Farydak is a brand-name prescription medication. It's used to treat multiple myeloma, which is a type of cancer that affects plasma cells. These are a kind of white blood cell.

Farydak is used with two other multiple myeloma drugs: bortezomib (Velcade) and dexamethasone.

Before your doctor can prescribe Farydak, you must have tried at least two other treatments for your multiple myeloma. These are bortezomib and an immunomodulatory agent (a treatment that helps your body fight cancer cells).

Farydak contains the active drug panobinostat, which belongs to a class of drugs called histone deacetylase inhibitors. (A class of drugs is a group of medications that work in a similar way.)

Farydak comes as a capsule that you swallow with a cup of water. You'll take the drug in 21-day cycles. For weeks 1 and 2, you'll take one capsule every other day. For week 3, you won't take Farydak at all. Your doctor may have you repeat the 21-day cycle several times.

Effectiveness

Farydak was studied in a clinical trial of people with multiple myeloma who had already tried at least two other treatments, including bortezomib and an immunomodulatory agent (either thalidomide or lenalidomide).

Based on blood tests and the presence of cancer cells in bones, multiple myeloma didn't progress or get worse for 10.6 months in people who took Farydak plus bortezomib and dexamethasone.

This was compared with 5.8 months in people who took a placebo (treatment with no active drug) plus bortezomib and dexamethasone.

For more about the effectiveness of Farydak, please see the "Farydak for multiple myeloma" section below.

Farydak is available only as a brand-name medication. It's not currently available in generic form.

A generic drug is an exact copy of a brand-name medication. Generics tend to cost less than brand-name drugs.

Farydak contains the active drug panobinostat. This means panobinostat is the ingredient that makes Farydak work.

The Food and Drug Administration (FDA) approves prescription drugs such as Farydak to treat certain conditions.

Farydak is FDA-approved to treat multiple myeloma in people who have received at least two other treatments for their multiple myeloma. These include bortezomib and an immunomodulatory agent such as lenalidomide (Revlimid). An immunomodulatory agent is a treatment that helps your body fight cancer cells.

Farydak is used with other two other multiple myeloma drugs: bortezomib (Velcade) and dexamethasone.

Multiple myeloma is a type of cancer that forms in plasma cells. These are a kind of white blood cell that help you make antibodies to fight infections. (Antibodies are type of protein.) Multiple myeloma cancer cells build up in the bone marrow, where healthy cells are usually produced.

The multiple myeloma cells take up space and crowd out the healthy cells, so your body can't fight off infections as effectively. Multiple myeloma cells can also cause other health problems, such as weak bones or kidney damage.

Effectiveness

Farydak was studied in a clinical trial of people with multiple myeloma who had already tried at least two other treatments, including bortezomib and an immunomodulatory agent (either thalidomide or lenalidomide).

Based on blood tests and the presence of cancer cells in bones, multiple myeloma didn't progress or get worse for 10.6 months in people who took Farydak plus bortezomib and dexamethasone. This was compared with 5.8 months in people who took a placebo (treatment with no active drug) plus bortezomib and dexamethasone.

About 59% of people who took Farydak plus bortezomib and dexamethasone had a response to treatment. This means they had a reduction in certain markers of multiple myeloma based on blood tests and the presence of cancer cells in bones.

The result was compared with 41% of people who took a placebo plus bortezomib and dexamethasone.

Farydak and children

Farydak isn't approved for use in children. It's not known if the drug is safe or effective to use in this age group.

Farydak can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Farydak. These lists don't include all possible side effects.

For more information on the possible side effects of Farydak, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they've approved. If you would like to report to the FDA a side effect you've had with Farydak, you can do so through MedWatch.

More common side effects

The more common side effects of Farydak can include:

Most of these side effects may go away within a few days or a couple of weeks. If they're more severe or don't go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Farydak aren't common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you're having a medical emergency.

Serious side effects and their symptoms can include:

  • Low blood cell counts. Symptoms can include:
    • unusual bruising or bleeding
    • frequent infections
    • feeling weak or tired
    • looking pale
    • feeling short of breath
  • Liver problems such as increases in the level of liver enzymes (proteins), which shows potential liver damage. Symptoms can include:
    • feeling tired or weak
    • loss of appetite
    • dark- or amber-colored urine
    • abdominal (belly) pain
    • yellowing of your skin or the whites of your eyes

Other serious side effects, explained in more detail below in "Side effect details," include:

*Farydak has boxed warnings for the risk of severe diarrhea and heart problems. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see "FDA warnings" at the beginning of this article.

Side effect details

You may wonder how often certain side effects occur with this drug. Here's some detail on some of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Farydak. However, in clinical studies, there were no reports of allergic reactions with the drug. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Farydak. Call 911 if your symptoms feel life threatening or if you think you're having a medical emergency.

Severe diarrhea

Severe diarrhea can occur with Farydak.* In clinical studies, up to 25% of people who took Farydak plus bortezomib and dexamethasone had severe diarrhea, compared with 8% of people who took a placebo (treatment with no active drug) plus bortezomib and dexamethasone.

And up to 68% of people who took Farydak plus bortezomib and dexamethasone reported having diarrhea, compared with 42% of people who took a placebo plus bortezomib and dexamethasone.

Symptoms of severe diarrhea can include:

  • belly cramps
  • loose stools
  • dehydration, which can cause dry mouth, dry lips, and dry skin

During your treatment, your doctor will regularly test your levels of fluids and electrolytes to make sure that you're not dehydrated. (Electrolytes are minerals that are electrically charged.)

If you have any symptoms of diarrhea while taking Farydak, tell your doctor right away. They may recommend an antidiarrheal drug and have you stop taking Farydak if your diarrhea is too severe. And keep in mind that you shouldn't use any stool softeners or other laxatives while taking Farydak.

Bleeding

Excessive bleeding can occur with Farydak use. In clinical studies, 4% of people who took Farydak plus bortezomib and dexamethasone had severe bleeding, compared with 2% of people who took a placebo plus bortezomib and dexamethasone.

In some instances, the bleeding may be dangerous and lead to death. In the clinical studies, 5 of 381 people who took Farydak plus bortezomib and dexamethasone died because of severe bleeding. Of the 377 people who took a placebo plus bortezomib and dexamethasone, 1 person died because of severe bleeding.

While you take Farydak, your doctor will check your platelet level. (Platelets are blood cells that help with clotting). You may have a higher risk for bleeding if your level is too low.

Symptoms of bleeding can include:

  • blood in your stool or black stool that looks like tar
  • pink or brown urine
  • vomit that looks like coffee grounds
  • coughing up blood or blood clots
  • bruising
  • feeling dizzy or weak
  • headache that lasts a long time

If you have any of these symptoms while taking Farydak, you should tell your doctor right away. They may have you stop taking the drug so the bleeding can be treated. Then they may recommend a medication other than Farydak.

Heart problems

Farydak can cause severe heart problems that may lead to death.*

In clinical studies, 12% of people who took Farydak plus bortezomib and dexamethasone had arrhythmia (problems with their heartbeat), compared with 5% of people who took a placebo plus bortezomib and dexamethasone.

Of the people who took Farydak plus bortezomib and dexamethasone, 4% had a lack of blood flow to the heart, compared with 1% of people who took a placebo plus bortezomib and dexamethasone.

A lack of blood flow to the heart is called an ischemic event, and it can be very dangerous. A heart attack is an example of an ischemic event. Farydak shouldn't be used by people who've had a recent heart attack or who have unstable angina (chest pain).

Problems with the heart's electrical activity can also occur with Farydak.

In the clinical studies, 22% to 40% of people who took Farydak plus bortezomib and dexamethasone had problems with the electrical activity of their heart. This was compared with 4% to 18% of people who took a placebo plus bortezomib and dexamethasone.

If you already have a heart condition called long QT syndrome or other heart problems, you may be at higher risk for additional heart problems while taking Farydak.

Symptoms of heart problems can include:

  • chest pain
  • faster or slower heartbeat
  • feeling like your heart is racing
  • dizziness
  • blue-colored lips
  • shortness of breath
  • swelling of the legs

Your doctor will monitor your heart's electrical activity when you first start taking Farydak and during your treatment. If you notice the above symptoms of heart problems, call 911 right away.

Pneumonia and other infections

The lung infection pneumonia can occur while taking Farydak.

In clinical studies, about 18% of people who used Farydak plus bortezomib and dexamethasone had pneumonia. This was compared with 13% of people who took a placebo plus bortezomib and dexamethasone.

Infections are generally common in people who have multiple myeloma because their immune system is weakened due to the cancer. (The immune system is the body's defense against infection.)

Other types of infections that people had during the clinical studies included bacterial infections, invasive fungal infections, and viral infections. (These are infections caused by bacteria, a fungus, or a virus.)

About 31% of people who took Farydak plus bortezomib and dexamethasone had a severe infection during the clinical studies, compared with 24% of people who took a placebo plus bortezomib and dexamethasone.

Your doctor will monitor you before and during your Farydak treatment for infection. Symptoms of an infection can include:

  • sweating or having chills
  • cough
  • flu-like symptoms
  • blood in your phlegm
  • sores on your body
  • warm or painful areas on your body
  • feeling tired

If you have any of these symptoms while taking Farydak, call your doctor right away. They could mean that you have an infection.

* Farydak has boxed warnings for the risk of severe diarrhea and heart problems. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see "FDA warnings" at the beginning of this article.

The Farydak dosage your doctor prescribes will depend on several factors. These include:

  • any side effects you have while taking Farydak
  • other medical conditions you may have

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Farydak comes as a capsule that you swallow with a cup of water. The drug is available in three strengths: 10 mg, 15 mg, and 20 mg.

Dosage for multiple myeloma

You'll take Farydak in 21-day cycles:

  • During week 1 of treatment, you'll take a 20-mg capsule of Farydak once every other day for three doses. This means that you'll take the drug on days 1, 3, and 5.
  • During week 2 of treatment, you'll continue to take a 20-mg capsule of Farydak once every other day for three doses. This means that you'll take the drug on days 8, 10, and 12.
  • During week 3 of treatment, you won't take Farydak at all.

At first, Farydak can be taken for up to eight 21-day cycles. But if you don't benefit from the drug treatment, your doctor may want you to complete another eight 21-day cycles for a total of 48 weeks.

You'll take Farydak with two other medications: bortezomib (Velcade) and dexamethasone.

What if I miss a dose?

If you miss a dose of Farydak, you can take it as soon as you remember up to 12 hours after the regularly scheduled dose. But if more than 12 hours has passed, skip this dose and wait until your next regularly scheduled Farydak dose. Don't double up on your doses.

To help make sure that you don't miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

No, Farydak is approved to be used for only 16 cycles of treatment. Each cycle is 21 days, so that's 48 weeks total. Most people will take the drug for just eight 21-day cycles. If your multiple myeloma doesn't improve, you may take Farydak for an additional eight 21-day cycles.

Other drugs are available that can treat multiple myeloma. Some may be a better fit for you than others. If you're interested in finding an alternative to Farydak, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that's approved to treat one condition is used to treat a different condition.

Alternatives for multiple myeloma

Examples of other drugs that may be used to treat multiple myeloma include:

  • melphalan (Alkeran injection or tablet)
  • pamidronate (Aredia)
  • cyclophosphamide
  • carmustine
  • doxorubicin (Doxil)
  • elotuzumab (Empliciti)
  • carfilzomib (Kyprolis)
  • lenalidomide
  • pomalidomide (Pomalyst)
  • zoledronic acid (Zometa)

You may wonder how Farydak compares with other medications that are prescribed for similar uses. Here we look at how Farydak and Pomalyst are alike and different.

Ingredients

Farydak contains the active drug panobinostat, which belongs to a class of drugs called histone deacetylase inhibitors. (A class of drugs is a group of medications that work in a similar way.)

Pomalyst contains the active drug pomalidomide, which belongs to a class of drugs called thalidomide analogs.

Uses

The Food and Drug Administration (FDA) has approved both Farydak and Pomalyst to treat multiple myeloma in people who have received at least two other treatments for their condition. Multiple myeloma is a type of cancer that affects certain white blood cells called plasma cells.

With Farydak, you must have already tried bortezomib (Velcade) and an immunomodulatory agent, which is a treatment that helps your body fight cancer cells. Farydak is used with two other multiple myeloma drugs: bortezomib and dexamethasone.

With Pomalyst, you must've already tried lenalidomide and a proteasome inhibitor, but your multiple myeloma still got worse.

Drug forms and administration

Both Farydak and Pomalyst come as capsules that you swallow with water.

Side effects and risks

Farydak and Pomalyst both contain drugs that treat multiple myeloma. Therefore, these medications can cause some similar and some different side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Farydak, with Pomalyst, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Farydak, with Pomalyst, or with both drugs (when taken individually).

  • Can occur with Farydak:
  • Can occur with Pomalyst:
    • birth defects if a woman or her sexual partner takes Pomalyst and becomes pregnant**
    • severe allergic reactions
    • severe skin reactions such as Stevens-Johnson syndrome, toxic epidermal necrolysis, or drug reaction with eosinophilia and systemic symptoms (DRESS)
    • nerve damage
    • risk of new cancers such as acute myeloid leukemia
    • tumor lysis syndrome (a condition in which cancer cells release harmful chemicals into your blood)
    • blood clots**
    • severe dizziness
    • confusion
  • Can occur with both Farydak and Pomalyst:
    • low blood cell counts
    • liver problems such as increases in the level of liver enzymes (proteins), which shows potential liver damage
    • birth defects if a woman or her sexual partner takes Farydak or Pomalyst** and becomes pregnant

*Farydak has boxed warnings for the risk of severe diarrhea and heart problems. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see "FDA warnings" at the beginning of this article.

** Pomalyst has boxed warnings for harm and death to growing babies, and blood clots.

Effectiveness

The only condition both Farydak and Pomalyst are used to treat is multiple myeloma.

These drugs haven't been directly compared in clinical studies, but studies have found both Farydak and Pomalyst to be effective for treating multiple myeloma in people who have tried other treatments.

In addition, guidelines from the National Comprehensive Cancer Network (NCCN) state that both drugs are options for treating multiple myeloma.

Costs

Farydak and Pomalyst are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, Farydak costs significantly less than Pomalyst. The actual price you'll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Like Pomalyst (above), the drug Empliciti has uses similar to those of Farydak. Here's a comparison of how Farydak and Empliciti are alike and different.

Ingredients

Farydak contains the active drug panobinostat, which belongs to a class of drugs called histone deacetylase inhibitors. (A class of drugs is a group of medications that work in a similar way.)

Empliciti contains the active drug elotuzumab, which belongs to a class of drugs called monoclonal antibodies.

Uses

The Food and Drug Administration (FDA) has approved both Farydak and Empliciti to treat multiple myeloma in people who have received other treatments for their condition. Multiple myeloma is a type of cancer that affects certain white blood cells called plasma cells.

With Farydak, you must've already tried bortezomib (Velcade) and an immunomodulatory agent, which is a treatment that helps your body fight cancer cells. Farydak is used with two other multiple myeloma drugs: bortezomib and dexamethasone.

With Empliciti, you'll take the drug with lenalidomide and dexamethasone if you've had one to three previous treatments for multiple myeloma.

But if you've had at least two other multiple myeloma treatments that included lenalidomide and a proteasome inhibitor, you'll take Empliciti with pomalidomide and dexamethasone.

Drug forms and administration

Farydak comes as a capsule that you swallow with a cup of water.

Empliciti comes as a powder that will be mixed with a liquid. You'll receive the drug in your doctor's office as an intravenous (IV) infusion (an injection into your vein that's given over a period of time).

Side effects and risks

Farydak and Empliciti both contain drugs that treat multiple myeloma. Therefore, these medications can cause some similar and some different side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Farydak, with Empliciti, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Farydak, with Empliciti, or with both drugs (when taken individually).

  • Can occur with Farydak:
    • severe diarrhea*
    • heart problems* such as severe arrhythmias (irregular heartbeats)
    • bleeding
    • low blood cell counts
  • Can occur with Empliciti:
    • infusion reaction (a type of allergic reaction)
    • risk of new cancers such as blood cancers and solid tumors (lumps of tissue)
  • Can occur with both Farydak and Empliciti:

* Farydak has boxed warnings for the risk of severe diarrhea and heart problems. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see "FDA warnings" at the beginning of this article.

Effectiveness

The only condition both Farydak and Empliciti are used to treat is multiple myeloma.

These drugs haven't been directly compared in clinical studies, but studies have found both Farydak and Empliciti to be effective for treating multiple myeloma in people who have tried other treatments.

According to guidelines from the National Comprehensive Cancer Network (NCCN), Empliciti (along with the multiple myeloma drugs lenalidomide and dexamethasone) is a preferred treatment option for multiple myeloma in people who have tried other treatments.

Costs

Farydak and Empliciti are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, Farydak usually costs more than Empliciti. The actual price you'll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

The Food and Drug Administration (FDA) has approved Farydak to treat multiple myeloma in people who have received at least two other treatments for their multiple myeloma. These include bortezomib and an immunomodulatory agent (a treatment that helps your body fight cancer cells).

Farydak is approved to be taken only with two other drugs used to treat multiple myeloma: bortezomib (Velcade) and dexamethasone.

Farydak, bortezomib, and dexamethasone are taken together as a part of a 21-day treatment cycle. To help maximize the drugs' effectiveness and minimize the strength and number of side effects, you'll take each drug on specific days.

Alcohol doesn't affect how Farydak works, and there aren't any warnings about avoiding alcohol while you're taking the drug. However, if you find that Farydak makes you feel tired or nauseous, drinking alcohol could worsen these side effects.

If you drink alcohol, talk with your doctor before you start to use Farydak. They can help you decide how much alcohol is safe for you to drink during your treatment.

Farydak can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Farydak and other medications

Below is a list of medications that can interact with Farydak. This list doesn't contain all drugs that may interact with Farydak.

Before taking Farydak, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Drugs that can increase the level of Farydak in your body

A protein called enzyme CYP3A metabolizes (breaks down) Farydak and several other drugs. Certain medications known as CYP3A4 inhibitors can slow down the metabolism of Farydak.

So, taking Farydak with strong CYP3A4 inhibitors can cause a buildup of Farydak in your body. This increases your risk of developing side effects from Farydak. (To learn more, see the "Farydak side effects" section above.)

Examples of drugs that can increase the level of Farydak in your body, include:

  • Certain antivirals such as:
    • boceprevir (Victrelis)
    • lopinavir/ritonavir (Kaletra)
    • nelfinavir (Viracept)
    • saquinavir (Invirase)
    • telaprevir (Incivek)
  • Certain antibiotics such as:
    • clarithromycin (Biaxin)
    • telithromycin (Ketek)
  • Certain antifungal medications such as:
    • itraconazole (Sporanox)
    • ketoconazole (Nizoral)
    • voriconazole (Vfend)

If you're taking any of these drugs, talk with your doctor before you start to use Farydak. Your doctor may lower your starting dose of Farydak to prevent levels from building up too high in your body.

Drugs that can decrease the level of Farydak in your body

A type of protein called enzyme CYP3A helps metabolize (break down) Farydak. Other drugs can increase the level of this protein in your body. So, taking those medications with Farydak can cause your body to break down Farydak more than normal, decreasing the level of Farydak in your system. This can reduce how well the drug helps treat your multiple myeloma.

Examples of drugs that can decrease the level of Farydak in your body include:

  • Certain antibiotics such as:
    • rifampicin (Rifadin)
    • rifabutin (Mycobutin)
    • rifapentine (Priftin)
  • Certain seizure medications such as:
    • carbamazepine (Tegretol)
    • fosphenytoin (Cerebyx)
    • phenytoin (Dilantin)
    • phenobarbital (Solfoton)

If you're taking any of these drugs, talk with your doctor before you start to use Farydak. Your doctor may change your medication to one that doesn't interact with Farydak.

Drugs whose levels can increase when taken with Farydak

Certain medications are broken down by an enzyme called CYP2D6. Farydak can decrease the effect of CYP2D6, which slows the breakdown of certain medications. This can lead to increased levels of the other drug in your body, which can result in side effects that are more severe or an increased number of side effects.

Examples of drugs whose levels might increase if you take them with Farydak include:

  • Drugs used for certain psychiatric conditions:
    • atomoxetine (Strattera)
    • desipramine (Norpramin)
    • perphenazine (Trilafon)
    • venlafaxine (Effexor)

If you're taking any of these drugs, talk with your doctor before you use Farydak. Your doctor may reduce your dose of the drug or switch you to a medication that doesn't interact with Farydak.

Drugs that can interact with your heart's electrical activity

Farydak can cause severe heart problems that may lead to death.* These include problems with the heart's electrical activity. If you already have a heart condition called long QT syndrome or other heart problems, you may be at higher risk for additional heart problems while taking Farydak.

Certain medications can cause or worsen long QT syndrome. So taking them with Farydak can be very dangerous for your heart.

Examples of drugs that can increase the risk of long QT syndrome include:

  • Drugs used to control the electrical activity of the heart, such as:
    • amiodarone (Cordarone)
    • disopyramide (Norpace)
    • procainamide
    • quinidine
    • sotalol (Betapace)
  • Certain antibiotics such as:
    • clarithromycin (Biaxin)
    • moxifloxacin (Avelox)
  • Certain anti-nausea drugs such as:
    • ondansetron (Zofran)

Before you start to use Farydak, tell your doctor if you're taking any of these drugs. Your doctor may suggest different medications.

* Farydak has a boxed warning for the risk of heart problems. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see "FDA warnings" at the beginning of this article.

Farydak and herbs and supplements

There aren't any herbs or supplements that have been specifically reported to interact with Farydak. However, you should still check with your doctor or pharmacist before using any of these products while taking Farydak.

Farydak and foods

Consuming certain foods and drinks may increase the level of Farydak in your body, leading to potentially dangerous side effects. (For more about side effects, see the "Farydak side effects" section above.) Some foods and drinks to avoid when taking Farydak include:

  • star fruit
  • pomegranates and pomegranate juice
  • grapefruit and grapefruit juice

As with all medications, the cost of Farydak can vary. To find current prices for Farydak in your area, check out WellRx.com. The cost you find on WellRx.com is what you may pay without insurance. The actual price you'll pay depends on your insurance plan, your location, and the pharmacy you use.

Your insurance plan may require you to get prior authorization before it approves coverage for Farydak. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Farydak.

If you're not sure if you'll need to get prior authorization for Farydak, contact your insurance plan.

Financial assistance

If you need financial support to pay for Farydak, help is available. Secura Bio, Inc., the manufacturer of Farydak, offers the Secura Care Patient Support Program. For more information and to find out if you're eligible for support, call 844-9SECURA (844-973-2872) or visit the drug's website.

Farydak comes as a capsule that you swallow with a cup of water.

You should take Farydak according to your doctor's or healthcare provider's instructions.

When to take

You'll take Farydak in 21-day cycles:

  • During week 1 of treatment, you'll take a 20-mg capsule of Farydak once every other day for three doses. This means that you'll take the drug on days 1, 3, and 5.
  • During week 2 of treatment, you'll continue to take a 20-mg capsule of Farydak once every other day for three doses. This means that you'll take the drug on days 8, 10, and 12.
  • During week 3 of treatment, you won't take Farydak at all.

At first, Farydak can be taken for up to eight 21-day cycles. But if you don't benefit from the drug treatment, your doctor may want you to complete another eight 21-day cycles for a total of 48 weeks.

You'll take Farydak with two other medications: bortezomib (Velcade) and dexamethasone.

Try to take each dose of Farydak at about the same time of day. To help make sure that you don't miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Farydak with food

You can take Farydak with or without food, but you should swallow the capsule with a full cup of water.

Can Farydak be crushed, split, or chewed?

No, you shouldn't open, crush, split, or chew Farydak.

Multiple myeloma is a type of cancer that forms in plasma cells. These are a kind of white blood cell that help you make antibodies to fight infections. (Antibodies are type of protein.)

Multiple myeloma cancer cells build up in the bone marrow, where healthy cells are usually produced. The multiple myeloma cells take up space and crowd out the healthy cells, so your body can't fight off infections as effectively. Multiple myeloma cells can also cause other health problems, such as weak bones or kidney damage.

Farydak belongs to a class of drugs called histone deacetylase inhibitors. (A class of drugs is a group of medications that work in a similar way.) Farydak works at the DNA level to remove certain amino acids from the DNA sequence of cancer cells. (Amino acids are building blocks that help form proteins.) By removing the amino acids, Farydak helps slow the growth of multiple myeloma cells or kill them.

How long does it take to work?

In clinical trials, about half of people who responded to treatment with Farydak did so within about 6.5 weeks. "Responded" means they had a reduction in certain markers of multiple myeloma based on blood tests and the presence of cancer cells in bones.

You shouldn't take Farydak during pregnancy. The drug can cause harm to an unborn baby if it's taken by the pregnant mother. There haven't been any human studies of Farydak use in pregnancy, but animal studies have shown birth defects and the death of babies whose mothers were given Farydak.

Women who can have children should get a pregnancy test before and during Farydak treatment to make sure they aren't pregnant.

If you're pregnant or planning to become pregnant, talk with your doctor. They may be able to suggest multiple myeloma treatments other than Farydak.

Farydak isn't safe to take during pregnancy. If you're sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you're using Farydak.

Women should use effective birth control for at least 3 months after their last dose of Farydak to avoid becoming pregnant.

Men who are sexually active and take Farydak should use condoms during their treatment and for at least 6 months after their last dose. This helps their partner avoid becoming pregnant.

You should avoid breastfeeding while taking Farydak. It's not known if Farydak passes into breast milk, but the drug may be dangerous for a child to consume, even in small amounts.

Talk with your doctor about how to feed your child during your Farydak treatment.

Here are answers to some frequently asked questions about Farydak.

Is Farydak safe for people ages 65 years and older?

Farydak may be safe for use in people ages 65 years and older, but they may have more frequent and more severe side effects. (To learn about side effects, see the "Farydak side effects" section above.) This is because this age group may be more sensitive to certain side effects of Farydak, especially nausea, diarrhea, low blood cell counts, and heart problems such as severe arrhythmias (irregular heartbeats).*

In clinical studies of Farydak, 42% of the people enrolled were ages 65 years or older. The drug was just as effective in this age group as in people ages 64 years and younger. However, 45% of people older than age 65 years stopped taking the drug because of side effects. This was compared with 30% of people younger than age 65 years.

Also in the study, 9% of the people older than age 65 years died from causes not related to their multiple myeloma getting worse. This was compared with 5% of people younger than age 65 years.

If you're age 65 years or older and are interested in taking Farydak, talk with your doctor. They can discuss the pros and cons of the medication with you.

*Farydak has boxed warnings for the risk of severe diarrhea and heart problems. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see "FDA warnings" at the beginning of this article.

If I vomit after a dose of Farydak, should I take a second dose?

No, if you vomit after you take Farydak, you shouldn't take a second dose. You should wait until it's time for your next regularly scheduled dose to take Farydak again.

Do I need to avoid certain foods while using Farydak?

Yes. While you're using Farydak, you should avoid consuming:

  • star fruit
  • pomegranates and pomegranate juice
  • grapefruit and grapefruit juice

These foods and drinks can slow down the enzyme (protein) that helps your body break down Farydak. So consuming these foods and drinks during your Farydak treatment may increase the level of Farydak in your body. This may lead to potentially dangerous side effects. (To learn about side effects, see the "Farydak side effects" section above.)

If you have any questions about your diet while taking Farydak, talk with your doctor.

What if the Farydak capsule opens while I'm taking it?

You should never crush, split, or open a Farydak capsule to take the medication. You should always swallow the capsules whole. But if a capsule does open by accident, try to avoid contact with the powder in the capsule. If the powder manages to get on your skin, wash the area with soap and water. And if the powder gets in your eyes, flush your eyes with water.

This drug comes with several precautions.

FDA warnings

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and people about drug effects that may be dangerous.

  • Severe diarrhea. In clinical studies, up to 25% of people who took Farydak had severe diarrhea. During your treatment, your doctor will regularly test your levels of fluids and electrolytes to make sure that you're not dehydrated. (Electrolytes are minerals that are electrically charged.) If you do develop diarrhea, your doctor can recommend medication to treat it. They may also pause your Farydak use, then lower your dose or have you stop taking the drug.
  • Heart problems. Some people who have taken Farydak have had reduced blood flow to their heart, which can be severe and even fatal. The drug may also cause other heart problems such as changes in the heart's electrical activity and severe arrhythmias (irregular heartbeats). If your electrolyte levels aren't normal, the arrhythmias may be worse. Your doctor will check the electrical activity of your heart and your electrolyte levels before and during your Farydak treatment.

Other precautions

Before taking Farydak, talk with your doctor about your health history. Farydak may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Diarrhea. Severe diarrhea is a common side effect of Farydak. If you already have a condition that makes you more likely to have diarrhea, taking Farydak may make the diarrhea worse. To help prevent diarrhea during your Farydak treatment, your doctor will monitor your fluid levels and make sure you have antidiarrhea medication on hand. (Low fluid levels can be a symptom of diarrhea.)
  • Blood clotting disorders. Severe bleeding is a common side effect of Farydak. To help prevent bleeding during your Farydak treatment, your doctor will monitor the levels of your blood cells and check you for any signs of bleeding. (Blood cell levels that aren't in the normal range may signal that you're at risk for bleeding.)
  • Liver damage. Farydak may cause liver damage, which can reveal itself as increases in the level of liver enzymes (proteins). If you already have liver damage, you may have a higher risk for liver-related side effects. (For more information, see the "Farydak side effects" section above.) To help prevent liver damage from Farydak use, your doctor will monitor your liver function through blood tests during your treatment.
  • Pregnancy. You shouldn't take Farydak during pregnancy. For more information, please see the "Farydak and pregnancy" section above.
  • Breastfeeding. You should avoid breastfeeding while taking Farydak. For more information, please see the "Farydak and breastfeeding" section above.

Note: For more information about the potential negative effects of Farydak, see the "Farydak side effects" section above.

Using more than the recommended dosage of Farydak can lead to serious side effects.

Overdose symptoms

Symptoms of an overdose can include:

What to do in case of overdose

If you think you've taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When you get Farydak from the pharmacy, the pharmacist will add an expiration date to the label on the box. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

You should store Farydak capsules at room temperature between 68°F and 77°F (20°C to 25° C) in the original blister pack away from light. If needed, it's fine to keep the medication between 59°F to 86°F (15°C to 30°C) for a short time. Avoid storing Farydak in areas where it could get damp or wet, such as in bathrooms.

Disposal

If you no longer need to take Farydak and have leftover medication, it's important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

Like other drugs that treat cancer, Farydak is considered to be a hazardous drug. This means it should be handled carefully, including during disposal. If you have unused pills, bring them to the pharmacy where your prescription was filled. Don't flush them down the toilet, dump them in the sink, or throw them away in the trash.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Farydak is indicated for the treatment of adults with multiple myeloma who have received treatment with two prior therapies: bortezomib (Velcade) and an immunomodulatory agent. The drug is to be taken in combination with bortezomib and dexamethasone as a part of 21-day cycles of treatment.

Mechanism of action

Farydak belongs to a class of drugs called histone deacetylase (HDAC) inhibitors. HDAC enzymes are overexpressed in the setting of multiple myeloma.

Farydak inhibits HDAC, resulting in hyperacetylation of histones, which leads to relaxation of chromatin. These changes lead to transcriptional activation. Farydak causes accumulation of acetylated histones, resulting in cell-cycle arrest and cell death of some cancer cells. Farydak shows greater toxicity toward tumor cells than normal cells. Farydak has synergistic activity with bortezomib.

Pharmacokinetics and metabolism

Farydak's oral bioavailability is about 21%, with peak plasma concentrations seen within 2 hours. Farydak is metabolized extensively via CYP3A pathways, which account for about 40% of hepatic metabolism.

The terminal elimination half-life is about 37 hours in patients with advanced cancer. Approximately 29% to 51% of the dose is cleared via renal excretion, and 44% to 77% is excreted in the feces.

Contraindications

Farydak has no contraindications.

Storage

Farydak capsules should be stored at room temperature between 68°F and 77°F (20°C to 25°C) in the original blister pack away from light. Excursions are permitted between 59°F to 86°F (15°C to 30°C).

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.