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Belinostat is a small molecule histone deacetylase (HDAC) inhibitor used as an antineoplastic agent for the treatment of relapsed or refractory peripheral T-cell lymphoma. It works by inhibiting HDAC enzymes, leading to accumulation of acetylated histones and other proteins, which induces cell cycle arrest and apoptosis in tumor cells. Warfarin is an oral anticoagulant that acts by inhibiting vitamin K epoxide reductase complex subunit 1, thereby preventing the synthesis of active clotting factors II, VII, IX, and X. Clinical studies have shown that co-administration of belinostat with warfarin does not result in clinically significant pharmacokinetic or pharmacodynamic interactions; specifically, belinostat does not significantly affect the metabolism or anticoagulant effect of warfarin[1][2][4][5].
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