Votrient 400mg (Pazopanib)

DESCRIPTION

Votrient (pazopanib) is a type of protein kinase inhibitors. It is also indicated for the treatment of advanced kidney cancer and soft tissue sarcoma

Votrient 400mg is an antineoplastics medications which interfere with the development and spreadness of cancer cells in the body

INDICATION

Votrient 400mg is used as a single agent to treat the renel cell carcinoma and its advanced stage It works by preventing the activity of proteins which are interferes with the growth and spread of cancer cells. Votrient 400mg is also used as a single regimen to treat the Soft Tissue Sarcoma, (a type of cancer that occurs in the supportive tissue of the body). The cancer can develop in muscles, blood vessels, fat tissue or in other tissues that support, surround and protect organs

MECHANISM OF ACTION

Votrient 400mg is an effective inhibitor of protein kinase and selective multiple receptor tyrosine kinases (RTKs) that are described in beginning of signal transduction pathways that ready for reproduction of tumor cells and affect processes critical to cell survival and tumor progression. RTKs comes in the blockage and involves the receptors for vascular endothelial growth factors (VEGFR-1, -2, and -3), platelet-derived growth factors (PDGFR-α and -β), and stem cell factor.

ADME

ABSORPTION

Fast GI absorption with food and Bioavailability is 14-39%. Time of high plasma concentration: 2-4 hr.

DISTRIBUTION

bounding of human protein of pazopanib 200mg is >99%.

METABOLISM

Mainly in the liver pazopanib 200mg metabolized by CYP3A4 enzyme and to a lesser extent by CYP1A2 and CYP2C8 enzymes.

ELIMINATION

pazopanib primarily excreted through faeces approx 82%, 67% as unchanged drug and urine (<4%)with renal elimination. Terminal Elimination half-life: Approx 31 hr.

DOSAGE MANAGEMENT

DOSAGE AND ADMINISTARTION

Votrient dosage for renal cell carcinoma and soft tissue sarcoma (cancer in joints, muscle) will be initially 800mg , the dose adjustment in 200mg increments or decrements dose based on tolerance but max dose in adult is 800mg/day. Moderate total bilirubin >1.5 to 3 times, Votrient dose of 200mg once daily. Votrient should be taken on a empty stomach (1hr before or 2hr after meals. Swallow the medicine whole don’t chew/crush. Food interaction :Avoid grapefruit juice or grapefruit juice.

OVERDOSAGE

overdose of the drug can be upto 2000mg can be administrated and It is evaluated in clinical trials and treatment of overdose with votrient should consist of supportive measures and there is no specific antidote.

PRECAUTIONS

Discuss with the doctor before to the treatment of Votrient 400mg tablets about: Allgeric to pazopanib or any other drug products of pazopanib, which include in prescription, over the counters,vitamins,herbal remedies. Do not take immunization or vaccination without doctors advice. Inform your doctor about pregnancy and planning to pregnant. Do not breast feed while treatment with Votrient

SIDE EFFECTS
Votrient 400mg has certain side effects, If any of the symptoms occrs or not cured then call the doctor immediately

MAJOR SIDE EFFECTS

Diarrhae; High blood pressure; low WBC; Elevated liver function test; Blood test abnormalities; increased in bilirubin levels.

COMMON SIDE EFFECTS

Nausea; loss of appetite; fatigue; blood test abnormalities (low magnesium, low glucose); weakness, stomach ache.

DRUG INTERACTION

Strong CYP3A4 enzyme inhibitors (e.g. ketoconazole, itraconazole, voriconazole,etc) + Votrient 400mg → Increase plasma concentration. Votrient + simvastatin → increases incidence of ALT elevation Votrient 400mg + PPI e.g. esomeprazole → decreases bioavailability. Concurrent use of strong of BCRP inhibitors or P-gp (e.g. lapatinib) and inducers + Votrient 400mg →alter the exposure and distribution of pazopanib. Votrient 400mg + rifampin(strong CYP3A4 Enzyme inducers) →decreases the plasma concentration.

PREGNANCY

Pregnancy Category D: The drug show positive in human fetal effects, but the benefits from use in pregnant women may be acceptable against the risk

LACTATION

Votrient 400mg cannot be used by pregnant women and the expert advice to either discontinue breastfeeding or the drug, in order to give importance of drug to the mother. The drug Excretion into human milk and effects in the newborn baby is unknown.

CONTRAINDICATION

Votrient 400mg is contraindicated with hypersensitivity or any of its excipients

STORAGE 

Votrient 400mg store at 20°C to 25°C. Votrient should store in locked cupboard in which children reach it. Votrient do not use after expiry date. Votrient must keep in its container till time to take the dose.

MISSED DOSE

If drug dose missed then take the drug dose as soon as remember. If subsequent dose arrived then swap the missed dose and follow the routine schedule. Avoid taking 2 dose at one time. Please consult your doctor for further clarification