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Pazopanib

    DEA Class; Rx

    Common Brand Names; Votrient

    • Antineoplastics, Tyrosine Kinase Inhibitor; 
    • Antineoplastics, VEGF Inhibitor

    Oral multi-tyrosine kinase inhibitor
    For advanced renal cell carcinoma and soft-tissue sarcoma
    Severe and fatal hepatotoxicity has been reported

    Indicated for advanced renal cell carcinoma (RCC)

    Indicated for advanced soft tissue sarcoma (STS) who have received prior chemotherapy

    • ALT/AST increased (53%)
    • Diarrhea (52%)
    • Glucose increased (41%)
    • Hypertension (40%)
    • Hair color changes (38%)
    • Leukopenia (37%)
    • Total bilirubin increased (36%)
    • Phosphorous decreased (34%)
    • Neutropenia (34%)
    • Thrombocytopenia (32%)
    • Lymphocytopenia (31%)
    • Sodium decreased (31%)
    • Magnesium decreased (26%)
    • Nausea (26%)
    • Anorexia (22%)
    • Vomiting (21%)
    • Fatigue (19%)
    • Glucose decreased (17%)
    • Asthenia (14%)
    • Abdominal pain (11%)

    Hepatotoxicity, manifested as increases in ALT, AST, and bilirubin, occurred 

    Mild, indirect (unconjugated) hyperbilirubinemia may occur in patients with Gilbert’s syndrome; manage elevation in ALT >3x ULN per dosing recommendations in such patients

    Fatal hemorrhage, fatal arterial thromboembolic events, and cerebral/intracranial hemorrhage have occurred

    Has not been studied in patients who have a history of hemoptysis, cerebral hemorrhage, patients who have had an arterial thromboembolic event within the previous 6 months, or clinically significant gastrointestinal hemorrhage in the past 6 months

    Venous thromboembolic events (VTEs), including venous thrombosis and fatal pulmonary embolus (PE) reported; monitor for signs and symptoms of VTE and PE

    Thrombotic microangiopathy (TMA), including thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS), occurred in clinical trials

    Gastrointestinal perforation or fistula has been reported; monitor for signs and symptoms of gastrointestinal perforation or fistula; withhold in case of Grade 2 or 3 gastrointestinal fistula and resume based on medical judgement; permanently discontinue in case of gastrointestinal perforation or Grade 4 gastrointestinal fistula

    ILD/pneumonitis and PRES, which can be fatal, has been reported

    Hypothyroidism has occurred; monitor thyroid tests at baseline, during treatment and as clinically indicated and manage appropriately

    Proteinuria has been reported; perform baseline and periodic urinalysis during treatment with follow up measurement of 24-hr urine protein as clinically indicated

    Cases of TLS, including fatal cases, have been reported

    Can cause fetal harm when administered to a pregnant woman

    Based on animal studies and its mechanism of action, fetal harm may occur; advise pregnant women of potential risk to a fetus

    No data available on the drug presence or its metabolites in human milk or the effects on the breastfed infant or milk production

    Adults

    800 mg PO/day.

    Elderly

    800 mg PO/day.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Pazopanib

    tablet

    • 200mg
    • 400mg