Pazopanib hydrochloride tablet 200 mg (Pazorest)

Pazopanib hydrochloride tablet 200 mg (Pazorest) is an oral targeted therapy approved by the FDA in 2009 to treat primarily advanced renal cell carcinoma and soft tissue sarcoma in adult patients. It works by blocking specific tyrosine kinases that promote cancer cell growth and blood vessel formation, helping to slow tumor progression and restrict cancer spread.

What is the use of Pazopanib Hydrochloride?

Pazopanib hydrochloride (Pazorest) is used to treat the following conditions in an adult patient

• Advanced renal cell carcinoma (RCC).
• Advanced soft tissue carcinoma patients who have received prior chemotherapy.

Limitations of use

The efficacy of the medication for the treatment of a patient with adipocytic soft tissue sarcoma and gastrointestinal stromal tumors has not been confirmed.

It is not known if the medication is safe and effective under 18 years old. 

How does Pazopanib hydrochloride work in Renal Cell Carcinoma?

Pazorest tablet works by blocking several proteins (called tyrosine kinases) that help cancer cells grow and form new blood vessels. These proteins include VEGFR, PDGFR, and FGFR, which are important for supplying tumors with oxygen and nutrients. Stopping their activity, this medication helps reduce blood flow to the tumor and slows or stops its growth in renal cell carcinoma.

What is the dose of the Pazopanib tablet?

• The generally recommended dose is 800 mg orally once daily without food.
• Baseline moderate hepatic impairment – 200 mg orally once daily. Not recommended in patients with severe hepatic impairment.

How should I take the Pazopanib 200 mg tablet?

• Take Pazorest tablet exactly as your healthcare provider tells you to take. Your healthcare provider will tell you how much to take.
• Your healthcare provider may change your dose according to your side effect profile. 
• Take the medication on an empty stomach, at least one hour before or two hours after food.
• Do not eat grapefruit or drink grapefruit juice during the treatment, as it may increase the amount of medicine in your body.
• If you miss a dose, take it as soon as you remember. Do not take the missed dose if it is closer to the next dose. Take the regular next dose, do not take more than one dose.
• Your healthcare provider will test your heart, blood, and urine before starting the medication and during the treatment.
• Tell your healthcare provider if you plan to have surgery during the treatment. Because you have to stop taking Pazorest at least 7 days before the surgery. Otherwise, it may affect the healing process after surgery.

What should I tell my healthcare provider before taking Pazopanib 200 mg?

Tell your healthcare provider before taking Pazorest 200 mg if you have

• liver problems
• high blood pressure
• heart problems, irregular heartbeat, including QT prolongation
• a history of stroke
• headache, seizures, or vision problems.
• coughed up blood in the last 6 months
• had bleeding in your stomach or intestine in the previous 6 months
• have a history of a tear in your stomach or intestine, or an abnormal connection between two parts of your gastrointestinal tract
• blood lots in the veins or legs
• thyroid problems
• recent surgery
• any other medical conditions
• pregnancy or planning to get pregnant.
• children of breastfeeding or planning to breastfeed.
• Tell your healthcare provider about all the medicines you take, including prescription, non-prescription, herbal supplements, vitamin supplements, and ayurvedic supplements.

What are the possible side effects of Pazopanib hydrochloride tablet?

Pazorest 200 mg tablet may cause serious side effects, including 

• Irregular fast heartbeat or fainting.
• Heart failure. This is a condition where your heart does not pump as well as it should, and it may cause shortness of breath.
• A heart attack or stroke may occur and cause death.
• Symptoms of a heart problem may include chest pain or pressure, pain in your jaw, neck, arms, or back, shortness of breath, numbness or weakness on one side of your body, trouble speaking, headache, or dizziness.
• Blood clots may form in your veins, especially in your legs, which is known as deep vein thrombosis. Blood clots may travel to your lungs, also known as pulmonary embolism. Sometimes it can be life-threatening. 
• Bleeding problems include unusual bleeding or bruising and wounds that do not heal.
• A tear in your stomach or intestinal wall or an abnormal connection between two parts of your gastrointestinal tract.  
• Reversible Posterior Leukoencephalopathy (RPLS) is a rare, temporary brain condition that causes symptoms like headaches, seizures, confusion, and vision changes, often due to high blood pressure or certain medications.
• High blood pressure can occur, including a sudden and severe rise in blood pressure, which may be life-threatening.
• Thyroid problems.
• Protein in your urine.
• Serious infections during the treatment can cause death.
• A collapsed lung can occur during treatment; in this situation, air may become trapped in the space between the lungs and the chest wall, causing shortness of breath.

Call your healthcare provider immediately if you experience any of the above reactions during treatment.

Other common side effects in people with advanced soft tissue sarcoma who take Pazorest include: 

• feeling tired 
• decreased weight 
• tumor pain  
• muscle or bone pain 
• headache
• taste changes 
• trouble breathing
• change in skin color

What are the drug interactions?

Pazorest can interact with drugs that affect liver enzymes, especially CYP3A4 inhibitors or inducers, such as ketoconazole, rifampin, and certain antibiotics. It may also interact with proton pump inhibitors, statins, and other medications that prolong QT intervals. These interactions can alter Pazopanib levels or increase side effects, requiring careful monitoring or dose adjustments.

Pazopanib hydrochloride 200 mg tablet price in Bangladesh

In Bangladesh, the 200 mg tablet of pazopanib hydrochloride is readily available both as generic versions and the brand name (Votrient). Medications like Pazorest (generic), Pazocent, Pazoren, Pazotab, Zopanib, Pazonib, and the originator Votrient are on the market.

Prices vary depending on manufacturer, pack size, and pharmacy, and tend to differ between generic and brand names.

Frequently Asked Questions (FAQs)

In conclusion, Pazopanib hydrochloride tablet 200 mg (Pazorest) has demonstrated significant efficacy in clinical trials for advanced renal cell carcinoma (RCC) and soft tissue sarcoma (STS). In the pivotal VEG105192 trial, patients receiving this medication had a median progression-free survival (PFS) of 9.2 months, compared to 4.2 months for those receiving a placebo. Additionally, in the VEG110727 trial for STS, the median PFS was 4.6 months with this medication versus 1.6 months with placebo. These results underscore the role in delaying disease progression and improving patient outcomes in these cancers.