Pazopanib

By Medically reviewed by hellodoktor

Generic Name: Pazopanib Brand Name(s): Pazopanib. Avability: Rx Pregnancy Category: D

Uses

What is Pazopanib used for?

Pazopanib is used to treat kidney cancer. It may also be used to treat certain other types of cancer (soft tissue sarcoma). Pazopanib belongs to a class of drugs known as tyrosine kinase inhibitors. It works by decreasing the blood supply to the cancer tumor to slow tumor growth.

This medication should not be used in children, especially younger than 2 years of age, because of the risk of serious side effects.

How should I take Pazopanib?

Take this medication by mouth without food as directed by your doctor, usually once daily. It is very important to take this medication on an empty stomach, at least 1 hour before or 2 hours after food.

Swallow this medication whole. Do not crush, chew, or break the tablets. Doing so can release all of the drug at once, increasing the risk of side effects.

Medications that reduce/block stomach acid (such as antacids, H2 blockers such as famotidine/ranitidine, proton pump inhibitors-PPIs such as omeprazole/lansoprazole) may reduce the absorption of pazopanib, making it work less well. Do not take H2 blockers or PPIs while using this medication. If you are taking antacids, ask your pharmacist about how to best take them, such as taking antacids at least several hours apart from when you take pazopanib. Ask your doctor or pharmacist if you are taking any of these medications.

Dosage is based on your medical condition, laboratory tests, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Your doctor will order lab tests to find the best dose for you. Keep all medical and lab appointments.

Do not increase your dose or take this drug more often than prescribed. Your condition will not improve any faster, and your risk of serious side effects will increase. Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. Follow your doctor’s instructions carefully.

Since this medication can be absorbed through the skin and lungs, women who are pregnant or who may become pregnant should not handle this medication or breathe the dust from the tablets.

Tell your doctor if your condition worsens.

How do I store Pazopanib?

Pazopanib is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Pazopanib in the bathroom or the freezer. There may be different brands of Pazopanib that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Pazopanib down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Pazopanib?

Before taking pazopanib, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, chest pain/heart attack, high blood pressure, stroke, bleeding/clotting problem, intestinal or stomach problems (such as ulcer, fistula, pancreatitis), underactive thyroid.

Pazopanib may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using pazopanib, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).

Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/”water pills”) or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using pazopanib safely.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Pazopanib may slow wound healing or cause healing wounds to reopen.

To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.

Older adults may be more sensitive to the side effects of this drug, especially liver disease or QT prolongation (see above).

Tell your doctor if you are pregnant or plan to become pregnant. Your doctor will give you a pregnancy test before starting treatment. You should not become pregnant while using pazopanib. Pazopanib may harm an unborn baby. Women and men should ask about reliable forms of birth control to use during treatment with this medication and for at least 2 weeks after stopping treatment. If you or your female partner becomes pregnant, talk to your doctor right away about the risks and benefits of this medication.

It is unknown if this medication passes into breast milk. Because of the possible risk to the infant, breast-feeding is not recommended while using this drug and for 2 weeks after stopping treatment. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Pazopanib during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Pazopanib. Pazopanib is pregnancy risk category D according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Pazopanib?

Diarrhea, nausea/vomiting, headache, loss of appetite, weight loss, altered sense of taste, numbness/tingling/redness in hands/feet, or feeling tired/weak may occur. If these effects persist or worsen, tell your doctor or pharmacist promptly.

Temporary hair loss and/or change in hair or skin color may occur. Normal hair growth should return after treatment has ended.

People using this medication may have serious side effects. However, your doctor has prescribed this drug because he or she has judged that the benefit to you is greater than the risk ofside effects. Careful monitoring by your doctor may decrease your risk.

Tell your doctor right away if you have any serious side effects, including: symptoms of heart failure (such as swelling ankles/feet, unusual tiredness), signs of an underactive thyroid (such as unusual weight gain, cold intolerance, slow heartbeat), signs of infection (such as fever, chills, persistent sore throat, cough), wounds that do not heal, signs of kidney problems (such as change in the amount of urine).

This drug can cause serious (rarely fatal) bleeding. Tell your doctor right away if you have any signs of unusual bleeding such as: bloody/black stools, easy bleeding/bruising (such as nose bleed or bloody/pinkish urine), vomit that looks like coffee grounds, severe stomach/abdominal pain, coughing up blood.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high. Your doctor may control your blood pressure with medication.

Get medical help right away if you have any very serious side effects, including: fast/irregular heartbeat, severe dizziness, fainting, symptoms of a heart attack (such as chest/jaw/left arm pain, shortness of breath, unusual sweating), signs of a stroke (such as weakness on one side of the body, slurred speech, vision changes, confusion), pain/redness/swelling in the arm/leg/calf/groin, signs of a certain brain condition (such as headache, seizure, decreased alertness, blindness).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Pazopanib?

Some products that may interact with this drug include: other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen, “blood thinners” such as warfarin).

Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually at dosages of 81-325 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

Other medications can affect the removal of pazopanib from your body, which may affect how pazopanib works. Examples include azole antifungals (such as ketoconazole), nefazodone, rifamycins (such as rifabutin, rifampin), St. John’s wort, drugs used to treat seizures (such as carbamazepine, phenobarbital, phenytoin, primidone), HIV protease inhibitors (such as ritonavir), among others.

Many drugs besides pazopanib may affect the heart rhythm (QT prolongation), including amiodarone, dofetilide, pimozide, procainamide, quinidine, sotalol, macrolide antibiotics (such as clarithromycin, erythromycin), among others. Therefore, before using this drug, report all medications you are currently using to your doctor or pharmacist.

Pazopanib may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Pazopanib?

Pazopanib may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

Avoid eating grapefruit or drinking grapefruit juice while taking this medication. Grapefruit can increase the amount of this medication in your bloodstream. Consult your doctor or pharmacist for more details.

What health conditions may interact with Pazopanib?

Pazopanib may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Pazopanib.

What is the dose of Pazopanib for an adult?

Usual Adult Dose for Renal Cell Carcinoma

800 mg orally once a day without food, at least 1 hour before or 2 hours after a meal

Comments:

-Limitation of Use: The efficacy of the drug for adipocytic soft tissue sarcoma or gastrointestinal stromal tumors has not been demonstrated.

-Dose should not exceed 800 mg.

-Swallow tablets whole with water; do not break or crush due to potential for increased rate of absorption which may affect systemic exposure.

-Do not take missed dose if less than 12 hours until the next dose.

-Avoid grapefruit or grapefruit juice as it may increase plasma concentration of the drug.

-There is no specific antidote for overdosage of the drug. Treatment should consist of general supportive measures.

Uses: Advanced renal cell carcinoma (RCC), advanced soft tissue sarcoma (STS) with prior chemotherapy

Usual Adult Dose for Soft Tissue Sarcoma

800 mg orally once a day without food, at least 1 hour before or 2 hours after a meal

Comments:

-Limitation of Use: The efficacy of the drug for adipocytic soft tissue sarcoma or gastrointestinal stromal tumors has not been demonstrated.

-Dose should not exceed 800 mg.

-Swallow tablets whole with water; do not break or crush due to potential for increased rate of absorption which may affect systemic exposure.

-Do not take missed dose if less than 12 hours until the next dose.

-Avoid grapefruit or grapefruit juice as it may increase plasma concentration of the drug.

-There is no specific antidote for overdosage of the drug. Treatment should consist of general supportive measures.

Uses: Advanced renal cell carcinoma (RCC), advanced soft tissue sarcoma (STS) with prior chemotherapy

Renal Dose Adjustments

No adjustment recommended, but caution is recommended in patients with creatinine clearance below 30 mL/min.

Liver Dose Adjustments

-Mild hepatic impairment (either total bilirubin within normal limit with ALT greater than upper limit of normal [ULN] or bilirubin greater than 1 to 1.5 x ULN regardless of the ALT value): No adjustment required, but caution and close monitoring recommended.

-Moderate hepatic impairment (total bilirubin greater than 1.5 to 3 x ULN regardless of the ALT value): Consider alternative therapy or reduce dose to 200 mg orally once daily.

-Severe hepatic impairment (total bilirubin greater than 3 x ULN regardless of the ALT value): Not recommended.

Dose Adjustments

RCC:

-Initial dose reductions of 400 mg and additional dose adjustments of 200 mg increments based on individual tolerability

STS:

-Dose adjustments of 200 mg increments based on individual tolerability

Strong CYP450 3A4 inhibitors:

-Avoid concomitant use of a strong CYP450 3A4 inhibitor, consider an alternative medication, or reduce dose to 400 mg orally once a day.

ALT elevation between 3 and 8 x ULN:

-Continue drug therapy and monitor liver function weekly until ALT returns to Grade 1 or baseline.

ALT elevation greater than 8 x ULN:

-Interrupt drug therapy until ALT returns to Grade 1 or baseline. If the potential benefit outweighs the risk for hepatotoxicity, reduce dose to no more than 400 mg orally once daily and measure serum liver tests weekly for 8 weeks. If transaminase elevations greater than 3 x ULN recur, permanently discontinue drug therapy.

ALT elevation greater than 3 x ULN concurrently with bilirubin elevations greater than 2 x ULN:

-Permanently discontinue drug therapy. Monitor patient until return to Grade 1 or baseline.

Other Comments

Administration advice:

-Preparation, handling, and disposal of this drug should be performed in a manner consistent with safe procedures for cytotoxic agents.

Monitoring:

-Monitor serum liver function tests (ALT, AST, bilirubin) before initiation of drug therapy, and at weeks 3, 5, 7, and 9. Thereafter, monitor at months 3 and 4, and periodically as clinically indicated.

-Blood pressure should be well-controlled before treatment, and should be monitored within the first week after starting drug therapy and frequently thereafter.

-Monitor thyroid function prior to initiating therapy and periodically thereafter.

-Baseline and periodic monitoring of ECGs and maintenance of electrolytes should be performed.

-Baseline and periodic monitoring of left ventricular ejection fraction and congestive heart failure is recommended in patients at risk of cardiac dysfunction including previous anthracycline exposure.

-Baseline and periodic urinalysis during treatment is recommended with follow up measurement of 24-hour urine protein as clinically indicated.

Patient advice:

-This drug can cause serious liver problems including death. Your doctor will do blood tests to check your liver before and during drug therapy. Tell your doctor right away if you get any of these signs of liver problems during treatment such as yellowing of your skin/whites of eyes (jaundice), dark urine, tiredness, nausea or vomiting, loss of appetite, pain on the right side of your stomach, and unusual bruising.

-This drug can harm your unborn baby; avoid pregnancy during treatment. If pregnancy occurs, contact your doctor immediately.

-This drug may cause high blood pressure. Monitor your blood pressure within the first week of treatment and often during treatment to make sure your blood pressure is well controlled. Tell your doctor if you have increases of blood pressure or symptoms such as blurred vision, confusion, nausea and vomiting, shortness of breath, severe headache, severe anxiety, severe chest pain, or seizures.

-This drug may impair wound healing. Stop this drug at least 7 days prior to surgery and consult your doctor before restarting drug therapy after surgery.

-Swallow drug tablets whole with water on an empty stomach, at least 1 hour before or 2 hours after a meal. Do not crush or break the tablets and avoid grapefruit and grapefruit juice.

-This drug can interact with several medications. Tell your doctor about all the medications you take, including prescription and over-the-counter drugs, vitamins, dietary and herbal supplements.

-This drug may cause side effects including but not limited to diarrhea, hair color changes, nausea, vomiting, and loss of appetite. Tell your doctor if you have any side effect that bothers you or does not go away.

What is the dose of Pazopanib for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Pazopanib available?

Pazopanib is available in the following dosage forms and strengths:

  • Oral tablet.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Pazopanib, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: August 10, 2018 | Last Modified: September 12, 2019

Want to live your best life?
Get the Hello Doktor Daily newsletter for health tips, wellness updates and more.
You might also like