Votrient

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What Is Votrient?

Votrient is an oral tablet from Novartis containing pazopanib 400 mg. Pazopanib is a multi-target tyrosine kinase inhibitor active against VEGFR-1, VEGFR-2, VEGFR-3, PDGFR-α, PDGFR-β, FGFR-1, and KIT. By blocking vascular and growth-factor signalling, it inhibits tumour angiogenesis and growth in vascular tumours.

Toepassingen en Indicaties

• Advanced renal cell carcinoma (RCC) — first-line and after cytokine therapy
• Advanced soft-tissue sarcoma (STS) — after prior chemotherapy (PALETTE trial)

Dosage and How to Take

Standaard dosering: 800 mg once daily (2 × 400 mg tablets) on an empty stomach — 1 hour before or 2 hours after any food. Food increases pazopanib absorption ~2-fold, raising toxicity risk.

1. Empty stomach — mandatory. Set a routine: dose 1 hour before breakfast, OR 2 hours after dinner before bed.
2. Swallow tablets whole — do not crush, dissolve or split (significant absorption change).
3. Mandatory monitoring: LFTs at baseline, then weekly for first 9 weeks, then monthly. BP at baseline + every 1–2 weeks for first 6 weeks, then monthly. ECG (QTc) at baseline + 4–6 weeks. Urinalysis for proteinuria monthly. TFT (thyroid) every 3 months.
4. Dose modifications: reduce in 200–400 mg increments for grade ≥ 3 toxicity, AST/ALT > 8× ULN, severe hypertension, severe proteinuria, or QT prolongation.
5. Hold pazopanib 7–14 days before elective surgery; resume 2–4 weeks after wound healing complete.

Bijwerkingen

Vaak voorkomend: diarrhoea, fatigue, nausea, decreased appetite, weight loss, hair colour change (depigmentation), hypertension, hand-foot syndrome, taste change, mucositis.

Belangrijk:

• Hepatotoxicity (BLACK BOX) — severe, sometimes fatal, hepatic injury. Most cases first 4–9 weeks. Mandatory LFT monitoring.
• Hypertension (~40%) — new-onset or worsening; treat aggressively
• QT prolongation and torsades
• Arterial thrombotic events (MI, stroke, TIA)
• Haemorrhage (epistaxis, GI, intracranial)
• GI perforation and fistula
• Proteinuria, nephrotic syndrome
• Hypothyreoïdie
• Reversible posterior leukoencephalopathy syndrome (PRES)
• Impaired wound healing

Waarschuwingen

• Zwangerschap: teratogenic. Reliable contraception throughout treatment + 2 weeks after.
• Severe hepatic impairment (Child-Pugh C): contraindicated.
• QT prolongation, electrolyte abnormalities: correct hypokalaemia / hypomagnesaemia before starting.
• Recent arterial thrombotic event (< 6 months): avoid.
• Surgery: hold 7–14 days before; resume 2–4 weeks after.

Geneesmiddelinteracties

Opslag

• Room temperature, 15–25°C, original blister.
• Out of reach of children, women of childbearing potential, pets.

Gerelateerde alternatieven op MedsBase

Other oncology medications stocked alongside this product:

• Imat (imatinib 400 mg)
• Imatib (imatinib 100 / 400 mg)
• Veenat (imatinib 100 mg)

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Veelgestelde vragen

Why must I take Votrient on an empty stomach?

Food (especially high-fat) can double pazopanib absorption, raising blood levels into toxic range and increasing risk of hepatotoxicity, hypertension and QT prolongation. Take 1 hour before any meal OR 2 hours after the last meal. Most patients find it easiest to take pazopanib just before bed (assuming dinner finished ≥ 2 hours earlier) or first thing in the morning.

Why is Votrient associated with severe hepatotoxicity?

Pazopanib carries an FDA black-box warning for severe, sometimes fatal, hepatic injury. Most cases occur in the first 4–9 weeks. Mandatory monitoring: LFTs at baseline, then weekly for the first 9 weeks, then monthly. Stop pazopanib immediately for AST/ALT > 8× ULN, or for any symptoms of hepatic injury (jaundice, dark urine, severe fatigue).

Why does my hair colour change on Votrient?

Pazopanib inhibits tyrosinase (involved in melanin synthesis) as a side effect. Hair depigmentation — often dramatic, sometimes turning hair white or grey within months — is reversible on discontinuation. Affects ~40% of patients. Cosmetic only, no clinical significance.

How is hypertension managed?

Pazopanib-induced hypertension is mechanistic (VEGF inhibition reduces nitric oxide synthesis). Affects ~40% of patients, often within first 6 weeks. Treat aggressively: ACE inhibitor or ARB first-line (ramipril, losartan, candesartan), add CCB or diuretic if needed. Avoid stopping pazopanib for hypertension if BP can be controlled — the hypertension actually correlates with anti-tumour efficacy.

Why do I need to stop Votrient before surgery?

Pazopanib impairs wound healing (VEGF-mediated angiogenesis is central to wound repair) and increases bleeding risk. Hold for 7–14 days before elective surgery. Resume only after the surgical wound is fully healed, typically 2–4 weeks post-op. Tell every surgeon and dentist about pazopanib.

Can I take a PPI on Votrient?

PPIs (omeprazole, pantoprazole, esomeprazole) raise gastric pH and substantially reduce pazopanib absorption — risking treatment failure. Switch to a short-acting H2-blocker (famotidine) and separate dosing by 2+ hours, OR use antacid only when symptomatic, separated by 2+ hours from pazopanib.

Can I drink alcohol on Votrient?

Limit alcohol — both alcohol and pazopanib are hepatotoxic and the combination amplifies severe liver injury risk. Occasional small amounts may be tolerable but daily or heavy drinking should be avoided.

Will Votrient cure my cancer?

Pazopanib is generally not curative for advanced RCC or sarcoma but produces meaningful disease-control. In RCC, median progression-free survival on pazopanib first-line is approximately 11 months (COMPARZ trial). In sarcoma after chemotherapy, PFS extension is more modest. Treatment continues until progression or unacceptable toxicity. Newer immunotherapy combinations (pembrolizumab + axitinib, nivolumab + cabozantinib) have largely supplanted pazopanib monotherapy for first-line RCC where available.

Waarom bestellen bij MedsBase

Elke batch wordt ingekocht bij een WHO-GMP gecertificeerde fabrikant. Bestellingen worden verzonden in eenvoudige, ongemarkeerde verpakkingen door onze logistieke partners en vallen onder onze Reshipment Assurance Policy: als een pakket niet binnen 20 werkdagen arriveert, sturen wij kosteloos een nieuwe zending, zonder vragen te stellen.

Related Anti-Cancer Medications

Other oncology medications stocked alongside this product:

• Imatib (imatinib 100/400 mg)
• Veenat (imatinib 100/400 mg)
• Imat (imatinib 100/400 mg)
• Riborea (ribociclib 200 mg)
• Keytruda (pembrolizumab 100 mg)

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