REDUCE STARTING DOSE TO 10 MG WHEN COADMINISTERED WITH STRONG CYP3A INHIBITORS E.G., BOCEPREVIR, CLARITHROMYCIN, CONIVAPTAN, INDINAVIR, ITRACONAZOLE, KETOCONAZOLE, LOPINAVIR/RITONAVIR, NEFAZODONE, NELFINAVIR, POSACONAZOLE, RITONAVIR, SAQUINAVIR, TELAPREVIR, TELITHROMYCIN, VORICONAZOLE.
A REDUCTION IN PANOBINOSTAT EXPOSURE IS LIKELY IN THE PRESENCE OF STRONG INDUCERS OF CYP3A.
AVOID COADMINISTRATING PANOBINOSTAT WITH SENSITIVE CYP2D6 SUBSTRATES I.E., ATOMOXETINE, DESIPRAMINE, DEXTROMETHORPHAN, METOPROLOL, NEBIVOLOL, PERPHENAZINE, TOLTERODINE, AND VENLAFAXINE OR CYP2D6 SUBSTRATES THAT HAVE A NARROW THERAPEUTIC INDEX I.E., THIORIDAZINE, PIMOZIDE.
CONCOMITANT USE OF ANTI-ARRHYTHMIC MEDICINES (INCLUDING, BUT NOT LIMITED TO AMIODARONE, DISOPYRAMIDE, PROCAINAMIDE, QUINIDINE AND SOTALOL) AND OTHER DRUGS THAT ARE KNOWN TO PROLONG THE QT INTERVAL (INCLUDING, BUT NOT LIMITED TO CHLOROQUINE, HALOFANTRINE, CLARITHROMYCIN, METHADONE, MOXIFLOXACIN, BEPRIDIL AND PIMOZIDE) IS NOT RECOMMENDED. ANTI-EMETIC DRUGS WITH KNOWN QT PROLONGING RISK, SUCH AS DOLASETRON, ONDANSETRON, AND TROPISETRON CAN BE USED WITH FREQUENT ECG MONITORING