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pazopanib (Oral route)

paz-OH-pa-nib

Oral route(Tablet)

Severe and fatal hepatotoxicity has occurred during clinical trials. Monitor hepatic function in all patients. Interrupt, reduce, or discontinue treatment as recommended .

Commonly used brand name(s)

In the U.S.

  • Votrient

Available Dosage Forms:

  • Tablet

Therapeutic Class: Antineoplastic Agent

Pharmacologic Class: Tyrosine Kinase Inhibitor

Uses For pazopanib

Pazopanib is a cancer medicine that is used to treat patients with kidney cancer (advanced renal cell carcinoma). It is also used to treat advanced soft tissue sarcoma (STS) in patients who have received other cancer treatments. Pazopanib interferes with the growth of cancer cells, which are eventually destroyed by the body.

pazopanib is available only with your doctor's prescription.

Before Using pazopanib

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For pazopanib, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to pazopanib or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of pazopanib in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of pazopanib in the elderly. However, elderly patients are more likely to have unwanted effects (eg, decreased appetite, high blood pressure, tiredness) and age-related liver problems, which may require caution and an adjustment in the dose for patients receiving pazopanib.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking pazopanib, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using pazopanib with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Amisulpride
  • Atazanavir
  • Bepridil
  • Boceprevir
  • Cisapride
  • Cobicistat
  • Dronedarone
  • Fluconazole
  • Ketoconazole
  • Mesoridazine
  • Nelfinavir
  • Pimozide
  • Piperaquine
  • Posaconazole
  • Saquinavir
  • Sparfloxacin
  • Telaprevir
  • Terfenadine
  • Thioridazine
  • Tipranavir
  • Ziprasidone

Using pazopanib with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alfentanil
  • Alfuzosin
  • Aluminum Carbonate, Basic
  • Aluminum Hydroxide
  • Aluminum Phosphate
  • Amiodarone
  • Amitriptyline
  • Amoxapine
  • Anagrelide
  • Apomorphine
  • Aripiprazole
  • Aripiprazole Lauroxil
  • Arsenic Trioxide
  • Artemether
  • Asenapine
  • Astemizole
  • Azithromycin
  • Bedaquiline
  • Buserelin
  • Calcium Carbonate
  • Carbamazepine
  • Ceritinib
  • Chloroquine
  • Chlorpromazine
  • Cimetidine
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clomipramine
  • Clozapine
  • Crizotinib
  • Cyclobenzaprine
  • Cyclosporine
  • Dabrafenib
  • Dasabuvir
  • Dasatinib
  • Degarelix
  • Delamanid
  • Desipramine
  • Deslorelin
  • Deutetrabenazine
  • Dexlansoprazole
  • Dihydroergotamine
  • Dihydroxyaluminum Aminoacetate
  • Dihydroxyaluminum Sodium Carbonate
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Donepezil
  • Doxepin
  • Droperidol
  • Ebastine
  • Efavirenz
  • Eliglustat
  • Enzalutamide
  • Ergotamine
  • Eribulin
  • Erythromycin
  • Escitalopram
  • Esomeprazole
  • Famotidine
  • Felbamate
  • Fentanyl
  • Fingolimod
  • Flecainide
  • Fluoxetine
  • Foscarnet
  • Fosphenytoin
  • Galantamine
  • Gatifloxacin
  • Gemifloxacin
  • Gonadorelin
  • Goserelin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Histrelin
  • Hydroquinidine
  • Hydroxychloroquine
  • Hydroxyzine
  • Ibutilide
  • Idelalisib
  • Iloperidone
  • Imipramine
  • Indinavir
  • Itraconazole
  • Ivabradine
  • Lansoprazole
  • Lapatinib
  • Leuprolide
  • Levofloxacin
  • Lumefantrine
  • Magaldrate
  • Magnesium Carbonate
  • Magnesium Hydroxide
  • Magnesium Oxide
  • Magnesium Trisilicate
  • Mefloquine
  • Methadone
  • Metronidazole
  • Mifepristone
  • Mizolastine
  • Moxifloxacin
  • Nafarelin
  • Nefazodone
  • Nilotinib
  • Nizatidine
  • Norfloxacin
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Olanzapine
  • Omeprazole
  • Ondansetron
  • Paclitaxel
  • Paliperidone
  • Panobinostat
  • Pantoprazole
  • Paroxetine
  • Pasireotide
  • Pentamidine
  • Perphenazine
  • Phenytoin
  • Pimavanserin
  • Pipamperone
  • Pitolisant
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Rabeprazole
  • Ranitidine
  • Ranolazine
  • Ribociclib
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rilpivirine
  • Risperidone
  • Ritonavir
  • Sertindole
  • Sevoflurane
  • Simvastatin
  • Sirolimus
  • Sodium Bicarbonate
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sorafenib
  • Sotalol
  • St John's Wort
  • Sulpiride
  • Sunitinib
  • Tacrolimus
  • Tamoxifen
  • Telavancin
  • Telithromycin
  • Tetrabenazine
  • Tizanidine
  • Tolterodine
  • Toremifene
  • Trazodone
  • Trifluoperazine
  • Trimipramine
  • Triptorelin
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Venlafaxine
  • Vinflunine
  • Voriconazole
  • Vorinostat
  • Zuclopenthixol

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using pazopanib with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use pazopanib, or give you special instructions about the use of food, alcohol, or tobacco.

  • food
  • Grapefruit Juice

Other Medical Problems

The presence of other medical problems may affect the use of pazopanib. Make sure you tell your doctor if you have any other medical problems, especially:

  • Angina (severe chest pain), history of or
  • Blood clotting problems (eg, pulmonary embolism, venous thrombosis), history of or
  • Congestive heart failure or
  • Gilbert syndrome (a genetic liver disease) or
  • Heart attack, history of or
  • Heart disease or
  • Heart rhythm problems (eg, QT prolongation), history of or
  • Hypertension (high blood pressure) or
  • Hypothyroidism (underactive thyroid) or
  • Lung problems (eg, interstitial lung disease, pneumonitis) or
  • Stomach or bowel problems (eg, fistula, perforation, tear), history of or
  • Stroke, history of or
  • Transient ischemic attack, history of—Use with caution. May make these conditions worse.
  • Infection—May decrease your body's ability to fight an infection.
  • Liver disease, moderate—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of pazopanib

Medicines used to treat cancer are very strong and can have many side effects. Before receiving pazopanib, make sure you understand all the risks and benefits. It is important for you to work closely with your doctor during your treatment.

Take pazopanib only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

pazopanib should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

It is best to take pazopanib on an empty stomach, at least 1 hour before or 2 hours after a meal.

Swallow the tablet whole. Do not break, crush, or chew it.

Take antacids several hours before or after you take pazopanib.

Do not use grapefruit products with pazopanib. Grapefruit products may change the amount of medicine that is absorbed in the body.

Dosing

The dose of pazopanib will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of pazopanib. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For advanced kidney cancer and soft tissue sarcoma:
      • Adults—800 milligrams (mg) once per day. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor.

Missed 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 go back to your regular dosing schedule. Do not double doses.

If you miss a dose and it is less than 12 hours before your next scheduled dose, skip the missed dose and take your next dose at the normal time.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using pazopanib

It is very important that your doctor check your progress at regular visits for any unwanted effects from the medicine. Blood and urine tests may be needed to check for unwanted effects.

Your blood pressure should be checked regularly during treatment with pazopanib. Your doctor may need to treat you if you develop high blood pressure. Symptoms of high blood pressure are blurred vision, dizziness, nervousness, headache, pounding in the ears, or a slow or fast heartbeat.

Using pazopanib while you are pregnant can harm your unborn baby. It may also cause birth defects if the father is using it when his sexual partner becomes pregnant. Men and women should use an effective form of birth control to keep from getting pregnant during treatment with pazopanib and for at least 2 weeks after the last dose. If you think you have become pregnant while using the medicine, tell your doctor right away.

Cancer medicines can cause diarrhea, nausea, vomiting, or stomach pain in most people, sometimes even after receiving medicines to prevent it. Ask your doctor or nurse about other ways to control these unwanted effects.

Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea and vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you had a heart rhythm problem, such as QT prolongation.

Pazopanib may cause heart problems. Check with your doctor right away if you have chest pain or tightness, decreased urine output, dilated neck veins, extreme fatigue, irregular heartbeat, swelling of the face, fingers, feet, or lower legs, troubled breathing, or weight gain.

pazopanib may increase your risk of having bleeding problems. Tell your doctor right away if you start to notice any signs of bleeding.

pazopanib may affect the way your body heals from cuts and wounds. Make sure any doctor who treats you knows that you are using pazopanib. You may need to stop using pazopanib at least 7 days before having a surgery.

Check with your doctor right away if you have new chest pain, troubled breathing, leg pain, swelling of the arms, hands, legs, or feet, or a cool or pale arm or leg. These may be symptoms of a blood clotting problem.

Check with your doctor right away if you start having severe stomach burning, cramps, or pains, bloody or black, tarry stools, trouble breathing, heartburn, indigestion, nausea, or vomiting of material that looks like coffee grounds. These could be symptoms of a serious bowel problem.

pazopanib may cause swelling of the lungs (pneumonitis) or interstitial lung disease. These are life-threatening conditions and require immediate medical attention. The symptoms may be similar to the symptoms of lung cancer. Check with your doctor right away if you have new or worsening cough, fever, or trouble breathing.

pazopanib may increase your chance of having a brain condition called reversible posterior leukoencephalopathy syndrome (RPLS). Check with your doctor right away if you have headaches, seizures, extreme drowsiness, confusion, or vision problems while using pazopanib.

pazopanib may cause hypothyroidism (underactive thyroid). Check with your doctor right away if you have depressed mood, dry skin and hair, feeling cold, hair loss, hoarseness or a husky voice, muscle cramps and stiffness, slowed heartbeat, weight gain, or unusual tiredness or weakness.

Pazopanib may cause serious side effects in the developing organs of children younger than 2 years of age. Check with your doctor if you have any concerns.

Pazopanib may cause kidney problems, including proteinuria or nephrotic syndrome. Check with your doctor right away if you have a cloudy or bloody urine, high blood pressure, or swelling of the face, feet or lower legs.

Call your doctor right away if you have a cough that would not go away, weight loss, night sweats, fever, chills, or flu-like symptoms, such as a runny or stuffy nose, headache, blurred vision, or you feel generally ill. These may be symptoms of an infection.

pazopanib may cause diarrhea, and in some cases it can be severe. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

pazopanib Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Black, tarry stools
  • bleeding gums
  • blood in the urine or stools
  • blurred vision
  • chest pain
  • chills
  • clay colored stools
  • cloudy urine
  • constipation
  • cough
  • coughing up blood
  • dark urine
  • decreased appetite
  • depressed mood
  • difficulty with breathing or swallowing
  • dizziness
  • dry skin and hair
  • feeling cold
  • fever
  • hair loss
  • headache
  • hoarseness or husky voice
  • increased menstrual flow or vaginal bleeding
  • itching, skin rash
  • loss of appetite
  • lower back or side pain
  • muscle cramps and stiffness
  • nausea and vomiting
  • nervousness
  • nosebleeds
  • painful or difficult urination
  • pale skin
  • paralysis
  • pinpoint red spots on the skin
  • pounding in the ears
  • prolonged bleeding from cuts
  • red or black, tarry stools
  • red or dark brown urine
  • redness, swelling, or pain of the skin
  • scaling of the skin on the hands and feet
  • slow or fast heartbeat
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stomach pain or tenderness
  • swelling of the feet or lower legs
  • swollen glands
  • tingling of the hands and feet
  • ulceration of the skin
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • weight gain
  • yellow eyes or skin
Less common
  • Bleeding from the rectum or bloody stools
  • bloody nose
  • chest discomfort
  • confusion
  • fainting
  • irregular or slow heart rate
  • numbness or tingling in the face, arms, or legs
  • pain or discomfort in the shoulders, arms, jaw, back, or neck
  • sweating
  • swelling or puffiness of the face
  • trouble speaking, thinking, or walking

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Change in hair color
  • change in taste
  • decreased weight
  • diarrhea
  • hair loss
  • lack or loss of strength
  • loss of taste
  • thinning of the hair
  • weight loss
Less common
  • Belching
  • heartburn
  • indigestion
  • stomach discomfort, upset, or pain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Side Effects (complete list)

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