What precautions should I take while taking Pazopanib?

Pazopanib is a prescription medicine used to treat advanced renal cell carcinoma (RCC) (kidney cancer). Pazopanib is also used to treat soft tissue sarcoma (a type of tumor that can develop in or around muscles, tendons, joints, organs, or blood vessels). Pazopanib is usually used after other treatments have failed.

What are the precautions for taking Pazopanib/PEzopanib(Pazopanib)?

1.Hepatotoxicity:Severe and fatal hepatotoxicity has occurred. Monitor liver tests at baseline, during treatment, and periodically as clinically indicated. Discontinue pazopanib and continue weekly monitoring at a reduced dose for 8 weeks, or permanently discontinue weekly monitoring until resolution based on severity of hepatotoxicity.

2.QTprolongation and torsade de pointes:Monitor patients who are at significant risk for QT prolongation. Monitor baseline electrocardiogram (ECG) and electrolytes as clinically indicated. Correct hypokalemia, hypomagnesemia, and hypocalcemia before initiating pazopanib and during treatment.

3.Heart dysfunction:Heart dysfunction has developed, including reduced left ventricular ejection fraction (LVEF) and congestive heart failure. Monitor blood pressure and manage as appropriate. Monitor for clinical signs or symptoms of congestive heart failure. Perform baseline and periodic assessments of LVEFin patients at risk for cardiac dysfunction. Withhold or permanently discontinue pazopanib based on severity of cardiac dysfunction.

4.Bleeding Event:A fatal bleeding event occurred. Pazopanib has not been studied in patients with a history of hemoptysis, intracerebral hemorrhage, or clinically significant gastrointestinal bleeding within the past 6 months. Depending on the severity of the bleeding event, discontinue pazopanib and reduce the dose or permanently discontinue the drug.

5.Arterial Thromboembolic Events:Arterial thromboembolic events have been observed and may be fatal. Pazopanib is not yet in the pastPatients with an arterial thromboembolic event within 6 months were studied. If an arterial thromboembolic event occurs, permanently discontinue pazopanib.

6.Venous Thromboembolic Events:Venous thromboembolic events (VTE), including fatal pulmonary embolism (PE), have been observed. Monitor for signs and symptoms of VTE and PE. Depending on the severity of VTE, pause pazopanib treatment and resume treatment at the same dose or permanently discontinue treatment.

7.Thrombotic microangiopathy:Thrombotic microangiopathies (TMA), including thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS), have been observed. If TMA occurs, permanently discontinue pazopanib.

8.Gastrointestinal perforation and fistula:Fatal perforations have occurred. Monitor for signs and symptoms of gastrointestinal perforation or fistula. If grade 2 or 3 gastrointestinal fistula occurs, pazopanib should be discontinued and resumed based on medical judgment. If gastrointestinal perforation or grade 4 gastrointestinal fistula occurs, permanently discontinue pazopanib.

9.Interstitial lung disease/Pneumonia:Can be fatal. Monitor patients for pulmonary symptoms. Pazopanib should be permanently discontinued in patients with interstitial lung disease (ILD) or pneumonia.

10.Posterior reversible encephalopathy syndrome:May be fatal. Pazopanib should be permanently discontinued in patients with posterior reversible encephalopathy syndrome (PRES).

11.Hypertension:Hypertension, including hypertensive crisis, has been observed. Do not use pazopanib in patients with uncontrolled hypertension. Optimize blood pressure before starting pazopanib. Monitor blood pressure as clinically indicated and initiate and adjust antihypertensive therapy as appropriate. Depending on the severity of hypertension, withhold medication and then reduce pazopanib dose or permanently discontinue.

12.Risk of impaired wound healing:Discontinue pazopanib at least 1 weeks before elective surgery. At least2 after major surgeryDo not administer the drug for several weeks until the wound is completely healed. The safety of resuming pazopanib after resolution of wound healing complications has not been established.

13.Embryo-Fetal Toxicity:Can cause fetal harm. Inform women of the potential reproductive risks to the fetus and patient and to use effective contraception.

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