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 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.
Pazopanib can be used to treat people with kidney cancer that has spread outside the kidney (advanced renal cell cancer). It can be used:
- as the first treatment (called first-line treatment)
- after treatment with interferon or aldesleukin.
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.
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.
We explain the most common side effects of this treatment here. We also include some less common side effects. You may get some of the side effects we mention here, but you will not get them all. Always tell your doctor or nurse about any side effects you have.
If a side effect is more severe, your doctors may need to reduce the dose, or stop the treatment for a short time. Some people may have this treatment stopped completely.
Your doctor can give you drugs to help control some side effects. It is very important to take them exactly as your nurse or pharmacist has explained. This will help the drugs work as well as possible for you. Your nurse will give you advice about managing side effects. Most side effects start to improve after treatment has finished.
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 for the first six weeks of treatment. 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.
You may have frequent or loose bowel movements. This can usually be easily controlled with medicines, but tell your doctor if it is severe or continues. If you have diarrhoea, it is important to drink plenty of fluids to stop you getting too dehydrated. But avoid alcohol and coffee.
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.
Your doctor will prescribe anti-sickness (anti-emetic) drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist explains to you. It’s easier to prevent sickness than to treat it after it has started.
If you still feel sick or are vomiting, contact the hospital as soon as possible. They can give you advice and change the anti-sickness drug to one that works 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
You may lose your appetite during treatment and may lose weight. Try to eat small meals regularly. If your appetite does not improve after a few days, tell your doctor or 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 some of these. You can also buy them from chemists.
This treatment may affect your skin. It can cause a rash, which may be itchy. Your doctor or nurse can tell you what to expect. If your skin feels dry, try using an unperfumed moisturising cream every day.
Always tell your doctor or nurse about any skin changes or if they get worse. They can give you advice and may prescribe creams or medicines to help. Any changes to your skin are usually temporary and improve when treatment finishes.
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 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.
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’s also very important to let them know if you have bleeding from the back passage, black stools, vomiting up blood or 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 shaky
- a sore throat
- a cough
- needing to pass urine a lot.
It is important to follow any specific advice your cancer treatment team gives you.
The number of white blood cells will usually return to normal before your next treatment. You will have a blood test before having more treatment. If your white blood cell count is low, your doctor may 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 can’t 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.
It is important to report this to your doctor if you are affected.
Joint and muscle pain
You may have pain and stiffness in your joints, and sometimes in your muscles. Tell your doctor or nurse if this happens. They can prescribe painkillers and give you advice.
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 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.
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. Signs of a stroke include:
- weakness or numbness in one or both of your arms
- slurred speech
- 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.
Rarely, this treatment can cause blurred vision. This may develop a few months after treatment has started. Let your doctor know about any changes to your vision.
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 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.
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 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.
Doctors do not know whether this drug may be present in breast milk, so women are advised not to breastfeed during treatment and for a few months afterwards.
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 this drug. 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 the names of your cancer medicines.