oncologist immediately.

• Electrolyte Imbalance: Zolinza can alter electrolyte levels, including potassium, magnesium, and calcium. Regular blood tests are recommended every two weeks for the first two months, and then monthly. If imbalances occur, supplements may be prescribed. Symptoms such as nausea, vomiting, and diarrhea should be reported promptly.

• Risks to Pregnancy: The effects of Zolinza on human pregnancy are not well-studied, but animal studies suggest potential harm to an unborn baby, including miscarriage. Individuals who can become pregnant should use effective contraception during treatment and for six months afterward. Those who can impregnate others should use contraception, like condoms, during treatment and for three months following the last dose.

Please ensure to follow these guidelines closely and maintain open communication with your healthcare provider throughout your treatment with Zolinza (vorinostat).

When taking this medication, you may encounter a range of side effects, some of which are more common and generally mild. These include tiredness, changes in taste, dry mouth, headache, dizziness, nausea, diarrhea, vomiting, weight loss, loss of appetite, and hair loss. Additionally, some individuals may experience higher serum sugar levels, protein in urine, and increased serum creatinine. If these effects persist or worsen, it's important to consult your healthcare provider for guidance.

There are other side effects that, while less common, may still occur. These include muscle spasms, chills, constipation, itching, and swelling in the arms and legs. Though these effects are typically manageable, it's advisable to inform your healthcare provider if you notice them, especially if they become severe.

This medication may also cause more serious side effects, although they are rare. These include blood clots in the legs or lungs, which can manifest as severe chest pain, trouble breathing, or significant pain and swelling in one leg. There is also a risk of serious bleeding, such as nosebleeds or blood in stools, and dangerously high blood sugar levels, which can lead to increased thirst, more frequent urination, and blurry vision. Immediate medical attention is crucial if you experience any of these severe symptoms.

In very rare cases, a serious allergic reaction may occur, characterized by rash, swelling, severe dizziness, or difficulty breathing. Should you encounter such reactions, seek emergency medical assistance. While this summary covers many potential side effects, it is not exhaustive. If you notice any other unusual effects, be sure to contact your healthcare provider.

Zolinza (vorinostat) may have interactions with various medications, so it's crucial to inform your doctor and pharmacist about all drugs and supplements you are taking. This includes both prescription and over-the-counter medications, as well as vitamins and herbal supplements.

Certain medications should not be used with Zolinza. Your doctor might opt not to prescribe this drug or adjust your other medications. These include Bepridil, Cisapride, Dronedarone, Mesoridazine, Pimozide, Piperaquine, Saquinavir, Sparfloxacin, Terfenadine, Thioridazine, and Ziprasidone.

There are some medications that are generally not recommended with Zolinza, but may be necessary in specific situations. If these are prescribed together, your doctor may adjust the dosage or frequency. Such medications include Amiodarone, Amisulpride, Anagrelide, Apomorphine, Aripiprazole, Aripiprazole Lauroxil, Arsenic Trioxide, Buprenorphine, Buserelin, Ceritinib, Chloroquine, Clarithromycin, Clofazimine, Clozapine, Crizotinib, Dabrafenib, Dasatinib, Degarelix, Delamanid, Deslorelin, Deutetrabenazine, Domperidone, Donepezil, Efavirenz, Encorafenib, Entrectinib, Escitalopram, Fingolimod, Fluconazole, Fluoxetine, Formoterol, Foscarnet, Fostemsavir, Glasdegib, Gonadorelin, Goserelin, Histrelin, Hydroxychloroquine, Hydroxyzine, Inotuzumab Ozogamicin, Ivabradine, Ivosidenib, Ketoconazole, Lefamulin, Lenvatinib, Levofloxacin, Lofexidine, Macimorelin, Methadone, Metronidazole, Mirtazapine, Moxifloxacin, Nafarelin, Nilotinib, Ondansetron, Osilodrostat, Osimertinib, Oxaliplatin, Ozanimod, Panobinostat, Pasireotide, Pazopanib, Pimavanserin, Pitolisant, Ponesimod, Posaconazole, Quetiapine, Ribociclib, Selpercatinib, Sertraline, Sevoflurane, Siponimod, Solifenacin, Sotalol, Sulpiride, Sunitinib, Tacrolimus, Trazodone, Triclabendazole, Triptorelin, Valproic Acid, Vandetanib, Vemurafenib, Vinflunine, Voclosporin, and Zuclopenthixol.

Additionally, using Zolinza with blood thinners such as Warfarin, Acenocoumarol, Dicumarol, or Phenprocoumon may heighten the risk of side effects. However, your doctor might determine that combining these medications is necessary for your treatment and may modify the dosage or administration schedule accordingly.