Pazopanib (Votrient )

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Ashlie Jones
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Pazopanib (Votrient ) Pronounced: [paz-oh-pa-nib] About Your Medication Pazopanib is an oral medicine that your doctor prescribed for the treatment of your cancer.

1 Pazopanib (Votrient ) Pronounced: [paz-oh-pa-nib] About Your Medication Pazopanib is an oral medicine that your doctor prescribed for the treatment of your cancer. Please take your pazopanib as directed by your prescriber. How to Take Your Medication Take your pazopanib at approximately the same time each day Take on an empty stomach - at least 1 hours before or 2 hours after eating Swallow pazopanib tablets whole with water. Do not break, chew, or dissolve tablets. If you miss a dose of pazopanib take the medicine as soon as you remember on that day. Do not take two doses on the same day to make up for a missed dose. Tell Your Healthcare Provider if you have any trouble taking your pazopanib, including: Trouble swallowing pills Forgetting to take doses Trouble affording your medications Throwing up pills Side effects Important Precautions Pazopanib may be harmful to an unborn child. If sexually active with a partner that is pregnant or who may become pregnant during and for several weeks after treatment, two forms of contraception must be used (a condom and another effective form of birth control). It is not known whether pazopanib passes into breast milk. Nursing mothers should discuss with their healthcare providers whether to discontinue nursing or to discontinue pazopanib. Liver toxicity, which may be severe and/or result in fatal liver failure, has been observed with pazopanib. QT prolongation is an abnormal heart rhythm associated with pazopanib. The cancer clinic will monitor your heart rhythm intermittently.

2 What foods and drugs may interact with my pazopanib? Please talk to your healthcare provider at your cancer clinic before starting or stopping any medications, vitamins, or herbal supplements, because some of these may interact with your pazopanib. Some examples of products that interact with pazopanib include: Grapefruit or grapefruit juice Certain anti-infectives such as rifampin (Rifadin ) Anti-seizure medicines, including carbamazepine (Tegretol ), phenobarbital (Luminal ), and phenytoin (Dilantin ) Some medications for mood, like St. John s Wort and nefazodone (Serzone ) Certain antifungals, such as itraconazole (Sporanox ), ketoconazole (Nizoral ), posaconazole (Noxafil ), and voriconazole (Vfend ) Antibiotics like clarithromycin (Biaxin ), telithromycin (Ketek ), ciprofloxacin (Cipro ), and levofloxacin (Levaquin ) Storage, Handling, and Disposal It is important to keep these safeguards in mind when storing and handling oral anticancer therapy to keep you and your caregivers safe. Keep your pazopanib in a safe place, away from other family members medications and away from any food or drinks. Store the medication at room temperature in a dry location avoid storing your medication in the bathroom. Store pazopanib in its original container. Keep the medication out of reach from children and pets. Return expired, damaged, or unused pazopanib to a pharmacy or hospital for disposal. Do not discard into the garbage or toilet, or anywhere that children or pets may have access.

3 Pazopanib (Votrient ) Side Effect Summary This list does not include all possible side effects of pazopanib. If you have an unusual symptom, call the clinic. Below are the most common side effects: Hand Foot Syndrome rash on hands and/or feet that can be painful What are your symptoms? Mild Symptoms Redness or swelling without pain Moderate Symptoms skin on hands has changes such as peeling or blisters with pain; unable to do some activities Severe Symptoms - skin on hands has changes such as peeling, blisters, swelling and/or you are unable to perform normal daily activities due to the pain or skin changes What can you do Apply non-scented lotion to areas of dry skin Heavy & frequent application of moisturizers Use of moisturizing product with lactic acid Use of gloves/socks at night The clinic may provide you with additional prescription creams or lotions to apply to the rashavoid direct sunlight (cover exposed areas of skin and use sunscreen) Try to manage using the measures listed above The clinic may provide you with additional oral medications to help manage the rash If not improved within a few days, or you are unable to care for yourself, Call the clinic Call the clinic Increased/Elevated Blood Pressure onset within 3 weeks What Can I Do? When to Call the Clinic? Depending on your specific treatment plan, you may be instructed by your clinic to monitor your blood pressure daily at home, especially during the first 6 weeks of therapy Blood pressure over 150/90 or less than 100/60 or as instructed by your clinic provider

4 Nausea and Vomiting queasy sensations or actually throwing up food or stomach contents What are your symptoms? What can you do Mild Nausea or Vomiting loss of appetite without a change in eating habits; or vomiting 1-2 times in 24 hours Moderate Nausea or Vomiting eating less than usual but not losing weight or becoming dehydrated; or vomiting 3-5 times within 24 hours Severe Nausea or Vomiting not being able to eat or stay hydrated; or vomiting more than 6 times within 24 hours Stay well hydrated Eat smaller, more frequent meals and snacks; avoid eating on an empty stomach Avoid fried, greasy, salty, sweet, or spicy foods Use anti-nausea medicine prescribed by the clinic Try to manage using the measures listed above and take your anti-nausea medicine regularly If not improved within 48 hours, or you are unable to stay hydrated or eat, Call the clinic Call the clinic Fatigue lack of energy or feeling sleepy What are your symptoms? What can you do Mild fatigue (slightly worse than before you started taking the drug) Moderate fatigue (difficulty performing some of your normal daily activities) Severe fatigue (severely interfering with your normal daily activities or inability to get out of bed) You may need to adjust your schedule to manage fatigue. Plan out the day, and prioritize activities, so you have time to rest. You should schedule periods of rest into your day, and try to rest before you feel tired. Frequent, short rests are helpful. Stay active regular mild/moderate exercise can boost your energy level. Try incorporating walking or other activities into your daily routine. Try not to over-exert yourself. Ask for help from family or friends with difficult tasks. Try to manage using the measures listed above. If it does not get better after a few days, call the clinic Call the clinic

5 Diarrhea frequent and/or watery bowel movements What are your symptoms? What can you do Mild diarrhea stools are more loose/watery or you are having 1-3 more stools per day than usual Moderate diarrhea - you are having 4-6 more stools per day than usual; you are still able to perform your normal daily activities Severe diarrhea you are having 7 or more stools per day than usual, or you are having trouble staying hydrated or performing normal daily activities, or you are not making it to the bathroom in time Stay well hydrated Avoid fatty, greasy, spicy foods that may increase your risk for diarrhea Avoid caffeine and alcohol Eat small, frequent meals; foods that are easy on the stomach include bananas, rice, applesauce, and toast Use your antidiarrheal medicine, loperamide (Imodium ) 4 mg at the onset of diarrhea, then 2 mg every 2 hours until diarrheafree for 12 hours If diarrhea is not improving after 48 hours of treatment with your antidiarrheal medicine, or you are having trouble staying hydrated, call the clinic Try to manage using the measures listed above. If diarrhea is not improving within 24 hours, or you are having trouble staying hydrated, call the clinic Stop taking the pazopanib and call the clinic

6 Below are some less common side effects of pazopanib. Less Common Side Effects What Can I Do? When to Call the Clinic? Change in Heart Rhythm (QT prolongation) The clinic will monitor your heart to assess Liver Dysfunction The clinic will monitor your labs to assess Blood Clots (Deep Vein Thrombosis/Pulmonary Embolism) Chest pain, shortness of breath, lightheadedness, nausea, vomiting or excessive sweating for longer than 5 minutes, call 911. Yellowing of the skin or eyes Shortness of breath Chest pain Swelling/tenderness/redness in the leg or arm Bleeding Coughing up blood or having blood in your urine or stools If you are planning to have surgery, call with the date Who to Call With Questions? If you are having an emergency, call 911 <Clinic Contact Info> <Hours for contacting clinic> <After-Hours Contact Info>

7 Information to have ready for each appointment: Number of missed doses per month: Problems receiving your medication (cost, insurance issues, etc; circle one): Yes / No New medications (Please call clinic before starting or stopping any medications): Symptoms and what you ve done to address them: Other concerns or questions: Who to Call With Questions? If you are having an emergency, call 911 <Clinic Contact Info> <Hours for contacting clinic> <After-Hours Contact Info>

8 Information to have ready for each appointment: Number of missed doses per month: Problems receiving your medication (cost, insurance issues, etc; circle one): Yes / No New medications (Please call clinic before starting or stopping any medications): Symptoms and what you ve done to address them: Other concerns or questions: Who to Call With Questions? If you are having an emergency, call 911 <Clinic Contact Info> <Hours for contacting clinic> <After-Hours Contact Info>

9 Information to have ready for each appointment: Number of missed doses per month: Problems receiving your medication (cost, insurance issues, etc; circle one): Yes / No New medications (Please call clinic before starting or stopping any medications): Symptoms and what you ve done to address them: Other concerns or questions: Who to Call With Questions? If you are having an emergency, call 911 <Clinic Contact Info> <Hours for contacting clinic> <After-Hours Contact Info>

Crizotinib (Xalkori )

Crizotinib (Xalkori ) Pronounced: [kriz-oh-ti-nib] About Your Medication Crizotinib is an oral medicine that your doctor prescribed for the treatment of your cancer. Please take your crizotinib as directed