Pazopanib (VOTRIENT)

Renal cell carcinoma

Renal cell carcinoma

• Oral: 800 mg once daily continuously until disease progression or unacceptable toxicity

Available as 200 mg and 400 mg film coated tablets. Tablets should NOT be crushed or broken. Store at room temperature.

Multi-targeted TKI (tyrosine kinase inhibitor) which includes action as a VEGF (vascular endothelial growth factor) inhibitor

Take on an empty stomach at least 1 hour before or 2 hours after a meal

If a dose is missed, patients should be instructed to take it as soon as they can if it is within 12 hours of the missed dose. If it is over 12 hours since the missed dose, patients should skip the missed dose and resume with the next scheduled dose.

Common: Diarrhea, Nausea, Vomiting, Hyperbilirubinemia, Anorexia, Hair color changes, Hypertension.

Less Common: Perforation or fistula, Fatigue, Hepatotoxicity, QT prolongation, Torsades de pointes, Cerebral hemorrhage, Cerebral vascular accident, Hypertensive crisis, Cardiac adverse events or dysfunction.

The adverse effects listed above are not exhaustive. Please refer to the relevant product monograph for full details.

Baseline before treatment: CBC & differential, platelets, sodium, potassium, creatinine, total protein, albumin, bilirubin, alkaline phosphatase, ALT, urine analysis, TSH.

Every 2 weeks for Cycles 1 and 2: CBC & differential, platelets, creatinine, ALT, bilirubin.

During treatment: CBC & differential, platelets, creatinine, ALT, bilirubin; TSH every other cycle or if clinically indicated.

If clinically indicated: MUGA scan or echocardiogram.

• This drug can impact or be impacted by metabolic enzymes for absorption and excretion. Many drugs can also affect or be affected by these enzymes, so please consult with pharmacy to assess for interactions.
• May increase the risk for QT interval prolongation. Avoid concurrent therapy with drugs associated with QTc prolongation and/or Torsades de pointes, if possible. If unavoidable, monitor for QT prolongation or cardiac arrhythmias.
• Avoid concurrent therapy with proton pump inhibitors, H2 receptor antagonists, and short acting antacids.
• Avoid grapefruit, grapefruit juice, Seville oranges, or Seville orange juice.
• Current drug interaction databases should be consulted for more information.

• Avoid in pregnancy and lactation.
• Hypertension is common with VEGF inhibitors. Monitor blood pressure closely and manage with antihypertensives and dose hold/reductions.

• Thyroid dysfunction, in particular hypothyroidism may occur with this treatment. Monitor for signs and symptoms of thyroid dysfunction and manage as clinically appropriate.
• Impaired wound healing is associated with VEGF inhibitors, drug may need to be held and restarted if patient requires surgery, discuss with team.

BC Cancer. BC Cancer Drug Manual. Pazopanib. Vancouver, British Columbia: BC Cancer Agency. Available at http://www.bccancer.bc.ca/drug-database-site/Drug%20Index/Pazopanib_monograph_1Oct2015.pdf. Updated October 1, 2015. Accessed January 25, 2024.

Lexicomp. Pazopanib Monograph. In: Lexi-Drugs. Hudson, Ohio: Lexi-Comp, Inc.; 2024. Available at: https://online-lexi-com.qe2a-proxy.mun.ca/lco/action/doc/retrieve/docid/patch_f/2005522?cesid=7nIES8c9mhb&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3DPAZOPanib%26t%3Dname%26acs%3Dtrue%26acq%3Dpazopanib. Updated January 24, 2024. Accessed January 25, 2024.

Cancer Care Ontario. Pazopanib - Drug Formulary. Cancer Care Ontario website. https://www.cancercareontario.ca/en/drugformulary/drugs/monograph/43756. Updated October 2020. Accessed January 25, 2024.

GlaxoSmithKline Inc. VOTRIENT® Product monograph. Mississauga, Ontario. Updated July 30, 2015.