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Pazopanib, marketed as Votrient, requires careful consideration due to its potential risks and necessary precautions. Below is a summary of critical safety information to be aware of when using this medication:

• Liver Health: Pazopanib can lead to severe liver damage, potentially resulting in life-threatening liver failure. Regular liver function tests are necessary before and during treatment, especially during the first two months with frequent monitoring every two weeks. If you experience persistent nausea, vomiting, dark urine, yellowing of the skin or eyes, or abdominal pain, contact your healthcare provider immediately. Adjustments to your dosage or discontinuation of the drug may be necessary.

• Cardiac Concerns: Patients may experience heart-related issues such as decreased cardiac function or heart failure, and changes in heart rhythm (QT prolongation). Regular monitoring through echocardiograms, electrocardiograms, and electrolyte level assessments are advisable, particularly if you have a history of heart problems or are on medications that affect heart rhythm.

• Bleeding Risks: Some patients may encounter unusual bleeding, including nosebleeds or rectal bleeding. Report any abnormal bleeding to your healthcare provider promptly.

• Blood Clots: The medication may increase the risk of blood clots, which could lead to serious conditions like stroke or heart attack. Seek immediate medical attention if you experience symptoms such as difficulty walking, blurred vision, breathing difficulties, chest pain, or leg swelling.

• Gastrointestinal Issues: Rarely, pazopanib may cause serious gut injuries or fistulas. Symptoms such as high fever, severe constipation, or persistent stomach pain should be communicated to your provider, as treatment may need to be stopped.

• Lung Complications: Although infrequent, serious lung problems including lung inflammation may occur. Notify your provider if you experience new or worsening respiratory symptoms.

• Neurological Effects: A rare condition called posterior reversible encephalopathy syndrome (PRES) could develop, leading to symptoms like headaches or vision changes. Immediate medical evaluation is necessary if these symptoms arise.

• Blood Pressure: The drug can elevate blood pressure, particularly within the first four months of treatment. Blood pressure should be controlled before starting the medication.

• Surgical and Wound Healing Concerns: Pazopanib may impede wound healing. It is advised to stop the medication a week prior to any surgery and until full healing is achieved post-operation.

• Thyroid Function: Pazopanib can affect the thyroid, potentially causing hypothyroidism. Regular thyroid function tests and potential hormone replacement therapy may be required.

• Kidney Monitoring: Kidney function should be regularly assessed, as pazopanib can affect renal health.

• Tumor Lysis Syndrome: This potentially fatal reaction occurs when cancer cells break down rapidly. Patients at increased risk require close monitoring.

• Infection Risk: Pazopanib can increase susceptibility to infections. Maintain good hygiene and avoid individuals with infections. Report any signs of infection to your provider promptly.

• Pregnancy Precautions: Pazopanib may harm an unborn child. Pregnancy tests and effective birth control are recommended during treatment and for two weeks following the last dose. Inform your healthcare provider immediately if pregnancy occurs.

For any concerns or unusual symptoms while on pazopanib, consult your healthcare provider promptly. This medication requires vigilant monitoring and communication with your healthcare team to manage its risks effectively.

When taking this medication, some individuals may experience common side effects that are generally mild and manageable. These include diarrhea, nausea, vomiting, headache, loss of appetite, weight loss, changes in taste, fatigue, and temporary hair color change. Some people may also notice elevated liver enzymes, blood sugar changes, high blood pressure, and low levels of blood cells like white blood cells and platelets. If these effects persist or worsen, consulting a healthcare provider is advisable.

There are also more significant side effects that can occur, although they are less common. These may include skin color changes, indigestion, belly pain, hoarseness, hand-foot syndrome, and protein in the urine. If any of these symptoms appear, especially if severe, it is important to seek medical advice.

Serious side effects are rare but require prompt medical attention. These include symptoms of heart failure, such as swelling in the ankles or feet, unusual tiredness, or signs of infection like persistent sore throat or fever. Serious bleeding, characterized by unusual bruising or blood in stools, and kidney problems, like painful urination or bloody urine, are critical signs to watch for. Additionally, monitor for severe allergic reactions, recognizable by rash, swelling, severe dizziness, or breathing difficulties.

For very serious conditions, immediate medical help is essential. These conditions include symptoms of a heart attack, stroke, or severe hypertension, such as chest pain, shortness of breath, vision changes, or confusion. Blood clots in the lungs or legs, tumor lysis syndrome, and severe liver problems are also highly critical. Prompt action can significantly affect the outcome of these conditions. Always discuss any concerning symptoms with your healthcare provider to ensure appropriate management.

Pazopanib, marketed as Votrient, can interact with several medications and supplements. It's important to inform your doctor and pharmacist about any drugs or supplements you're taking, whether they are prescription, over-the-counter, vitamins, or herbal products.

Some specific medications should not be used with pazopanib. These include atazanavir, bepridil, boceprevir, cisapride, cobicistat, dronedarone, fluconazole, ketoconazole, mesoridazine, nelfinavir, pimozide, piperaquine, posaconazole, saquinavir, sparfloxacin, telaprevir, terfenadine, thioridazine, tipranavir, and ziprasidone. Your doctor may opt for an alternative treatment if you are taking any of these.

Additionally, combining pazopanib with certain other drugs is usually not recommended unless necessary. If both medications are prescribed, your doctor might adjust the dose or frequency. This list includes, but is not limited to, drugs like alfentanil, amiodarone, amitriptyline, carbamazepine, clarithromycin, erythromycin, haloperidol, ibutilide, methadone, moxifloxacin, phenytoin, quinidine, rifampin, ritonavir, sotalol, and St. John's wort.

Furthermore, drugs that affect heart rhythm (QT prolongation) or influence the removal of pazopanib from the body may alter its effectiveness and safety. Always consult your healthcare provider for detailed advice tailored to your specific medications and health condition.