Pazotab 400 Tablet

Description of Pazotab 400 (Pazopanib 400 mg) tablet

Pazotab 400 tablet is a compound, pazopanib, an antineoplastic drug and falls under the category of multi-targeted tyrosine kinase inhibitors (TKIs). It is mostly employed in cases of advanced renal cell carcinoma and soft tissue sarcoma. Pazopanib is an inhibitor of multiple receptor tyrosine kinases, such as the vascular endothelial growth factor receptors (VEGFR), platelet derived growth factor receptors (PDGFR) and c-KIT that are involved in tumour growth and angiogenesis. Pazopanib blocks these pathways and denies the tumors of blood and also suppresses the growth of cancer cells thus slowing the progression of the disease.

Indications of Pazotab 400 (Pazopanib 400 mg) tablet

Pazopanib has been commercially used for advanced renal cell carcinoma (RCC) particularly in those who have been treated with prior chemotherapy and soft tissue sarcoma (STS).

Mechanism of action of Pazotab 400 (Pazopanib 400 mg) tablet

The mechanism of action of pazopanib is inhibiting cancer progression by preventing the appearance of new blood vessels and survival of tumor cells by blocking the signaling pathways of the latter.

How to consume Pazotab 400 (Pazopanib 400 mg) tablet

Pazopanib is administered as a single dose but on an empty stomach either in the morning, at least an hour before eating or at night, at least two hours before going to sleep. Food increases its absorption and it may lead to toxicity. The dosage is dependent on the condition and tolerance of the patients.

Side Effects of Pazotab 400 (Pazopanib 400 mg) tablet

1. Common Side Effects

• Hypertension
• Diarrhea
• Nausea
• Fatigue
• Hair color changes

2. Serious Side Effects

• Hepatotoxicity
• Cardiotoxicity
• QT prolongation
• Bleeding complications

3. Rare Side Effects

• Thromboembolic events
• Severe liver injury
• Gastrointestinal perforation

Safety Advice for Pazotab 400 (Pazopanib 400 mg) tablet

Pazopanib can influence the work of different systems; thus, the patients under Pazopanib treatment should be monitored in terms of liver functioning, blood pressure, and heart condition.

Breastfeeding: Contraindicated since the drug is likely to be passed to the breast milk and lead to baby harm.

Pregnancy: Not recommended due to potential exposure to potential damage to the fetus.

Alcohol: Alcohol should be avoided because it predisposes one to liver toxicity.

Liver: Pazopanib may result in serious hepatotoxicity such as liver failure. Liver enzmes should be monitored regularly, particularly in the first few months of treatment.

Lungs: Shortness of breath, which cannot be attributed to any other cause, should be considered especially in relation to cardiac issues

Kidney: The renal activity is to be monitored, but the drug is majorly excreted in liver.

Driving: Patients might feel fatigued, dizzy or weak they should not drive when they feel this way.

Interaction of Pazotab 400 (Pazopanib 400 mg) tablet

• Drug–Drug Interaction

Itraconazole × Pazopanib
These are drugs which prevent Pazopanib metabolism, raising its plasma concentration and the chances of toxicity including hepatotoxicity and QT prolongation.

Carbamazepine × Pazopanib

These medications enhance metabolism of Pazopanib which minimize its therapeutic activity.

QT-prolonging drugs × Pazopanib

Additive QT prolongation effects add to risk of cardiac arrhythmias by concurrent use.

Anticoagulants × Pazopanib

May predisposes to bleeding, because of anti-angiogenic effects.

Antacids × Pazopanib

May interfere with the absorption of Pazopanib by changing the gastric pH, and reduces its efficacy.

• Drug–Food Interaction

Food has a high absorption of pazopanib leading to toxicity. Therefore, it ought to be taken in an empty stomach. The use of grapefruit juice is also not recommended as it prevents the CYP3A4 enzyme and increases the concentration of drugs.

• Drug–Disease Interaction of Pazotab 400 (Pazopanib 400 mg) tablet

Liver disease:
Pazopanib is highly metabolised in the liver and liver impaired patients are in danger of the severity of hepatotoxicity. Close observation and change of dose is required.

Cardiovascular disease:

Pazopanib has the ability to induce hypertension, QT increase, and dysfunction of the heart. Patients having heart related conditions require close follow-ups.

Bleeding disorders:

Pazopanib is an anti-angiogenic and therefore is likely to cause bleeding and hence use of it in these patients should be use with caution.

Gastrointestinal disorders:

There may be gastrointestinal perforation or bleeding.

Thyroid disorders:

Pazopanib could affect thyroid functioning and this must be followed-up during long term usage.

Contraindication of Pazotab 400 (Pazopanib 400 mg) tablet

Should not be used in hypersensitivity and in extreme liver impairment.

Dosage of Pazotab 400 (Pazopanib 400 mg) tablet

It has a standard dose of 800 mg/day given depending on the condition of the patient.

Storage of Pazotab 400 (Pazopanib 400 mg) tablet

Store in a dry place but not in the heat or moisture.

Missed Dose of Pazotab 400 (Pazopanib 400 mg) tablet

In case of a dose omission then go on with the next dose. Do not double dose.

Other General Information of Pazotab 400 (Pazopanib 400 mg) tablet

Regular follow-up visits should be offered to the patients. Symptoms which include jaundice, Excessive fatigue, bleeding and/or chest pain are all symptoms that should be reported.

FAQs of Pazotab 400 (Pazopanib 400 mg) tablet

1. What is the reason why Pazopanib should be taken on an empty stomach?

Due to its absorption that is much greater when food is involved and this results in greater drug concentration as well as enhanced toxicity.

2. Why is liver monitoring important?

Pazopanib may induce severe liver damage, and the early diagnosis by monitoring can eliminate severe side effects.

3. What is the mechanism of Pazopanib to induce hypertension?

Since the VEGF pathways are inhibited, which decreases the amount of nitric oxide, it raises vascular resistance and blood pressure.

4. Is Pazopanib going to have any impact on the heart?

Yes, it can lead to QT prolongation and heart dysfunction, which will need frequent check-ups.

5. What puts one at risk of bleeding?

Angiogenesis inhibition, which is the action of Pazopanib, influences the integrity of the blood vessels and predisposes to bleeding.

Fact Box of Pazotab 400 (Pazopanib 400 mg) tablet

References

• FDA Prescribing Information – Pazopanib
  https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/022465s025lbl.pdf
• European Medicines Agency (EMA) – Pazopanib Product Information
  https://www.ema.europa.eu/en/documents/product-information/votrient-epar-product-information_en.pdf
• DrugBank – Pazopanib
  https://go.drugbank.com/drugs/DB06589
• National Cancer Institute (NCI) – Pazopanib
  https://www.cancer.gov/about-cancer/treatment/drugs/pazopanib