[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Histone deacetylase (HDAC) inhibitors](https://durgical.com/en/pharmacology/classes/histone-deacetylase-inhibitors/) › Vorinostat

# Vorinostat

## Histone deacetylase (HDAC) inhibitors?

Histone deacetylase (HDAC) inhibitors

## High alert?

An error with this medicine can cause serious harm: double checks and protocols are used.

Oral histone deacetylase inhibitor for cutaneous T-cell lymphoma. Watch for dehydration, high blood sugar, low platelets and blood clots.

Updated Nov 1, 2026

Also called: SAHA (suberoylanilide hydroxamic acid)

## Quick facts

**Group**
[Histone deacetylase (HDAC) inhibitors](https://durgical.com/en/pharmacology/classes/histone-deacetylase-inhibitors/)

**Target**
Histone deacetylases (class I HDAC1, 2 and 3, and HDAC6)

**Used for**
Cutaneous T-cell lymphoma

**Key effects**
Diarrhoea · Fatigue · Taste changes

**Monitor**
Complete blood count · Electrolytes · Signs of clots

**ATC**
L01XH01

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Clinical What the labels mean

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

✂**Histone deacetylases (class I HDAC1, 2 and 3, and HDAC6)**Vorinostat

ⓘ The crystal structure shows vorinostat in the active site of human HDAC2, with its hydroxamic acid holding the catalytic zinc ion.

**Target in 3D:** Histone deacetylases (class I HDAC1, 2 and 3, and HDAC6). PDB structure 4LXZ (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/4LXZ) · Drag to rotate · pinch to zoom

Vorinostat binds the active site of histone deacetylases and chelates the zinc ion there. HDAC1, 2, 3 and 6 are inhibited, so acetylated histones and other acetylated proteins, including transcription factors needed for differentiation, accumulate. Gene expression changes, and some cancer cells stop the cell cycle or undergo apoptosis.

- Vorinostat enters the HDAC active site
- Its hydroxamic acid chelates the zinc ion
- Acetylated histones accumulate and chromatin opens
- Silenced genes return: arrest or apoptosis

## Indications

- Cutaneous T-cell lymphoma with progressive, persistent or recurrent skin disease during or after two systemic therapies. [Mycosis fungoides and Sézary syndrome (cutaneous T-cell lymphoma) →](https://durgical.com/en/conditions/mycosis-fungoides-and-sezary-syndrome/)

## Adverse effects

### Common

- Diarrhoea, nausea, vomiting, decreased appetite, weight loss
- Fatigue, dizziness, drowsiness
- Taste changes, dry mouth
- Thrombocytopenia, anaemia
- Hair loss, itching, muscle aches

### Serious (rare, important)

- Pulmonary embolism and deep vein thrombosis
- Dehydration from vomiting and diarrhoea
- Hyperglycaemia
- Severe thrombocytopenia with bleeding
- Heart rhythm problems (fast heartbeat, fainting)

## Contraindications

- Severe liver impairment (excluded from treatment)
- Caution with prior blood clots, diabetes, rhythm problems and low potassium or magnesium

## Key interactions

**Drugs that prolong the QT interval or lower potassium or magnesium**
Add to the risk of rhythm problems; electrolytes are corrected.

**Anticoagulants and antiplatelet drugs**
Bleeding risk is higher when platelets fall; coagulation tests and counts are watched.

## What is monitored

- Complete blood count, especially platelets
- Electrolytes (potassium, magnesium), creatinine and glucose
- ECG when there is a risk of QT prolongation
- Signs of clots: painful leg swelling, chest pain, breathlessness
- Hydration

## Administration and safety

- Oral, once a day with food at about the same time.
- Capsules are swallowed whole and not opened or crushed.
- Plenty of fluids are taken every day to prevent dehydration.
- Hazardous oral chemotherapy: handled with gloves and kept away from children; caregivers who are pregnant avoid handling it.

## Pregnancy and breastfeeding

May harm the fetus; a pregnancy test is done before starting and effective contraception is used; breastfeeding is avoided during treatment and shortly after.

## Nursing care

- Ask about diarrhoea and vomiting and check for dehydration.
- Check glucose, especially in people with diabetes.
- Ask about leg swelling, chest pain or sudden breathlessness (clots).
- Teaching: drink plenty of fluids, report bleeding or bruising, be careful driving if drowsy, tell lab staff about the treatment.

## Pharmacokinetics

**Absorption**
Oral; absorption is slightly better with a meal.

**Metabolism**
Mostly glucuronidation and hydrolysis.

**Half-life**
Short, about 2 hours.

## Memory aid

«SAHA grabs zinc»: vorinostat's hydroxamic acid holds the HDAC zinc; side effects «Dry (dehydration), Sweet (glucose), Sticky (clots), Bleeding (platelets)».

## Test yourself

Think of the answer, then tap the question to see it.

## What enzyme family does vorinostat inhibit?

Histone deacetylases (HDACs).

## How does vorinostat bind its target?

It binds the HDAC active site and chelates the catalytic zinc ion.

## Which lymphoma is vorinostat used for?

Cutaneous T-cell lymphoma.

## Which two metabolic or vascular problems are watched with vorinostat?

Any two of: hyperglycaemia, dehydration, blood clots (pulmonary embolism, deep vein thrombosis).

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/pharmacology/vorinostat/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## What the labels mean

**High alert**
An error with this medicine can cause serious harm: double checks and protocols are used.

## Connections

## Related drugs 1

- [Romidepsin](https://durgical.com/en/pharmacology/romidepsin/)

## Related conditions 1

- [Mycosis fungoides and Sézary syndrome (cutaneous T-cell lymphoma)](https://durgical.com/en/conditions/mycosis-fungoides-and-sezary-syndrome/)

[← Back to the class: Histone deacetylase (HDAC) inhibitors](https://durgical.com/en/pharmacology/classes/histone-deacetylase-inhibitors/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Vorinostat: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a607050.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [Vorinostat - NCI](https://www.cancer.gov/about-cancer/treatment/drugs/vorinostat) (National Cancer Institute, 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01XH01) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/vorinostat/