TM Owner Novartis
Pazopanib 200mg Tablet
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Indications & Clinical Uses
- Pazopanib 200 mg tablets contain pazopanib hydrochloride, a tyrosine kinase inhibitor that blocks VEGFR, PDGFR and c-KIT signalling to reduce the blood supply and growth of certain tumours; the originator brand, marketed by Novartis, is called Votrient.
- Pazopanib is approved for adults with advanced renal cell carcinoma (advanced kidney cancer), used either as initial treatment or after other therapies, and for adults with advanced soft tissue sarcoma who have already received chemotherapy; it has not shown benefit in adipocytic sarcoma or gastrointestinal stromal tumours, and is not used for these.
- Pazopanib is taken by mouth once daily on an empty stomach, at least one hour before or two hours after food, at a dose and schedule set by the treating oncologist, and treatment continues for as long as it is working and tolerated.
Side Effects
- Pazopanib carries a boxed warning for severe and sometimes fatal liver injury (hepatotoxicity); liver blood tests are required before starting and regularly during treatment, especially in the first four months, and the dose is interrupted, reduced or stopped if liver tests worsen.
- Very common side effects include diarrhoea, high blood pressure, hair colour lightening, nausea, reduced appetite, vomiting, fatigue, headache and altered taste.
- Other important risks include prolongation of the QT interval on the heart tracing, which can lead to dangerous heart rhythms, bleeding events, blood clots, poor wound healing and, rarely, serious bowel perforation or an abnormal connection (fistula) between organs.
- Report yellowing of the skin or eyes, dark urine, unusual bruising or bleeding, severe diarrhoea, chest pain, fainting, or severe abdominal pain to the care team without delay.
Precautions & Warnings
- Liver function must be checked before starting pazopanib and monitored regularly throughout treatment because of the boxed warning for hepatotoxicity, with dose changes made according to the results.
- Blood pressure should be well controlled before starting and monitored regularly, since pazopanib commonly causes or worsens hypertension.
- An ECG and electrolyte check are advised before starting in patients at risk of QT prolongation and periodically thereafter.
- Pazopanib should be stopped at least 7 days before and after planned surgery because of the risk of impaired wound healing, and should not be used in patients with recent significant bleeding or tumour invading major blood vessels.
- It must not be used in pregnancy, as it can harm the unborn baby, and effective contraception is required during and for a period after treatment for both women and men; it should not be used while breastfeeding.
Avoid Interactions
- Pazopanib is broken down by the CYP3A4 liver enzyme, so strong inhibitors such as ketoconazole, ritonavir, clarithromycin and grapefruit juice can raise pazopanib levels and should be avoided or require a reduced dose, while strong inducers such as rifampicin, carbamazepine, phenytoin and St John's Wort can lower its effectiveness and should also be avoided.
- Combining pazopanib with other drugs that prolong the QT interval, such as certain antiarrhythmics, some antipsychotics and some antibiotics, increases the risk of dangerous heart rhythms and should be avoided or closely monitored.
- Taking simvastatin with pazopanib increases the risk of liver toxicity and requires extra liver monitoring.
- Pazopanib should be taken without food, since food significantly increases how much of the drug is absorbed.
- Tell the healthcare provider and pharmacist about every other medicine, herbal remedy and supplement being taken before starting pazopanib.
References
Frequently Asked Questions
Pazopanib (brand name Votrient) is a targeted cancer therapy for advanced kidney cancer (renal cell carcinoma) and, after prior chemotherapy, advanced soft tissue sarcoma. It works by blocking blood vessel growth signals that tumours need to grow and spread further.
Pazopanib tablets are swallowed whole once daily, on an empty stomach, at least one hour before or two hours after eating. Food significantly increases how much drug the body absorbs, so this exact timing matters for every single dose you take.
Pazopanib commonly causes diarrhoea, high blood pressure, hair colour lightening, fatigue and nausea. It carries a boxed warning for serious, sometimes fatal liver injury, so liver blood tests are required before treatment starts and regularly afterward throughout the entire course of care.
Avoid grapefruit juice and strong CYP3A4 inhibitors like ketoconazole, which raise pazopanib levels, and inducers like rifampicin, which lower them and reduce effect. Avoid taking pazopanib with food, and tell your doctor about all other medicines and supplements you regularly take.
Liver function tests are required before starting pazopanib and at least every 4 weeks for the first 4 months of treatment. Blood pressure and, in at-risk patients, an ECG for heart rhythm are also checked regularly throughout the course of treatment.
No. Pazopanib can seriously harm an unborn baby's development and must not be used in pregnancy. Effective contraception is needed during treatment and for a period afterward, and pazopanib should not be used at all while breastfeeding a newborn baby.
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