Pazopanib, sold under the brand name Votrient, is a targeted cancer medication frequently prescribed to treat specific types of cancers. It belongs to the class of potent kinase inhibitors that work to slow down tumor growth and spread to other parts of the body.
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Pazopanib was initially approved by the FDA in 2009 for the treatment of kidney cancer. Later, its approval was expanded to include the treatment of sarcoma as well.
This cancer drug comes in the form of a capsule-shaped tablet that is taken orally, as prescribed. It is available only with a prescription from a physician. Read on to learn how Pazopanib works, how it is used, possible side effects, and what to expect during treatment.
Pazopanib (Votrient): Uses
Pazopanib is an FDA-approved drug and is typically prescribed to adult patients with the following types of cancers:
- Kidney cancer, also known as advanced renal cell carcinoma (RCC), is a type of cancer that has advanced or has spread to other organs.
- Soft-tissue sarcoma (a cancer that occurs in bone and connective tissues, such as fat, muscle, and blood vessels).
Pazopanib may be prescribed for other purposes as determined by your healthcare provider.
Important Safety Information (Boxed Warning)
Pazopanib may cause severe or life-threatening liver damage (hepatotoxicity). Therefore, it is recommended that liver function be monitored during treatment with this drug. Call your doctor immediately if you experience any of the following symptoms: yellowing of the skin or eyes, dark urine, extreme tiredness, nausea, vomiting, loss of appetite, pain in the upper right part of the stomach, or unusual bleeding or bruising.
Pazopanib: Working Mechanism
Pazopanib is a type of targeted cancer medicine that attacks cancer in a more specific way than traditional chemotherapy. Typically, cancer cells need oxygen and nutrients to grow and spread. To achieve this, they release specific proteins (tyrosine kinases) that signal the body to form new blood vessels (a process called angiogenesis).
Pazopanib, which is a potent tyrosine kinase inhibitor (TKI), blocks these proteins (tyrosine kinases) and helps:
- Stop the growth of new blood vessels that feed the tumor
- Reduce the supply of oxygen and nutrients to cancer cells
- Slow down tumor growth and spread
In short, it starves the cancer cells by cutting off their blood supply and growth signals that tumors need to grow.
Pazopanib: Drug Form
Pazopanib is available as a capsule-shaped oral tablet in strengths of 200 mg and 400 mg.
Recommended Dosage and Administration
The recommended dose of pazopanib for patients with advanced kidney cancer and soft-tissue sarcoma is 800 mg once a day.
Pazopanib tablets are taken on an empty stomach with a glass of water, at least 1 hour before or 2 hours after a meal. You should swallow the tablet whole; do not crush, chew, or break it.
Also, do not eat grapefruit or drink grapefruit juice during treatment with pazopanib. Grapefruit products may increase the amount of pazopanib in your body.
If you miss a dose, take it as soon as you remember. Do not take it if it is close (within 12 hours) to your next dose. Just take the next dose at your regular time.
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About Copay AssistancePossible Side Effects
Pazopanib may cause some side effects. You might have one or more of them. The commonly reported side effects in individuals with kidney cancers after taking pazopanib are:
- Diarrhea
- Hypertension
- Hair color changes (depigmentation)
- Nausea
- Anorexia
- Vomiting
People with soft-tissue sarcoma may experience the following side effects after taking Pazopanib:
- Fatigue
- Diarrhea
- Nausea
- Decreased weight
- Hypertension
- Decreased appetite
- Vomiting
- Tumor pain
- Hair color changes
- Musculoskeletal pain
- Headache
- Dysgeusia (taste changes)
- Dyspnea (shortness of breath)
- Skin hypopigmentation
Adverse Side Effects
Pazopanib may cause serious side effects, including:
- Liver problems (yellowing of skin or eyes, dark urine, severe tiredness)
- Severe high blood pressure (hypertension)
- Irregular or fast heartbeat or fainting
- Heart failure
- Heart attack or stroke
- Bleeding problems (unusual bruising, coughing up blood, black stools)
- Blood clots (sudden leg pain or swelling, trouble breathing)
- Severe stomach or bowel problems (tear in your stomach or intestinal wall [perforation] or an abnormal connection between two parts of your gastrointestinal tract [fistula])
- Lung problems (inflammation in the lungs)
- Reversible Posterior Leukoencephalopathy Syndrome (a serious brain condition in which blood vessels in your brain swell)
- Hypothyroidism (low thyroid hormones)
- Proteinuria (high amount of protein in the urine)
- Serious infections
Although less common, these require immediate medical attention. Always tell your doctor if you notice new or worsening symptoms.
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Pazopanib: Precautionary Measures
Before taking Pazopanib, tell your doctor if you:
- Have or had liver problems
- Have high blood pressure
- Have heart problems or an irregular heartbeat, including QT prolongation
- Have a history of a stroke
- Have headaches, seizures, or vision problems
- Have coughed up blood in the last 6 months
- Had bleeding in your stomach or intestines in the last 6 months
- Have a history of a tear (perforation) in your stomach or intestine, or an abnormal connection between two parts of your gastrointestinal tract (fistula)
- Have had blood clots in a vein or in the lung
- Have thyroid problems
- Had recent surgery (within the last 7 days) or are going to have surgery
- Have any other medical conditions
- Are allergic to pazopanib or any of the other ingredients of this medicine
- Are pregnant or plan to become pregnant. Pazopanib can harm your unborn baby.
- Are breastfeeding or plan to breastfeed. It is not known if pazopanib passes into your breast milk. You and your healthcare provider should decide if you will take Pazopanib or breastfeed. You should not do both.
- Are taking any prescription or non-prescription medicines, vitamins, and herbal supplements. Pazopanib may affect the way other medicines work, and other medicines may affect how pazopanib works.
Medicines To Avoid
You should avoid taking the following medications, as they may alter the blood level of pazopanib, may affect how Votrient works, or make it more likely that you’ll have side effects. These include:
- A proton pump inhibitor (PPI), such as esomeprazole (Nexium)
- Any medicine that can cause QT prolongation, which is a potentially dangerous heart rhythm problem
- Dextromethorphan (a medicine used to treat a cough caused by the common cold or other illnesses)
- Ketoconazole (a medicine used for fungal infections)
- Lapatinib (Tykerb) (a medicine used to treat certain types of breast cancer)
- Midazolam (a medicine used to relieve anxiety before surgery)
- Medicines that contain simvastatin to treat high cholesterol levels
- Herbal supplements containing St. John’s wort
Pazopanib Cost
Pazopanib (Votrient) can be very expensive without insurance because it is a branded medication. The cost may reach several thousand dollars per month, depending on the tablet strength and how many tablets are prescribed.
For example, a 120-tablet supply of 200 mg pazopanib may cost between $9,495 and $22,701, whereas a 30-tablet supply of 400 mg may cost approximately $3,749 or more before discounts, insurance, or assistance programs.
Many patients do not pay the full price because insurance coverage, copay assistance, or pharmacy discount cards can help reduce the cost. Contact us if you are interested in exploring financial assistance opportunities for Pazopanib.
REFERENCES:
- US Food and Drug Administration (FDA). VOTRIENT (pazopanib) Prescribing Information: https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/022465s-010S-012lbl.pdf
- European Medicines Agency (EMA). VOTRIENT (pazopanib) Prescribing Information: https://www.ema.europa.eu/en/documents/product-information/votrient-epar-product-information_en.pdf#:~:text=Pazopanib%20is%20for%20oral%20use.%20It%20should,not%20broken%20or%20crushed%20(see%20section%205.2).
- Heudel, P., Cassier, P., Derbel, O., Dufresne, A., Meeus, P., Thiesse, P., Ranchère-Vince, D., Blay, J. Y., & Ray-Coquard, I. (2012). Pazopanib for the treatment of soft-tissue sarcoma. Clinical Pharmacology : Advances and Applications, 4, 65. https://doi.org/10.2147/CPAA.S33195
- National Institute of Diabetes and Digestive and Kidney Diseases. (2020, May 10). Pazopanib. LiverTox – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK548110/#:~:text=Pazopanib%20also%20has%20activity%20against,%2C%20and%20embryo%2Dfetal%20toxicity.
- Méndez-Vidal, M. J., Molina, Á., Anido, U., Chirivella, I., Etxaniz, O., Fernández-Parra, E., Guix, M., Hernández, C., Lambea, J., Montesa, Á., Pinto, Á., Ros, S., & Gallardo, E. (2018). Pazopanib: Evidence review and clinical practice in the management of advanced renal cell carcinoma. BMC Pharmacology & Toxicology, 19, 77. https://doi.org/10.1186/s40360-018-0264-8
- Zarkar, A., Pirrie, S., Stubbs, C., Hodgkins, A., Farrugia, D., Fife, K., MacDonald-Smith, C., Vasudev, N., & Porfiri, E. (2022). A Study of Pazopanib Safety and Efficacy in Patients With Advanced Clear Cell Renal Cell Carcinoma and ECOG Performance Status 2 (Pazo2): An Open label, Multicentre, Single Arm, Phase II Trial. Clinical Genitourinary Cancer, 20(5), 473-481. https://doi.org/10.1016/j.clgc.2022.06.012
