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(pan'' oh bin' oh stat)Panobinostat may cause severe diarrhea and other serious gastrointestinal (GI; affecting the stomach or intestines) side effects. If you experience any of the following symptoms, call your doctor immediately: stomach cramps; loose stools; diarrhea; vomiting; or dry mouth, dark urine, decreased sweating, dry skin, and other signs of dehydration. Talk to your doctor about what you should do if you develop diarrhea during your treatment with panobinostat. Also talk to your doctor before taking any laxatives or stool softeners while you are taking this medication. Panobinostat may cause serious or life-threatening heart problems during your treatment. Tell your doctor if you have recently had a heart attack or if you have long QT syndrome (condition that increases the risk of developing an irregular heartbeat that may cause fainting or sudden death), angina (chest pain), or other heart problems. Your doctor will order tests such as an electrocardiogram (ECG; test that records the electrical activity of the heart) before and during your treatment to see if it is safe for you to take panobinostat. If you experience any of the following symptoms, call your doctor immediately: chest pain, rapid, pounding, or irregular heart beat, lightheadedness, feeling faint, dizziness, blue-colored lips, shortness of breath, or swelling of the hands, arms, feet, ankles, or lower legs. Keep all appointments with your doctor and the laboratory. Your doctor will order certain tests to check your body's response to panobinostat. Talk to your doctor about the risks of taking panobinostat.
Before taking panobinostat,
- tell your doctor and pharmacist if you are allergic to panobinostat, any other medications, or any of the ingredients in panobinostat capsules. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: amiodarone (Cordarone, Nexterone, Pacerone); antifungals such as itraconazole (Onmel, Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), and voriconazole (Vfend); atomoxetine (Strattera); bepridil (Vascor; no longer available in the U.S.); boceprevir (Victrelis); carbamazepine (Carbatrol, Tegretol, Teril, others); chloroquine (Aralen); clarithromycin (Biaxin, in PrevPac); conivaptan (Vaprisol); desipramine (Norpramin); dextromethorphan; disopyramide (Norpace); dolasetron (Anzemet); certain medications for HIV such as indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra, in Viekira Pak), saquinavir (Invirase); methadone (Dolophine, Methadose); metoprolol (Lopressor, Toprol-XL); moxifloxacin (Avelox); nebivolol (Bystolic); nefazodone; ondansetron (Zofran, Zuplenz); perphenazine; pimozide (Orap); phenobarbital; phenytoin (Dilantin, Phenytek); procainamide; quinidine (in Nuedexta); rifampin (Rifadin, Rimactane, in Rifamate, in Rifater); sotalol (Betapace, Sorine, Sotylize); telaprevir (Incivek; no longer available in U.S.); telithromycin (Ketek); thioridazine; tolterodine (Detrol); and venlafaxine (Effexor). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor what herbal products you are taking, especially St John's wort.
- tell your doctor if you have an infection or have or have ever had bleeding problems or liver disease.
- tell your doctor if you are pregnant or plan to become pregnant. Panobinostat may harm the fetus. Use birth control to prevent pregnancy during your treatment with panobinostat and for at least 1 month after the last dose. If you are a man and your partner can become pregnant, you should use a condom while taking this medication and for 90 days after your treatment is completed. Ask your doctor if you have questions about types of birth control that will work for you. If you become pregnant while taking panobinostat, call your doctor immediately.
- tell your doctor if you are breastfeeding. You should not breastfeed while taking panobinostat.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking panobinostat.
- weight loss
- black, tarry, or bloody stools
- bloody vomit or vomited material that looks like coffee grounds
- unusual bruising or bleeding
- pink or brown urine
- blood in phlegm
- changes in your speech
- fever, cough, chills, sweating or other signs of infection
- pale skin
- nausea, vomiting, loss of appetite, dark urine, stomach pain, extreme tiredness, lack of energy, or yellowing of skin or white of eyes