Pazopanib: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
Pazopanib: clinical details
Prescribing considerations
- Initiation should be supervised by a clinician experienced in anticancer treatment.
- For soft-tissue sarcoma, confirm that the histological subtype and prior-treatment setting match the licensed indication.
- Review hepatic function, cardiovascular and bleeding risks, gastrointestinal perforation risk, renal impairment, thyroid disease and interacting medicines.
- Control hypertension before treatment and consider wound-healing implications around surgery.
- Assess tumour-lysis risk in patients with rapidly growing or bulky tumours, renal dysfunction or dehydration.
Contraindications and cautions
- Hypersensitivity to pazopanib or any formulation excipient.
- Severe hepatic impairment is not recommended because exposure and clinical benefit may be inadequate.
Monitoring
- Liver function before treatment and regularly thereafter.
- Blood pressure before treatment, early after initiation and frequently during treatment.
- Thyroid function and urinalysis for protein at baseline and periodically.
- Clinical surveillance for cardiac dysfunction, QT prolongation, bleeding, thrombosis, infection, gastrointestinal perforation and pulmonary toxicity.
- Consider ECG, electrolytes and left-ventricular function according to cardiovascular risk.
Clinical pharmacology
Pazopanib inhibits VEGFR, PDGFR and c-KIT signalling. It is highly protein-bound, metabolised mainly through CYP3A4 and eliminated predominantly in faeces; food and tablet crushing substantially increase exposure.
Formulation and product differences
- The product is a film-coated tablet containing pazopanib as the hydrochloride salt.
- Tablets must be swallowed whole; crushing changes the rate and extent of absorption.
- Products should not be assumed interchangeable without checking the prescribed preparation and current product information.
Pazopanib preparations and strengths
Tablet
Route: Oral
Strengths: 200 mg, 400 mg
Pazopanib interactions
The oncology or pharmacy team should review all prescribed, non-prescribed and herbal products before treatment.
Strong CYP3A4, P-glycoprotein or BCRP inhibitors
Clarithromycin, itraconazole and ritonavir can increase pazopanib exposure and toxicity, so alternatives are generally preferred.
Strong CYP3A4 inducers
Medicines such as rifampicin can reduce pazopanib exposure and potentially reduce its effect.
Proton-pump inhibitors, H2-receptor antagonists and antacids
Increasing stomach pH can reduce pazopanib absorption; use only with specialist guidance.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.