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. This is known as anti-angiogenesis treatment.
It’s best to read this information with our general information about the type of cancer you have. During treatment, you will see a cancer doctor and a cancer nurse. This is who we mean when we mention doctor or nurse in this information.
When pazopanib is given
Pazopanib can be used to treat people with kidney cancer that has spread outside the kidney (advanced renal cell cancer).
Soft tissue sarcoma
Pazopanib may only be available in some situations. Your cancer doctor can tell you if it is appropriate for you. Some people may be given pazopanib as part of a clinical trial. If a drug is not available on the NHS, there may be different ways you can still have it. Your cancer doctor can give you advice.
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.
You take pazopanib once a day as tablets.
There are some important things to remember when taking your tablets:
- Take them with a glass of water.
- Do not take pazopanib with food, as it affects the way the medicine is absorbed. Take it at least two hours after a meal or one hour before a meal.
- Do not chew or crush the tablets before you take them.
- Avoid grapefruit and grapefruit juice during your treatment.
- If you forget to take your tablets or are sick after taking them, just take your next dose at the usual time – do not 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 sight and 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. Do not flush them down the toilet or throw them away.
We explain the main side effects of this treatment here. We also include some other possible side effects.
You may get some of the side effects we mention, but you are unlikely to get all of them. If you are also having treatment with other cancer drugs, you may have some side effects that we have not listed here. Always tell your doctor, nurse or pharmacist about any side effects you have.
Your doctor can give you drugs to help control some side effects. It is important to take them exactly as your nurse or pharmacist explains. This means they will be more likely to work for you. Your nurse will give you advice about managing your side effects. After your treatment is over, most side effects start to improve.
Serious and life-threatening side effects
Some cancer treatments can cause severe side effects. Rarely, these may be life-threatening. Your cancer doctor or nurse can explain the risk of these side effects to you.
Contact the hospital
Your nurse will give you telephone numbers for the hospital. If you feel unwell or need advice, you can call them at any time of the day or night. Save these numbers in your phone or keep them somewhere safe.
We cannot list every side effect for this treatment. There are some rare side effects that are not listed. You can visit the electronic Medicines Compendium (eMC) for more detailed information.
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 when you are taking pazopanib. If your blood pressure goes up, it is most likely to happen in the first few weeks of taking the drug. If you develop high blood pressure, you will be prescribed medicines to help control it.
This treatment may cause diarrhoea. Diarrhoea means passing more stools (poo) than is usual for you, or having watery or loose stools. If you have a stoma, it will be more active than usual.
If you have diarrhoea:
- try to drink at least 2 litres (3½ pints) of fluids each day
- avoid alcohol, caffeine, milk products, high-fat foods and high-fibre foods
- contact the hospital for advice.
Your doctor can prescribe anti-sickness (anti-emetic) drugs to help prevent or control sickness. If you still feel sick, tell your doctor. They can prescribe other anti-sickness drugs that may work better for you.
You may get a sore mouth or mouth ulcers. This can make you more likely to get a mouth infection.
Use a soft toothbrush to clean your teeth or dentures in the morning, at night and after meals.
If your mouth is sore:
- tell your nurse or doctor – they can give you a mouthwash or medicines to help
- try to drink plenty of fluids
- avoid alcohol, tobacco, and foods that irritate your mouth.
Changes to your taste
You may get a bitter or metal taste in your mouth. Sucking sugar-free sweets may help with this. Some foods may taste different or have no taste. Try different foods to find out what tastes best to you. Taste changes usually get better after treatment finishes. Your nurse can give you more advice.
Loss of appetite
This treatment can affect your appetite. If you are finding difficult to eat enough or are losing weight, tell your nurse or dietitian. They will give you advice. They may give you food or drink supplements.
Feeling tired is a common side effect. It is often worse towards the end of treatment and for some weeks after it has finished. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.
Effects on the hair
Your hair may lose colour and it may become thinner while you are 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
Hand and 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 does not 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.
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 and sickness and vomiting. It is also very important to let them know if you:
- are bleeding from the back passage
- have black stools
- are vomiting up blood
- have vomit that looks like coffee grounds.
This treatment may cause headaches. If this happens, tell your doctor or nurse. They can give you painkillers.
Risk of infection
This treatment can reduce the number of white blood cells in your blood. These cells fight infection. If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is called neutropenia.
If you have an infection, it is important to treat it as soon as possible. Contact the hospital straight away on the 24-hour contact number you have if:
- your temperature goes over 37.5°C (99.5°F)
- you suddenly feel unwell, even with a normal temperature
- you have symptoms of an infection.
Symptoms of an infection include:
- feeling shivery
- a sore throat
- a cough
- needing to pass urine often.
It is important to follow any specific advice your cancer treatment team gives you.
You will have regular blood tests during treatment. If your white blood cell count is low, your doctor may reduce or delay your treatment for a short time.
Bruising and bleeding
Pazopanib can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any bruising or bleeding that you cannot explain. This includes:
- bleeding gums
- tiny red or purple spots on the skin that may look like a rash.
Some people may need a drip to give them extra platelets. This is called a platelet transfusion. 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.
Muscle or joint pain
You may get pain in your muscles or joints when taking this treatment. If this happens, tell your doctor so they can give you give you painkillers. Tell them if the pain does not get better. Having warm baths and taking regular rests may help.
Some people notice swelling around the eyes and ankles because of fluid retention. This is not 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 are retaining fluid.
Effects on the lungs
This treatment can cause changes to the lungs. Tell your doctor if you develop:
- a cough
- a fever (high temperature)
You should also tell them if any existing breathing problems get worse. You may have tests to check your lungs.
Wounds may take longer to heal while you are 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.
Effects on the heart
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 a doctor straight away if you:
- have pain or tightness in your chest
- feel breathless or dizzy
- feel your heart is beating too fast or too slowly.
Other conditions can cause these symptoms, but it is important to get them checked by a doctor.
Pazopanib can increase the risk of having a stroke. It is important to be aware of the possible signs of stroke such as:
- Face: Weakness on one side of the face such as drooping eyelid or difficulty smiling
- Arms: Being unable to raise both arms and keep them up
- Speech: Not being able to speak clearly or slurred speech
- Time: If you have any of these three signs, call 999 to get immediate medical help.
Other possible symptoms of stroke include:
- Sudden weakness or numbness on one side of the body, including legs, hands or feet.
- Sudden blurred vision or loss of sight in one or both eyes.
- Sudden memory loss or confusion, and dizziness or a sudden fall.
- A sudden, severe headache.
If you or someone you know notices you have any of these symptoms, you should tell a doctor immediately.
Effects on the thyroid gland
This treatment 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 does not generally cause any symptoms and usually goes back to normal when treatment stops. Your doctor will monitor your liver with regular blood tests.
It is important to let your doctor know straight away if you feel unwell or have any severe side effects, even if they are not mentioned above.
Some medicines, including ones you buy in a shop or chemist, can be harmful while you are having this treatment. Tell your cancer doctor about any drugs you are taking, including vitamins, herbal drugs and complementary therapies.
Your doctor or nurse may talk to you about vaccinations. These help reduce your risk of getting infections.
Doctors usually recommend that you have a flu jab, which is an inactivated vaccination. People with weak immune systems can have this type of vaccination.
If your immune system is weak, you need to avoid live vaccinations such as shingles. Your cancer doctor or GP can tell you more about live vaccinations.
Your doctor will advise you not to get pregnant or make someone pregnant while having this treatment. The drugs may harm a developing baby. It is important to use contraception during your treatment and for a while after treatment finishes. Your doctor, nurse or pharmacist can tell you more about this.
Women are advised not to breastfeed while having this treatment. This is because the drugs could be passed to the baby through breast milk.
Medical and dental treatment
If you need medical treatment for any reason other than cancer, always tell the doctors and nurses that you are having cancer treatment. Give them the contact details for your cancer doctor so they can ask for advice.
If you think you need dental treatment, talk to your cancer doctor or nurse. Always tell your dentist you are having cancer treatment.