HDAC inhibitor

Panobinostat (Specialist drug)

Brand names: Farydak

Panobinostat is a specialist oral histone deacetylase inhibitor used in combination therapy for relapsed or refractory multiple myeloma.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It inhibits histone deacetylase enzymes, leading to accumulation of acetylated proteins, altered gene expression, cell-cycle arrest and apoptosis in malignant cells.

Prescribing in practice

It can cause severe and potentially fatal cardiac arrhythmias and QT prolongation as well as severe diarrhoea, so an ECG and electrolytes must be checked and corrected before and during treatment.
Severe thrombocytopenia and other cytopenias are common and require blood count monitoring with dose modification.
It is metabolised by CYP3A4, so avoid concurrent strong CYP3A4 inhibitors and inducers.

Monitoring

Monitor ECG, electrolytes including potassium and magnesium, and full blood count before and during each cycle.

Counselling the patient

Report palpitations, fainting, severe diarrhoea or unusual bruising and bleeding promptly.
Avoid grapefruit and tell your team about all other medicines you take.

Evidence & guidelines

Approval was supported by the PANORAMA 1 trial in combination with bortezomib and dexamethasone for multiple myeloma.

Reference: NICE TA380; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways