Votrient - Tablet Pazopanib Hydrochloride - 200mg 1 Tablet(s) / Tablet Glaxo SmithKline Pharmaceuticals Ltd Introduction: Votrient is a protein kinase inhibitor used in the treatment of kidney cancer and soft tissue sarcoma. Votrient should be taken on an empty stomach, but try to have it at the same time every day to get the most benefits. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects.... Uses of Votrient: Kidney cancerSoft tissue sarcoma Side effects of Votrient: HeadacheNauseaVomitingMusculoskeletal (bone, muscle or joint) painFatigueChange in color of hairDiarrheaHigh blood pressureDecreased appetiteWeight lossTaste changeAbnormal skin pigmentationHair discolorationTumor painBreathlessness How to use Votrient: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Votrient is to be taken empty stomach. How Votrient works: Votrient is an anti-cancer medication. It works by binding and inhibiting the enzyme receptors (tyrosine kinase) that are responsible for the proliferation of the cancerous cells. It also restricts the growth of new blood vessels within the tumor. This is how it works against cancer. Indication: Renal cell carcinoma, soft tissue sarcoma Administration: Should be taken on an empty stomach: Take at least 1 hr before or 2 hr after meals. Swallow whole, do not break/crush. Adult Dose: Advanced Renal Cell Carcinoma 800 mg PO qDay on empty stomach Soft Tissue Sarcomas 800 mg PO qDay on empty stomach Hepatic Impairment Billirubin ULN: No dosage adjustment required Billirubin >1.5-3 x ULN: Decreased dose to 200 mg PO qDay Billirubin >3 x ULN: Not recommended Child Dose: Safety and efficacy not established; not indicated for use in pediatric patients Renal Dose: Renal impairment: No dosage adjustment required Contraindication: Hypersensitivity. Mode of Action: Multikinase inhibitor (including VEGF & PDGF receptor tyrosine kinases) some of which are implicated in tumor growth, angiogenesis, & metastasis Precaution: Hepatic Toxicity and Hepatic Impairment, QT Prolongation, Cardiac Dysfunction, Hemorrhagic Events, Thromboembolic Events, Gastrointestinal Perforation and Fistula, Hypertension, Hypothyroidism, Pregnancy. Lactation: Unknown whether distributed in breast milk, do not nurse Side Effect: >10% ALT (SGPT) level raised (all grades, 53%; grade 3, 10%; grade 4, 2% ) AST/SGOT level raised (all grades, 53%; grade 3, 7%; grade 4, less than 1% ) Diarrhea (52%),Increased glucose (41%),Hypertension (40%),Hair depigmentation (38%) Leukopenia (all grades, 37%; grade 3, 0%; grade 4, 0% ) Increased bilirubin level (all grades, 36%; grade 3, 3%; grade 4, less than 1% ) Neutropenia (all grades, 34%; grade 3, 1%; grade 4, less than 1% ) Phosphorous decreased (34%) Thrombocytopenia (all grades, 32%; grade 3, less than 1%; grade 4, less than 1% ) Lymphocytopenia (all grades, 31%; grade 3,... Interaction: Co-administration w/ CYP3A4 (eg, itraconazole, clarithromycin, atazanavir, idinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole, grapefruit juice), P-gp & BCRP inhibitors, high-/low-fat food increases exposure & conc of pazopanib. Co-administration w/ CYP3A4 (eg, rifampicin) inducers may decrease plasma pazopanib conc. P-gp & BCRP inducers may alter exposure & distribution of pazopanib. Pazopanib may alter exposure &/or distribution of CYP3A4 substrates (eg, midazolam), CYP2C8 substrates (eg, paclitaxel) & UGT1A1 substrates (eg, irinotecan & its active metabolite SN-38). Pazopanib may increase the ratio of dextrometrophan to dextrophan conc after administration of dextrometrophan. Proton-pump inhibitors (eg, esomeprazole) & other agents that increase gastric pH...