Summary

Commonly reported side effects of pazopanib include: bleeding tendency disorder, abdominal pain, decreased serum glucose, decreased serum magnesium, decreased serum phosphate, diarrhea, fatigue, hypertension, increased serum alanine aminotransferase, increased serum aspartate aminotransferase, increased serum bilirubin, leukopenia, nausea, neutropenia, thrombocytopenia, vomiting, and anorexia. Other side effects include: hypothyroidism, and proteinuria. Continue reading for a comprehensive list of adverse effects.

Applies to pazopanib: oral tablet.

Serious side effects of Pazopanib

Along with its needed effects, pazopanib may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking pazopanib:

More common

• Black, tarry stools
• bleeding gums
• blood in the urine or stools
• blurred vision
• chest pain
• chills
• clay colored stools
• cloudy urine
• constipation
• cough
• coughing up blood
• dark urine
• decreased appetite
• depressed mood
• difficulty with breathing or swallowing
• dizziness
• dry skin and hair
• feeling cold
• fever
• hair loss
• headache
• hoarseness or husky voice
• increased menstrual flow or vaginal bleeding
• itching, skin rash
• loss of appetite
• lower back or side pain
• muscle cramps and stiffness
• nausea and vomiting
• nervousness
• nosebleeds
• painful or difficult urination
• pale skin
• paralysis
• pinpoint red spots on the skin
• pounding in the ears
• prolonged bleeding from cuts
• red or black, tarry stools
• red or dark brown urine
• redness, swelling, or pain of the skin
• scaling of the skin on the hands and feet
• slow or fast heartbeat
• sore throat
• sores, ulcers, or white spots on the lips or in the mouth
• stomach pain or tenderness
• swelling of the feet or lower legs
• swollen glands
• tingling of the hands and feet
• ulceration of the skin
• unusual bleeding or bruising
• unusual tiredness or weakness
• weight gain
• yellow eyes or skin

Less common

• Bleeding from the rectum or bloody stools
• bloody nose
• chest discomfort
• confusion
• fainting
• irregular or slow heart rate
• numbness or tingling in the face, arms, or legs
• pain or discomfort in the shoulders, arms, jaw, back, or neck
• sweating
• swelling or puffiness of the face
• trouble speaking, thinking, or walking

Other side effects of Pazopanib

Some side effects of pazopanib may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Change in hair color
• change in taste
• decreased weight
• diarrhea
• hair loss
• lack or loss of strength
• loss of taste
• thinning of the hair
• weight loss

Less common

• Belching
• heartburn
• indigestion
• stomach discomfort, upset, or pain

For Healthcare Professionals

Applies to pazopanib: oral tablet.

Hepatic

Very common (10% or more): Increased ALT (up to 53%), increased AST (up to 53%), increased total bilirubin (up to 36%), increased alkaline phosphatase (up to 32%)

Common (1% to 10%): Abnormal hepatic function, hepatotoxicity, decreased alkaline phosphatase, increased gamma-glutamyltransferase (GGT), abnormal liver function test

Uncommon (0.1% to 1%): Jaundice, drug-induced liver injury, hepatic failure, increased hepatic enzyme

Postmarketing reports: Increased GGT^[Ref]

Cardiovascular

Very common (10% or more): Hypertension (up to 42%), myocardial dysfunction (up to 11%), chest pain (up to 10%)

Common (1% to 10%): Venous thromboembolic events, cardiac dysfunction, bradycardia, QT prolongation, myocardial infarction or ischemia, hot flush, flushing

Uncommon (0.1% to 1%): Torsades de pointes, congestive heart failure, fatal arterial thromboembolic events, hypertensive crisis^[Ref]

Other

Very common (10% or more): Tumor pain (up to 32%), hemorrhagic events (up to 13%)

Common (1% to 10%): Edema, epistaxis, mouth ulceration, dry mouth, mucosal inflammation, gingival infection, hiccups

Uncommon (0.1% to 1%): Fatal hemorrhage, cerebral/intracranial hemorrhage, infections (with or without neutropenia), infectious peritonitis, menorrhagia, metrorrhagia, oropharyngeal pain

Postmarketing reports: Infections (with or without neutropenia)^[Ref]

Renal

Very common (10% or more): Increased creatinine (up to 26%), proteinuria (up to 12%)

Common (1% to 10%): Increased urea

Uncommon (0.1% to 1%): Nephrotic syndrome, thrombotic microangiopathy (TMA)

Postmarketing reports: Thrombotic microangiopathy (TMA)^[Ref]

Gastrointestinal

Very common (10% or more): Diarrhea (up to 59%), nausea (up to 56%), vomiting (up to 33%), gastrointestinal pain (up to 23%), abdominal pain (up to 14%), mucositis (up to 12%), stomatitis (up to 11%)

Common (1% to 10%): Dyspepsia, flatulence, abdominal distension

Uncommon (0.1% to 1%): Perforation or fistula, fatal perforations, hematochezia, melena, frequent bowel movements, hematemesis, pancreatitis, peritonitis

Postmarketing reports: Pancreatitis, flatulence^[Ref]

Nervous system

Very common (10% or more): Fatigue (up to 65%), dysgeusia (up to 28%), headache (up to 23%), dizziness (up to 11%)

Common (1% to 10%): Insomnia, dysphonia, lethargy, paresthesia, peripheral sensory neuropathy, chills

Uncommon (0.1% to 1%): Hypoesthesia, somnolence, mucous membrane disorder, cerebral infarction, transient ischemic attack, cerebrovascular accident, ischemic stroke, posterior reversible encephalopathy syndrome/reversible posterior leukoencephalopathy syndrome (PRES/RPLS)

Postmarketing reports: PRES/RPLS^[Ref]

Endocrine

Common (1% to 10%): Hypothyroidism, increased thyroid stimulating hormone

Uncommon (0.1% to 1%): Abnormal thyroid function test^[Ref]

General

-Renal cell carcinoma (RCC): The most commonly observed adverse reactions (20% or more) were diarrhea, hypertension, hair color change, nausea, fatigue, anorexia, and vomiting.

-Soft tissue sarcoma (STS): The most commonly observed adverse reactions (20% or more) were fatigue, diarrhea, nausea, decreased weight, hypertension, decreased appetite, vomiting, tumor pain, hair color changes, musculoskeletal pain, headache, dysgeusia, dyspnea, and skin hypopigmentation.^[Ref]

Dermatologic

Very common (10% or more): Hair color changes (up to 39%), skin hypopigmentation (up to 21%), exfoliative rash (up to 18%), palmar-plantar erythrodysesthesia syndrome (up to 18%), alopecia (up to 12%), rash (up to 11%)

Common (1% to 10%): Dry skin, skin depigmentation, nail disorder, pruritus, erythema, hyperhidrosis

Uncommon (0.1% to 1%): Skin exfoliation, photosensitivity reaction, erythematous rash, skin disorder, macular rash, pruritic rash, vesicular rash, papular rash, skin ulcer^[Ref]

Genitourinary

Common (1% to 10%): Hematuria^[Ref]

Hematologic

Very common (10% or more): Leukopenia (up to 44%), lymphocytopenia (up to 43%), thrombocytopenia (up to 36%), neutropenia (up to 34%), anemia (up to 27%)

Common (1% to 10%): Decreased white blood cell count

Uncommon (0.1% to 1%): Decreased platelet count^[Ref]

Metabolic

Very common (10% or more): Decreased weight (up to 48%), increased glucose (up to 45%), decreased appetite (up to 40%), increased albumin (up to 34%), decreased albumin (up to 34%), decreased phosphorus (up to 34%), decreased calcium (up to 33%), decreased sodium (up to 31%), increased potassium (up to 27%), decreased magnesium (up to 26%), anorexia (up to 22%), decreased glucose (up to 17%)

Common (1% to 10%): Increased lipase, increased amylase, dehydration, abnormal blood cholesterol^[Ref]

Musculoskeletal

Very common (10% or more): Musculoskeletal pain (up to 23%), myalgia (up to 23%), asthenia (up to 14%)

Common (1% to 10%): Arthralgia, muscle spasms^[Ref]

Ocular

Common (1% to 10%): Blurred vision

Uncommon (0.1% to 1%): Eyelash discoloration

Oncologic

Frequency not reported: Increased toxicity and mortality with other cancer therapies

Respiratory

Very common (10% or more): Dyspnea (up to 20%), cough (up to 17%)

Common (1% to 10%): Pneumothorax

Uncommon (0.1% to 1%): Rhinorrhea^[Ref]