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How does this medication work? What will it do for me?
Pazopanib belongs to the group of cancer-fighting medications known as antineoplastics and more specifically to a class of medications called tyrosine kinase inhibitors. These medications are antitumour medications that slow the growth of blood vessels that feed nutrients to cancer cells. By slowing the growth of these blood vessels, pazopanib can help slow the growth of tumours, which are collections of cancer cells. Pazopanib also works directly on cancer cells to slow down the speed at which they grow.
Pazopanib is used by people who have either not been treated with medication or have unsuccessfully used cytokines (another type of medication) to treat cancer in the kidneys that has metastasized, or spread to other parts of the body. It is also used to treat certain types of soft tissue sarcoma, when other treatment has not worked.
This medication has been shown to slow tumour growth, but it has not yet been shown to help people that take it live longer or have a better quality of life.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Each modified-capsule-shaped, grey, film-coated tablet, with "GS JT" debossed on one side contains 200 mg of pazopanib as pazopanib hydrochloride. Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, povidone (K30) and sodium starch glycollate. The tablet coating contains hypromellose, iron oxide black (E172), macrogol, polysorbate 80, and titanium dioxide (E171).
Each modified-capsule-shaped, yellow, film-coated tablet, with "GS UHL" debossed on one side contains 400 mg of pazopanib as pazopanib hydrochloride. Nonmedicinal ingredients: magnesium stearate, microcrystalline cellulose, povidone (K30) and sodium starch glycollate. The tablet coating contains hypromellose, iron oxide yellow (E172), macrogol, polysorbate 80, and titanium dioxide (E171).
How should I use this medication?
The recommended dose of pazopanib is 800 mg taken by mouth, once a day. This medication should be taken on an empty stomach, at least 1 hour before or 2 hours after a meal, for the best effect.
Pazopanib must not be crushed or broken. Swallow the tablets whole, with a glass of water.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is less than 12 hours until your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not take this medication if you are allergic to pazopanib or any ingredients of the medication.
Do not give this medication to children under 2 years of age.
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- changes in the way things taste
- changes to skin and/or hair colour
- dry skin
- hair loss or thinning
- increased sweating
- lack of energy
- loss of appetite
- loss of strength
- mouth sores
- muscle, joint, or bone pain
- muscle spasms
- nail changes
- prickling, crawling sensation on the skin
- skin rash
- stomach pain or discomfort
- tumour pain
- trouble sleeping
- weight loss
Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- chest pain
- decreased heart rate
- diarrhea with fever or more than 3 episodes per day
- increased blood pressure
- irregular heartbeat
- prickling, tingling, or numbness in the arms or legs
- signs of bleeding (e.g., bloody nose, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
- signs of decreased heart function (e.g., cough, wheeze, fatigue, difficulty breathing when resting or lying down, swollen ankles and feet)
- signs of decreased thyroid function (e.g., constipation, dry skin, tiredness, weight gain, sensitive to the cold)
- signs of dehydration (e.g., decreased urine, dry skin, dry and sticky mouth, sleepiness, dizziness, headache, thirst, confusion)
- signs of infection (fever, severe chills, sore throat, mouth ulcers)
- signs of abnormal liver function (e.g., skin or whites of the eyes turning yellow; feeling tired; dark or brown coloured urine; nausea, vomiting or not wanting to eat)
- symptoms of a urinary tract infection (e.g. pain when urinating, urinating more often than usual, low back or flank pain)
- swelling of the hands, ankles, or feet
- symptoms of lung inflammation (e.g., cough, shortness of breath)
- tingling, numbness, pain, redness, or swelling on palms of hands or soles of feet
- symptoms of too much potassium in the body (e.g., muscle fatigue, weakness, difficulty moving, abnormal heart rhythms, nausea)
- vision changes
Stop taking the medication and seek immediate medical attention if any of the following occur:
- collapsed lung (e.g., shortness of breath, sudden chest pain)
- signs of bleeding in the lung or in the stomach (e.g., bloody, black, or tarry stools; spitting up of blood; vomiting blood or material that looks like coffee grounds)
- signs of a blood clot (e.g., sudden chest pain, shortness of breath, sudden leg pain, leg swelling, or leg redness)
- signs of heart attack (e.g., sudden chest pain or pain radiating to back, down arm, jaw; sensation of tightness or pressure of the chest; nausea; vomiting; sweating; anxiety)
- signs of an irregular heartbeat (e.g., dizziness, palpitations [pounding or racing heartbeat], fainting, or loss of consciousness)
- signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
- signs of a rare neurological disorder called reversible posterior leukoencephalopathy syndrome (RPLS; e.g., confusion, dizziness, headache, high blood pressure, seizures, vision problems, or blindness)
- signs of stroke (e.g., sudden or severe headache; sudden loss of coordination; vision changes; sudden slurring of speech; or unexplained weakness, numbness, or pain in arm or leg)
- signs of swelling in the brain (e.g., clumsiness; gradually worsening weakness; visual, speech, or personality changes; seizures)
- sudden, severe pain in the back, neck, or abdomen
- symptoms of a fistula (e.g., diarrhea, rectal bleeding, weight loss)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Abnormal heart rhythms: Pazopanib may cause a heart rhythm problem called QT prolongation. If you have a history of QT prolongation, slow or irregular heartbeat, irregular heart rhythm, heart failure, heart attack, heart disease, taking other medications known to cause QT prolongation, or a family history of sudden cardiac death at less than 50 years of age, discuss with your doctor how this medication may affect your medical condition and how your medical condition may affect the dosing and effectiveness of this medication. Your doctor will perform tests at regular intervals to monitor for any changes in your heart rhythm.
Bleeding problems: Pazopanib may increase your risk of bleeding. If you have a history of coughing up blood, brain bleeds, or bleeding from the stomach, discuss with your doctor how this medication may affect your medical condition. If you notice signs of serious bleeding, such as vomiting blood or a coffee grounds-like substance or bleeding from the rectum, get immediate medical attention.
Blood clots: This medication may increase the chance of blood clot formation, causing reduction of blood flow to organs or the extremities.
If you have a history of clotting you may be at increased risk of experiencing blood clot-related problems such as heart attack, stroke, or clots in the deep veins of your leg. Discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience symptoms such as sharp pain and swelling in the leg, difficulty breathing, chest pain, blurred vision, or difficulty speaking, contact your doctor immediately.
Congestive heart failure (CHF): Pazopanib may make the heart less effective at pumping blood through the body, causing congestive heart failure and reduced heart function. If you have a history of heart disease or you are at risk of developing heart disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Gastrointestinal (stomach and bowel) problems: Rarely, pazopanib can cause perforation (holes) in the stomach or intestines. If you experience severe abdominal pain, fever, vomiting, or black and tarry stools, contact your doctor immediately.
Grapefruit juice: Grapefruit juice affects how pazopanib is removed from the body and may cause too much of the medication to build up in the body and cause possibly harmful side effects. People should not drink grapefruit juice or eat grapefruit at anytime while taking this medication for treatment.
High blood pressure: Pazopanib can cause increased blood pressure. People with uncontrolled high blood pressure should be closely monitored closely by their doctor.
If you experience symptoms of a severe increase in blood pressure, such as severe chest pain, headache with confusion, nausea, vomiting, or shortness of breath, contact your doctor immediately.
Infection: Pazopanib, like other medications used to treat cancer, can reduce the number of cells that fight infection in the body (white blood cells). If possible, avoid contact with people with contagious infections. Tell your doctor immediately if you notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness. Your doctor will do blood tests regularly to monitor the number of specific types of blood cells in your blood.
Kidney function: This medication has been linked with decreased kidney function. If you experience symptoms of kidney problems, such as fluid retention and puffiness in the lower legs and feet, talk to your doctor.
If you have a history of kidney problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Reversible Posterior Leukoencephalopathy Syndrome (RPLS): This is a rare condition of the brain where the covering that protects the nerves is destroyed, affecting how the nerves in the brain transmit messages. Signs and symptoms of leukoencephalopathy include unusual clumsiness, gradually worsening weakness, visual, speech or personality changes, or possibly seizures. If you experience any of these, contact your doctor immediately.
Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Pazopanib has been reported to cause liver failure, which has in cases, caused death. This medication may also cause a decrease in liver function. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Your doctor may want to test your liver function regularly with blood tests while you are taking this medication. This often allows reduced liver function to be identified before it becomes too severe.
Lung inflammation: Lung inflammation (interstitial lung disease), causing difficulty breathing has occurred rarely in some people taking this medication. This complication can be serious and sometimes fatal. If you experience new or worsening shortness of breath or cough (with or without fever) at any time while you are taking pazopanib, contact your doctor immediately.
Reproduction: Pazopanib may decrease fertility for both men and women. Discuss with your doctor any concerns you have about having children in the future. Women of childbearing age who are taking this medication should use an effective method of birth control (e.g., birth control pill, condoms) during treatment and for 8 weeks after treatment. Pazopanib has also been linked to birth defects in babies born to mothers whose male partner used the medication during the pregnancy. Men whose partners are or may become pregnant should use a barrier form of birth control, such as condoms, while taking pazopanib and for at least 2 weeks after taking the last dose.
Surgery: Pazopanib may reduce the speed of wound healing. If you have a surgery scheduled, let the doctors and nurses involved with your care know that you are taking this medication. Your doctor may want you to stop taking pazopanib temporarily until you have recovered from the surgery.
Thyroid function: This medication may reduce the function of the thyroid gland. If you have thyroid disease, discuss with your doctor how this medication may affect your medical condition. Your doctor may want to test your thyroid function regularly with blood tests while you are taking this medication.
Pregnancy: This medication may cause harm to an unborn fetus if taken by the mother while she is pregnant. It should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if pazopanib passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about breast-feeding, as it is recommended that breast-feeding be stopped while using this medication.
Children: The safety and effectiveness of using this medication have not been established for children less than 18 years of age and is not recommended for this age group. Do not give this medication to children less than 2 years of age as it severely affects body weight gain, organ growth, and maturation, and may cause serious problems with a child’s growth.
What other drugs could interact with this medication?
There may be an interaction between pazopanib and any of the following:
- antacids (e.g., aluminum hydroxide, calcium carbonate, magnesium hydroxide)
- antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
- antipsychotic medications (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
- "azole" antifungals (e.g., fluconazole, itraconazole, voriconazole)
- certain biologics (e.g., denosumab, natalizumab, siltuximab, tocilizumab)
- bisphosphonates (e.g., alendronate, etidronate)
- calcium channel blockers (e.g., diltiazem, nifedipine, verapamil)
- grapefruit juice
- H2-inhibitors (e.g., famotidine, ranitidine)
- Hepatitis C antivirals (daclatasvir, dasabuvir, elbasvir, ledipasvir, velpatasvir)
- HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
- HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
- macrolide antibiotics (e.g., clarithromycin, erythromycin)
- other cancer medication (capecitabine, irinotecan, mitotane, trastuzumab)
- proton pump inhibitors (e.g., lansoprazole, omeprazole, pantoprazole)
- quinolone antibiotics (e.g., ciprofloxacin, levofloxacin, norfloxacin, ofloxacin)
- St. John’s wort
- "statin" cholesterol medications (e.g., atorvastatin, pravastatin, simvastatin)
- tyrosine kinase inhibitors (e.g., crizotinib, dasatinib, imatinib, nilotinib, sunitinib)
If you are taking any of these medications, speak with your doctor or pharmacist.
Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
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