Pazopanib (Votrient ®)
Pazopanib is used to treat renal cell carcinoma that has spread outside the kidney. It can also treat some soft tissue sarcomas.
Pazopanib is a type of treatment called a tyrosine kinase inhibitor (TKI), also known as a cancer growth inhibitor. Kinases are important proteins in the body that regulate how the cells grow and divide.
Pazopanib blocks the proteins (kinases) from sending signals to cancer cells to grow. Blocking the signals causes the cells to die. Pazopanib can also stop the cancer cells from developing new blood vessels. This reduces their supply of oxygen and nutrients, so that the tumour shrinks or stops growing.
When pazopanib is givenBack to top
Pazopanib may be given if you have kidney cancer that has spread outside the kidney (advanced renal cell cancer). It can be given as a first treatment or after treatment with interferon or aldesleukin. Talk to your doctor to see if pazopanib is recommended for your type of kidney cancer.
If pazopanib isn’t recommended for you, it may not be available on the NHS, although you may be given it as part of a clinical trial.
Soft tissue sarcoma
Pazopanib may be given for certain types of soft tissue sarcoma when the cancer has spread to another part of the body (metastatic cancer) and chemotherapy treatment has already been used. Talk to your doctor to see if pazopanib is recommended for your type of sarcoma.
You take pazopanib as a tablet once a day. Take the tablets with a glass of water, one hour before you eat or two hours after you eat. If you take pazopanib at the same time as you eat, it can affect how it works. Don’t chew or crush the tablets before you take them as this may increase side effects. Avoid grapefruit and grapefruit juice during your treatment as it may increase side effects.
Always take your tablets exactly as your nurse or pharmacist explained. This is important to make sure they work as well as possible for you.
There are some important things to remember when taking your tablets:
- If you forget to take your tablets or are sick after taking them, just take your next dose at the usual time – don’t take a double dose.
- Keep the tablets in the original packaging and at room temperature, away from heat and direct sunlight.
- Keep the tablets in a safe place, out of the reach of children.
- Get a new prescription before you run out of tablets and make sure you have plenty for the holidays.
- If your doctor decides to stop the treatment, return any remaining tablets to the pharmacist. Don’t flush them down the toilet or throw them away.
Possible side effects of pazopanibBack to top
Each person’s reaction to cancer treatment is different. Some people have very few side effects, while others may experience more. The side effects described here won’t affect everyone having this treatment.
We explain the most common side effects but haven't included all the less common ones as they are unlikely to affect you. If you have any side effects that we don’t mention, tell your doctor or specialist nurse.
High blood pressure
Pazopanib can cause high blood pressure in some people. You should let your doctor know if you already have high blood pressure before starting this treatment.
Your blood pressure will be checked regularly for the first six weeks of treatment. If your blood pressure goes up, it’s most likely to happen within the first few weeks of taking the drug. If you develop high blood pressure, you will be prescribed medicines to help control it.
You may have frequent or loose bowel movements. This can usually be controlled by taking anti-diarrhoea drugs. Your doctor can prescribe these for you. If diarrhoea is severe or continues, tell your doctor. If you have diarrhoea, it’s important to drink plenty of fluids, around two litres (three and half pints) per day.
Feeling or being sick
Feeling or being sick can be controlled by taking anti-sickness drugs that your doctor can prescribe for you. Tell your doctor if the sickness doesn’t improve so they can prescribe other anti-sickness drugs which may work better for you.
Some anti-sickness drugs can cause constipation. Let your doctor or nurse know if this is a problem.
Effects on the mouth
You may notice food tastes different while you are taking pazopanib. Your specialist nurse can give advice on coping with this. Some people may get a sore mouth or mouth ulcers. Drink plenty of fluids, and clean your teeth regularly and gently with a soft toothbrush. Tell your doctor or nurse if you have any mouth problems. They can prescribe mouthwashes and medicines to treat mouth infections and relieve soreness.
Loss of appetite
Your appetite may be affected by this treatment. In some people, this can lead to weight loss. Try to eat small meals regularly. If your appetite doesn’t improve, tell your doctor or specialist nurse. They can arrange for you to see a dietitian who can give you advice. You may be given food supplements or meal replacement drinks to try. Your doctor can prescribe these or you can buy some of them from chemists.
If tiredness occurs it’s usually mild. It’s important to try to pace yourself and get as much rest as you need. Try to balance this with taking some gentle exercise, such as short walks, which will help.
Effects on the hair
Your hair may lose colour and it may become thinner while you’re taking pazopanib. Changes to your hair are usually temporary and get better if you stop treatment. But for some people, hair changes can be permanent.
Effects on the skin
You may develop a rash and your skin may feel dry and itchy or peel. Some people notice their skin loses some of its colour. Tell your doctor or specialist nurse if you notice any skin changes. They can advise you about creams or lotions to help with dryness and can prescribe medicines to relieve itching.
Hand/foot skin reaction
The palms of your hands and soles of your feet may get red, sore or swollen. You may also notice numbness or tingling in them. If this happens, moisturise your hands and feet with an unperfumed moisturiser, keep them cool and avoid hot water.
If soreness doesn’t settle or if blistering develops, your doctor may need to reduce the dose of pazopanib or interrupt the treatment. Very occasionally, people may need to stop having the treatment completely.
Abdominal (tummy) pain
Some people have pain or discomfort in their tummy when taking pazopanib. Let your doctor know if this happens to you.
Very rarely, pazopanib can cause a hole (perforation) in the small bowel. Contact your doctor immediately if you have severe pain in the tummy or signs of bleeding, such bleeding from the back passage, black stools, or vomiting up blood (or vomit that looks like coffee grounds).
Let your doctor or nurse know if you have headaches. They can give you painkillers to relieve this.
Risk of infection
Pazopanib can reduce the number of white blood cells, which help fight infection. If the number of your white blood cells is low, you will be more prone to infections. A low white blood cell count is called neutropenia.
Contact the hospital straight away on the contact number you’ve been given if:
- your temperature goes over 37.5°C (99.5°F) or over 38°C (100.4°F), depending on the advice given by your hospital
- you suddenly feel unwell, even with a normal temperature
- you have symptoms of an infection – this can include feeling shaky, a sore throat, a cough, diarrhoea or needing to pass urine a lot.
You will have blood tests while you’re taking pazopanib to check the number of white blood cells. If they get too low, your doctor may ask you to stop taking pazopanib or reduce the dose for a time.
Bruising and bleeding
Pazopanib can reduce the number of platelets in your blood. Platelets are cells which help the blood to clot. Tell your doctor if you have any bruising or bleeding which you can’t explain. This includes nose bleeds, bleeding gums, heavier than normal menstrual periods, blood in your urine or stools, blood spots or rashes on the skin.
Sometimes your doctor may ask you to stop taking pazopanib or reduce the dose for a time to help.
You may have some mild dizziness. Tell your doctor if you notice this. It may affect your ability to drive.
Some people have pains in their joints or muscles during treatment. Your doctor can prescribe painkillers for this.
Some people notice swelling around the eyes and ankles because of fluid retention. This isn’t harmful, but it can be upsetting and uncomfortable. Diuretics (drugs that make you pass more urine) can help get rid of some of the fluid, but it often settles down by itself. Let your doctor know if you put on a lot of weight very quickly. This can be a sign that you’re retaining fluid.
Effects on lungs
Occasionally people feel more breathless or develop a cough while taking pazopanib. Let your doctor know if you notice this.
Occasionally people have hot flushes while taking pazopanib. If you are affected tell your doctor or specialist nurse, who can give you advice on coping with them.
Wounds often take longer to heal while you're having treatment with pazopanib. If you need an operation, your doctor will tell you to stop taking pazopanib before it and for a few weeks afterwards. You may also need to stop taking pazopanib for a few days if you are having dental treatment. Talk to your doctor if you need to have surgery or dental treatment.
Less common side effectsBack to top
In a small number of people, pazopanib can affect the heart. Tell your doctor if you have a heart condition or high blood pressure before starting treatment. Contact your doctor immediately if you have chest pain, your heartbeat becomes less regular, or your heart feels like it’s beating too fast or too slowly.
Pazopanib can increase the risk of having a stroke. Signs of a stroke include weakness or numbness in one or both of your arms, slurred speech or drooping of your face, mouth or eye. If you or someone you know notices you have any of these symptoms, you should tell a doctor immediately.
Confusion and seizures (fits)
Rarely, pazopanib can cause the brain to swell. This can cause confusion, seizures or sudden loss of vision. Contact your doctor immediately if you experience any of these symptoms.
You may notice your vision becomes blurred. Rarely, this can be a sign of an eye problem which needs urgent medical treatment. Contact your doctor straightaway if your vision becomes blurred.
Effects on the thyroid gland
Pazopanib can sometimes affect the thyroid gland, making it less active. Your doctor will check how your thyroid is working with regular blood tests. If this happens, it can be easily treated with medication and goes back to normal after the treatment is finished.
Effects on the liver
Pazopanib may cause changes in the way your liver works. This doesn’t generally cause any symptoms and usually goes back to normal when treatment stops. Your doctor will monitor your liver with regular blood tests.
It’s important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they’re not mentioned above.
Other information about pazopanibBack to top
Some medicines, including those that you can buy in a shop or chemist , can be harmful to take when you are having pazopanib. Tell your doctor about any medicines you are taking, including ones you can buy for yourself, complementary therapies and herbal drugs.
It’s not known if pazopanib affects your fertility (being able to get pregnant or father a child). If you are worried about this, talk to your doctor or nurse before treatment starts.
Your doctor will advise you not to become pregnant or to father a child during treatment. This is because pazopanib may harm a developing baby.
Women are advised not to breastfeed during treatment and for a few months after. This is in case there is pazopanib in their breast milk.
Medical and dental treatment
If you need to go into hospital for any reason other than cancer, always tell the doctors and nurses you are taking pazopanib. Give them the name of your cancer doctor so they can ask for advice.
Talk to your cancer doctor or nurse if you think you need dental treatment. Always tell your dentist you are having pazopanib.
This page has been compiled using information from a number of reliable sources, including the electronic Medicines Compendium (eMC; medicines.org.uk). If you’d like further information on the sources we use, please feel free to contact us.
This information was reviewed by a medical professional.
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