Pazopanib (Votrient®)

About This Drug

Pazopanib is used to treat cancer. It is given orally (by mouth).

Possible Side Effects

  • Headache
  • Tiredness
  • Changes in your hair color and/or texture
  • Trouble breathing
  • Decreased appetite (decreased hunger)
  • Changes in the way food and drinks taste
  • Nausea and throwing up (vomiting)
  • Pain in your abdomen
  • Loose bowel movements (diarrhea)
  • Weight loss
  • High blood pressure
  • Tumor flare phenomenon. During the first few weeks, typical signs and symptoms of your cancer may worsen
  • Joint, bone, and/or muscle pain

Note: Each of the side effects above was reported in 20% or greater of patients treated with pazopanib. Not all possible side effects are included above.

Warnings and Precautions

  • Severe infections, including viral, bacterial and fungal, which can be life-threatening
  • Changes in the tissue of the heart, which can be life-threatening. Some changes may happen that can cause your heart to have less ability to pump blood or cause heart attack. You may have abnormal heartbeats.
  • Abnormal bleeding, which may be life-threatening; symptoms may be coughing up blood, throwing up blood (may look like coffee grounds), red or black tarry bowel movements, abnormally heavy menstrual flow, nosebleeds or any other unusual bleeding.
  • Blood clots and events such as stroke and heart attack, which may be life-threatening. A blood clot in your leg may cause your leg to swell, appear red and warm, and/or cause pain. A blood clot in your lungs may cause trouble breathing, pain when breathing, and/or chest pain.
  • Abnormal opening in stomach, intestine or esophagus (fistula) which may be life-threatening; symptoms of a fistula may be: severe abdominal pain or difficulty swallowing
  • Perforation - a hole in your stomach, small and/or large intestine, which may be life-threatening.
  • Inflammation (swelling) of the lungs, which may be life-threatening. You may have a dry cough or trouble breathing.
  • Changes in your central nervous system can happen, which may be life-threatening. The central nervous system is made up of your brain and spinal cord. You could feel extreme tiredness, agitation, confusion, hallucinations (see or hear things that are not there), have trouble understanding or speaking, loss of control of your bowels or bladder, eyesight changes, numbness or lack of strength to your arms, legs, face, or body, seizures or coma. If you start to have any of these symptoms let your doctor know right away.
  • Severe high blood pressure
  • Changes in your thyroid function
  • Changes in your liver function, which can very rarely cause liver failure and be life-threatening
  • Changes in your kidney function causing protein in your urine

Note: Some of the side effects above are very rare. If you have concerns and/or questions, please discuss them with your medical team.

Important Information

  • Pazopanib may cause slow wound healing. It should be stopped 7 days prior to surgery. If you must have emergency surgery or have an accident that results in a wound, tell the doctor that you are on pazopanib.

How to Take Your Medication

  • Take this drug by mouth without food, at least 1 hour before you eat or 2 hours after you eat. Do not crush it.
  • Missed dose: If you miss a dose, take it as soon as you think about it.If it is within 12 hours of your next dose, then skip the missed dose, continue with your regular dosing schedule and contact your physician.
  • Handling: Wash your hands after handling your medicine, your caretakers should not handle your medicine with bare hands and should wear latex gloves.
  • This drug may be present in the saliva, tears, sweat, urine, stool, vomit, semen, and vaginal secretions. Talk to your doctor and/or your nurse about the necessary precautions to take during this time.
  • Storage: Store this medicine in the original container at room temperature. Discuss with your nurse or your doctor how to dispose of unused medicine

Treating Side Effects

  • To help with weight loss, drink fluids that contribute calories (whole milk, juice, soft drinks, sweetened beverages, milkshakes, and nutritional supplements) instead of water.
  • Include a source of protein at every meal and snack, such as meat, poultry, fish, dry beans, tofu, eggs, nuts, milk, yogurt, cheese, ice cream, pudding, and nutritional supplements.
  • To help with decreased appetite, eat small, frequent meals.
  • Eat high caloric food such as pudding, ice cream, yogurt and milkshakes.
  • Taking good care of your mouth may help food taste better and improve your appetite.
  • Drink plenty of fluids (a minimum of eight glasses per day is recommended).
  • If you throw up or have loose bowel movements, you should drink more fluids so that you do not become dehydrated (lack water in the body from losing too much fluid).
  • To help with nausea and vomiting, eat small, frequent meals instead of three large meals a day. Choose foods and drinks that are at room temperature. Ask your nurse or doctor about other helpful tips and medicine that is available to help or stop lessen these symptoms.
  • If you get diarrhea, eat low-fiber foods that are high in protein and calories and avoid foods that can irritate your digestive tracts or lead to cramping.
  • Ask your nurse or doctor about medicine that can lessen or stop your diarrhea.
  • Keeping your pain under control is important to your well-being. Please tell your doctor or nurse if you are experiencing pain.

Food and Drug Interactions

  • Do not eat grapefruit or drink grapefruit juice while taking this medicine.Grapefruit and grapefruit juice may raise the levels of pazopanib in your body. This could make side effects worse
  • Check with your doctor or pharmacist about all other prescription medicines and over-the-counter medicines and dietary supplements (vitamins, minerals, herbs and others) you are taking before starting this medicine as there are known drug interactions with pazopanib.Also, check with your doctor or pharmacist before starting any new prescription or over-the-counter medicines, or dietary supplements to make sure that there are no interactions.
  • Avoid the use of St. John’s Wort while taking pazopanib as this may lower the levels of the drug in your body, which can make it less effective
  • Drugs that treat heartburn and stomach upset such Maalox®, Mylanta®, Protonix®, Nexium®, Prilosec®, Pepcid®, Tagamet®, and Zantac® may lower the effect of your cancer treatment if taken with pazopanib. Call your doctor to find out what drug you may take with pazopanib to help with heartburn or stomach upset.

When to Call the Doctor

Call your doctor or nurse if you have any of these symptoms and/or any new or unusual symptoms:

  • Fever of 100.5 F (38 C) or higher
  • Chills
  • Confusion and/or agitation
  • Seizures
  • Hallucinations
  • Trouble understanding or speaking
  • A headache that does not go away
  • Blurry vision or changes in your eyesight
  • Numbness or lack of strength to your arms, legs, face, or body
  • Pain in your chest
  • Dry cough
  • Coughing up blood
  • Wheezing and/or trouble breathing
  • Feeling that your heart is beating in a fast or not normal way (palpitations)
  • Your leg or arm is swollen, red, warm and/or painful
  • Chest pain or symptoms of a heart attack. Most heart attacks involve pain in the center of the chest that lasts more than a few minutes. The pain may go away and come back. It can feel like pressure, squeezing, fullness, or pain. Sometimes pain is felt in one or both arms, the back, neck, jaw, or stomach. If any of these symptoms last 2 minutes, call 911.
  • Symptoms of a stroke such as sudden numbness or weakness of your face, arm, or leg, mostly on one side of your body; sudden confusion, trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, feeling dizzy, loss of balance or coordination; or sudden, bad headache with no known cause.If you have any of these symptoms for 2 minutes, call 911.
  • Blood in your urine, vomit (bright red or coffee-ground) and/or stools ( bright red, or black/tarry)
  • Easy bleeding or bruising
  • Lasting loss of appetite or rapid weight loss of five pounds in a week
  • Fatigue that interferes with your daily activities
  • Pain in your abdomen that does not go away
  • Difficulty swallowing
  • Nausea that stops you from eating or drinking and/or is not relieved by prescribed medicines
  • Throwing up more than 3 times a day
  • Loose bowel movements (diarrhea) 4 times a day or loose bowel movements with lack of strength or a feeling of being dizzy
  • Signs of possible liver problems: dark urine, pale bowel movements, bad stomach pain, feeling very tired and weak, unusual itching, or yellowing of the eyes or skin
  • Swelling of legs, ankles, or feet
  • Weight gain of 5 pounds in one week (fluid retention)
  • Pain that does not go away, or is not relieved by prescribed medicines
  • If you think you may be pregnant or may have impregnated your partner

Reproduction Warnings

  • Pregnancy warning: This drug can have harmful effects on the unborn baby. Women of childbearing potential should use effective methods of birth control during your cancer treatment and for at least 2 weeks after treatment. Men with female partners of childbearing potential should use effective methods of birth control during your cancer treatment and for at least 2 weeks after your cancer treatment. Let your doctor know right away if you think you may be pregnant or may have impregnated your partner.
  • Breastfeeding warning: Women should not breast feed during treatment and for 2 weeks after treatment because this drug could enter the breast milk and cause harm to a breast feeding baby.
  • Fertility warning: In men and women both, this drug may affect your ability to have children in the future. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.

Revised March 2018

This information is intended to provide helpful health information to the general public and is not to be used in place of any medical, health, psychological, or any other kind of personal professional services. The information herein does not cover all possible uses, actions, precautions, side effects, or interactions of the medicines mentioned, nor is the information intended as medical advice for individual problems or for making an evaluation as to the risks and benefits of taking a particular medication. The dose, method of administration and contraindications for any administered medication should be confirmed before use. UPMC specifically disclaims all responsibility for any liability, loss or risk, personal or otherwise, which is incurred as a consequence, directly or indirectly, of the use and application of any medication mentioned herein.