WHAT IS THIS MEDICINE AND WHAT IS IT USED FOR?
Pazonix contains pazopanib, a targeted cancer medicine that blocks
several proteins (called receptor tyrosine kinases, including VEGFR, PDGFR, and
c-KIT) that cancer cells and nearby blood vessels use to grow and form new
blood vessels.
Without a blood supply, tumours cannot get the nutrients they need to
grow and spread. Pazopanib is used in adults for: advanced renal cell carcinoma
(kidney cancer) — as a first-line treatment or after previous immunotherapy;
and advanced soft tissue sarcoma (a type of cancer affecting muscles, fat,
tendons, and other connective tissues) — in patients who have had prior
chemotherapy.
The 200mg tablet is used for dose titration or as part of a reduced dose
regimen — the standard full dose is 800mg (four 200mg tablets) once daily.
3. HOW TO TAKE THIS MEDICINE
The standard dose is 800mg once daily (four 200mg tablets). Reduced doses
of 400mg or 600mg may be used if side effects require dose adjustment.
Tablets must be taken on an empty stomach — at least 1 hour before or 2
hours after a meal. Do not crush or break the tablets — swallow whole with
water. Take at the same time each day.
Blood pressure must be monitored before starting pazopanib and regularly
throughout treatment — high blood pressure (hypertension) is one of the most
common side effects and almost always requires antihypertensive treatment.
Liver function tests are essential before and regularly during treatment, as
pazopanib can cause significant liver toxicity.
⚠ PATIENT TIP: Check your blood pressure at home
every day if possible and keep a log for your oncologist. Report any reading
above 150/100 mmHg promptly. Also report any yellowing of the skin or eyes,
unusual tummy pain, or very dark urine — these can be signs of liver problems,
which need urgent assessment.
4. POSSIBLE SIDE EFFECTS
|
How Common? |
Side Effects |
|
Very Common |
High blood pressure
(hypertension — very common, affecting most patients), diarrhoea, hair colour
changes (depigmentation — hair may turn lighter or grey-white), nausea,
fatigue, decreased appetite, vomiting, weight loss, raised liver enzymes on
blood tests |
|
Common |
Headache, taste
changes (metallic or reduced taste), skin problems (rash, hand-foot syndrome
— redness and soreness on palms and soles), hypothyroidism (underactive
thyroid), raised blood sugar |
|
Serious — Tell Your
Doctor Right Away |
Liver toxicity
(hepatotoxicity): jaundice (yellow skin or eyes), dark urine, right-sided
tummy pain — can be severe and occasionally fatal; requires urgent review and
possible treatment discontinuation. Severe high blood pressure or
hypertensive crisis. Arterial thromboembolism (heart attack, stroke — sudden
chest pain, weakness, speech difficulty). Tumour-related bleeding. QT
prolongation (heart rhythm change). Gastrointestinal perforation or fistula
(severe abdominal pain). |
5. WHO SHOULD NOT TAKE THIS MEDICINE
Pazopanib should not be used during pregnancy — it can seriously harm an
unborn baby. Effective contraception is essential during treatment and for at
least 2 weeks after the last dose.
It must be used with extreme caution — or avoided — in patients with
significant liver impairment (it is primarily processed by the liver). Do not
use in patients with a recent history of heart attack, stroke, or serious
haemorrhage.
⚠ LIVER TOXICITY: This is the most serious
safety concern with pazopanib. Liver enzyme tests (ALT, AST) must be checked
before treatment, then at weeks 3, 5, 7, and 9, then monthly for the first
year. Liver failure has occurred. Report any jaundice, dark urine, or severe
fatigue immediately.
⚠ BLOOD PRESSURE MONITORING: Monitor blood
pressure daily at home and keep a log. High blood pressure must be treated
promptly — it increases the risk of stroke and heart attack. If BP exceeds
150/100 mmHg, contact your care team.
⚠ EMPTY STOMACH: Always take pazopanib on an
empty stomach. A high-fat meal increases absorption dramatically and can cause
unpredictable and dangerous drug levels.
6. MEDICINES THAT INTERACT WITH THIS TREATMENT
Strong CYP3A4 inhibitors (ketoconazole, ritonavir, grapefruit juice,
clarithromycin) significantly raise pazopanib levels — avoid these. Strong
CYP3A4 inducers (rifampicin, phenytoin, carbamazepine, St. John's Wort) reduce
efficacy — avoid.
Pazopanib itself inhibits CYP enzymes and may raise levels of statins
(particularly simvastatin) and other CYP substrates — discuss all medicines
with your oncologist. QT-prolonging medicines increase cardiac risk. Proton
pump inhibitors (omeprazole) reduce pazopanib absorption — avoid or take
pazopanib at a specific time relative to the PPI.
7. HOW TO STORE THIS MEDICINE
Store below 25°C in original packaging. Keep away from moisture and
light. Keep out of reach of children.
8. PRESCRIPTION REQUIREMENT
|
Field |
Details |
|
Status |
Prescription Only
Medicine (POM) — Specialist (oncology) prescription required |
9. GUIDANCE FOR PATIENTS & CAREGIVERS
Take your tablets on an empty stomach — at least 1 hour before eating or
2 hours after a meal — at the same time each day. Check your blood pressure
every day and keep a written log to share with your oncology team.
Attend all liver function blood test appointments without fail. Report
any yellow discolouration of skin or eyes, dark urine, or severe right-sided
tummy pain to your oncologist immediately.
Protect your hands and feet with thick moisturiser to manage hand-foot
syndrome. Avoid grapefruit. Use effective contraception throughout treatment.
10. PHARMACIST & PRESCRIBER NOTES
|
Field |
Details |
|
Clinical Dispensing
Notes |
Fasting administration
is critical — food (especially high-fat meal) dramatically increases AUC. LFT
monitoring schedule: pre-treatment, weeks 3, 5, 7, 9, then monthly for 12
months — hepatotoxicity is the primary safety concern and can be fatal. BP
monitoring: daily home monitoring, treat hypertension promptly. CYP3A4
interaction screening mandatory — avoid strong inhibitors and inducers.
Grapefruit counselling. PPI interaction: advise separation or switch to
short-acting H2 blocker taken in morning. Statin interaction (especially
simvastatin, atorvastatin) — dose reduction may be needed. QT-prolonging drug
interaction check. Embryo-fetal toxicity — contraception during and 2 weeks
post-treatment. Hand-foot syndrome prevention counselling. Hair depigmentation
— common and benign; counsel proactively. |
11. FREQUENTLY ASKED QUESTIONS
Q: Why is monitoring my liver so important?
Pazopanib can cause liver inflammation and, in rare cases, serious liver
damage. Regular liver blood tests allow your care team to detect any problem
early and adjust your dose or stop the medicine before serious harm occurs.
Report yellowing of skin or eyes, dark urine, or severe tummy pain to your
doctor straight away — do not wait for your next scheduled blood test.
Q: My hair has gone lighter or grey — is this normal?
Yes — hair colour change (depigmentation) is a very common and harmless
side effect of pazopanib that affects many patients. It is thought to be
related to the medicine's effect on melanin-producing cells. Hair colour
typically returns to normal after stopping treatment.
Q: What is hand-foot syndrome?
Redness, tenderness, swelling, or peeling of the palms and soles.
Moisturise daily with a thick cream, wear soft well-cushioned shoes, and avoid
activities that put friction or pressure on these areas. Tell your care team if
it becomes painful or prevents you from walking normally.
Q: Can I take my regular cholesterol medicine (statin)?
Pazopanib can raise levels of certain statins in the blood, increasing
the risk of muscle damage (myopathy). Your oncologist may review your statin
dose or switch you to a safer option. Always mention that you are taking pazopanib
when any doctor reviews your statins.
Q: Do I need contraception?
Yes — pazopanib can harm an unborn baby. Use effective contraception
throughout treatment and for at least 2 weeks after your last dose.