Votrient (pazopanib) is a targeted anticancer medication that’s used to treat advanced kidney cancer (renal cell carcinoma) and advanced soft tissue sarcoma in adults. This medication is conveniently taken by mouth once a day. But it can commonly cause side effects like diarrhea, high blood pressure, and changes in hair color (lighter or grayer).
Advanced kidney cancer (renal cell carcinoma)
Advanced soft tissue sarcoma, after previously receiving chemotherapy
Votrient (pazopanib) is a targeted therapy for cancer known as a tyrosine kinase inhibitor (TKI). It targets and blocks specific proteins in cancer cells called tyrosine kinases, including those in the VEGFR family, among others. These proteins are involved in providing blood supply to the tumor.
By blocking these tyrosine kinases, Votrient (pazopanib) prevents blood vessels from forming and supplying blood to the tumor. This helps slow and stop cancer growth.
Source: DailyMed
Along with its needed effects, a medicine 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:
More common
Black, tarry stools
bleeding gums
blood in the urine or stools
blurred vision
chills
clay colored stools
cloudy urine
coughing up blood
dark urine
decreased appetite
depressed mood
difficulty with breathing or swallowing
dizziness
dry skin and hair
feeling cold
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
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
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
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
Some side effects 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
lack or loss of strength
loss of taste
thinning of the hair
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pills that are swallowed once daily
More precise in the way it targets cancer cells than traditional chemotherapy
Recommended treatment option for certain types of kidney cancer and soft tissue sarcoma
Shouldn’t take with food (must take at least 1 hour before or 2 hours after a meal)
Has many risks, including infection, bleeding, and blood clots
Not safe to take while pregnant or breastfeeding
Take Votrient (pazopanib) once a day without food, at least 1 hour before or 2 hours after a meal. For each dose, you'll need to take several tablets all at once (or one right after another).
Swallow Votrient (pazopanib) tablets whole with water. Don't crush, break, or chew tablets because this might affect how well and how quickly the medication is absorbed into the body.
If you miss a dose of Votrient (pazopanib), take it as soon as you remember. But if your next dose is less than 12 hours away, don’t take the medication until your next regularly scheduled time. Don't double the dose because this can raise your risk for side effects.
Let your provider know if you have diarrhea while you’re taking Votrient (pazopanib). Your provider can recommend over-the-counter antidiarrheal medications like loperamide (Imodium A-D). Eating fiber-rich foods can also help prevent future episodes of diarrhea.
Regularly check your blood pressure while you’re taking Votrient (pazopanib) because the medication can raise your blood pressure. Tell your provider if your blood pressure is higher than usual. Your provider can prescribe blood pressure medications to help lower your blood pressure to a safer range.
Call your provider if you fall or get injured while you’re taking Votrient (pazopanib). The medication can raise your risk for bleeding, so your provider should check for any serious bleeding to be safe. Also, tell your provider if you notice bruises that don’t go away or bleeding that’s hard to stop because you might need more medical attention.
Be sure to tell your provider about any upcoming surgeries or procedures because Votrient (pazopanib) can make it harder for your body to heal from them. Your provider will typically ask you not to take the medication a week before and at least 2 weeks after your procedure and until the wounds fully heal.
Sometimes, Votrient (pazopanib) can make urine look cloudy. This can mean that too much protein has passed into your urine, which can be a sign of kidney problems. Tell your provider if you have cloudy-looking urine. You might need lab tests done to check your kidneys.
Let your provider and pharmacist know about other medications and supplements you take because Votrient (pazopanib) can interact with many medications. For example, taking the cancer medication with simvastatin (Zocor) can raise your risk for liver damage. Your providers can make sure all your medications are safe for you.
Avoid taking heartburn medications like esomeprazole (Nexium) and famotidine (Pepcid AC) because they can make Votrient (pazopanib) work less well. If you have to take something for heartburn during treatment, try taking antacids like calcium carbonate (Tums) 2 hours before or 2 hours after taking Votrient (pazopanib) to lower the risk for this drug interaction.
If you or your partner can have children, use reliable birth control methods while you’re taking Votrient (pazopanib) to avoid getting pregnant. After you take your last dose of medication, continue to use birth control for at least 2 weeks. Tell your provider right away if you or your partner gets pregnant while you’re taking this medication. Votrient (pazopanib) can harm an unborn baby.
Votrient (pazopanib) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Age greater than 65 years |Taking simvastatin (Zocor)
Votrient (pazopanib) can cause liver damage that can sometimes lead to life-threatening liver failure. Your risk for liver damage is higher if you take the cholesterol medication simvastatin (Zocor) with Votrient (pazopanib).
In studies, signs of liver damage appeared in the first 4 months of treatment. Your provider will check your liver through lab work at the start of treatment and regularly while you’re taking this medication. Tell your provider if you have symptoms of liver problems, such as tiredness, loss of appetite, nausea or vomiting, dark urine, right-side stomach pain, or yellowing of the eyes or skin. Your provider might check your liver more frequently, pause treatment until your symptoms get better, lower your dose, or stop the medication altogether.
Risk factors: History of QT prolongation | Taking antiarrhythmics or other medications that can cause QT prolongation | Already have heart problems | Previous treatment with medications like doxorubicin
Some people taking Votrient (pazopanib) had heart problems, like a lowering of the heart’s ability to pump blood and heart failure. Some also had changes in the electrical activity of the heart called QT prolongation, which raises the risk for life-threatening, irregular heartbeats. To monitor your risk for heart problems, your provider might check your heart’s ability to pump using an echocardiogram (echo), check your electrolyte levels through blood testing, and check your heart’s electrical activity using an electrocardiogram (ECG).
Tell your provider right away if you have symptoms like chest pain, shortness of breath, swelling in the lower legs or feet, racing or irregular heartbeat, lightheadedness, or tiredness. These symptoms might suggest heart problems, and you might need to pause or stop treatment with Votrient (pazopanib) if they occur.
Some people who took Votrient (pazopanib) had unusual bleeding, such as nosebleeds and rectal bleeding (blood on toilet paper after you wipe). Let your healthcare provider know immediately if you have any unusual bleeding, especially bleeding that’s hard to stop.
Rarely, serious and fatal bleeding has happened. Serious bleeding can happen in any area of the body, including in the lungs, stomach, and brain. Get medical help right away if you feel nauseous, have a sudden or painful headache, notice a change in your vision, have stomach pain, or are coughing or spitting up blood. Your healthcare provider might stop treatment with Votrient (pazopanib) based on how severe the bleed is.
Votrient (pazopanib) can raise your risk for blood clots in your body. Sometimes, blood clots can be life-threatening and lead to stroke or heart attack. Symptoms of a blood clot might be different depending on the location of the clot. They can include trouble walking, blurry vision, breathing problems, chest pain, and swelling in the leg. Get medical attention as soon as possible if you have any of these symptoms. You’ll need to stop stop treatment with Votrient (pazopanib).
Votrient (pazopanib) can also cause blood clotting problems called thrombotic microangiopathy (TMA), which includes thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS). Your provider might monitor for signs of these problems through lab work. You’ll probably need to permanently stop treatment if you develop these conditions.
Though uncommon, some people who took Votrient (pazopanib) developed tears and fistulas (an abnormal connection from one part of the body to another) in the gut. These problems are serious and can sometimes be life-threatening. Notify your provider if you have symptoms of gut injuries or fistulas, like high fever, shivering, vomiting, severe constipation, pain in the anal area, or severe stomach pain (especially if it doesn’t go away). Your provider might permanently stop your Votrient (pazopanib) treatment.
Though rare, a few people who took Votrient (pazopanib) had serious lung problems, like lung inflammation and interstitial lung disease, which can be fatal. Tell your provider if you have any new or worsening breathing problems, such as shortness of breath, dry cough, and faster breathing. You might need to stop taking Votrient (pazopanib) if you develop lung inflammation or interstitial lung disease.
Posterior reversible encephalopathy syndrome (PRES) is a very rare, but sometimes fatal side effect of Votrient (pazopanib) that affects your nervous system. Let your provider know if you have any symptoms of PRES, like headache, feeling sluggish, confusion, and vision loss. If you develop symptoms, your provider will check for PRES by ordering a brain scan called an MRI (magnetic resonance imaging) for you. Your provider will stop your treatment if it’s confirmed that you have PRES.
Votrient (pazopanib) can raise your blood pressure, most commonly within the first 4 months of treatment. Don’t start taking this medication until your blood pressure gets under control (with guidance from your provider).
Once you’ve started Votrient (pazopanib), regularly check your blood pressure and contact your provider if it rises during treatment. You might need to start blood pressure medications to manage this side effect. Depending on your blood pressure, you also might need to take Votrient (pazopanib) at a lower dosage or even stop the medication. Tell your provider if you feel dizzy or tired or if you have headaches. And get medical help right away if you have signs of extremely high blood pressure, like changes in vision or speech, confusion, shortness of breath, weakness, or numbness.
Votrient (pazopanib) can make it harder for wounds to heal. Tell your provider if you’re planning to have a surgery or procedure. You shouldn’t take Votrient (pazopanib) a week before and at least 2 weeks after surgery and until your surgical wounds fully heal.
Votrient (pazopanib) can cause thyroid gland problems like hypothyroidism (low thyroid hormone levels). Symptoms of thyroid gland problems can include weight loss or weight gain, feeling nervous or anxious, depression, eye or neck swelling, feeling hot or cold, sweating, or changes in menstruation. Contact your healthcare provider if you have any of these symptoms. Your provider will check your thyroid hormone levels during treatment and start thyroid replacement therapy if needed.
It’s possible for Votrient (pazopanib) to cause kidney problems, sometimes causing more proteins than usual to seep into the urine. Your provider will regularly monitor your kidney health through blood tests and urine samples while you’re taking this medication.
If you develop kidney problems, your provider might pause treatment until your kidney gets better or stop treatment permanently depending on how severe the problem is. Talk to your provider if you notice any changes in how often you urinate (more or less), any blood in your urine, or any cloudy urine so they can check for kidney issues.
Risk factors: Fast-growing tumor | High tumor burden | Kidney problems | Dehydration
Some people treated with Votrient (pazopanib) have had a serious and sometimes fatal reaction called tumor lysis syndrome (TLS). This reaction happens when many cancer cells quickly die and suddenly break down in your body. In the process, these cells release their inner contents, like uric acid, potassium, and phosphorus, into your blood.
High levels of uric acid and electrolytes in your body can cause serious problems, such as kidney damage and abnormal heart rhythms. Your provider will routinely order blood tests to check for signs of TLS. Tell your provider right away if you’re urinating less than usual or if you have dark urine, muscle cramps, or a racing heartbeat.
Votrient (pazopanib) can raise your risk of getting a serious infection, which can be fatal. To prevent getting sick, stay away from people who are sick and practice good hand hygiene (wash your hands often with soap and water). Tell your provider if you have any signs or symptoms of a new infection, like fever, chills, stuffy nose, cough, ear or sinus pain, pain while urinating, or wounds that won’t heal. If you have an infection, your provider might pause your treatment with Votrient (pazopanib) until you recover from it.
Votrient (pazopanib) can cause harm to an unborn baby when it’s taken during pregnancy. If you can have children, your provider might ask you to take a pregnancy test before you start treatment. And if you or your partner can become pregnant, use effective birth control once you start the medication. Continue using birth control for at least 2 weeks after your last dose. Tell your provider right away if you or your partner becomes pregnant during this time.
The typical dose is 800 mg (four 200 mg tablets) by mouth once daily. Your dose might be lower if you have liver problems.
During treatment, your dose can change based on how well you tolerate Votrient (pazopanib). It might also change if you’re taking certain medications that interact with Votrient (pazopanib).
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Advanced kidney cancer (renal cell carcinoma)
Advanced soft tissue sarcoma, after previously receiving chemotherapy
Liver cancer that can’t be removed by surgery
Advanced kidney cancer
Advanced or metastatic differentiated thyroid cancer
By providing your email, you consent to receive marketing communications from GoodRx, which may include content and/or data related to men’s health, women's health, reproductive care, or sexual health. You agree to the GoodRx Terms of Use and acknowledge the Privacy Policy. You can unsubscribe at any time.
American Cancer Society. (2023). Targeted drug therapy for kidney cancer.
American Cancer Society. (2024). Preventing infections in people with cancer.
American Heart Association. (2023). Symptoms, diagnosis and treatment of excessive blood clotting (hypercoagulation).
Arnold, D. M., et al. (2017). Thrombotic microangiopathies: A general approach to diagnosis and management. Canadian Medical Association Journal.
Gupta, A., et al. (2018). Tumor lysis syndrome. Journal of the American Medical Association Oncology.
MedlinePlus. (2022). Bilirubin blood test.
MedlinePlus. (2022). Uric acid test.
MedlinePlus. (2023). Fistula.
National Cancer Institute (n.d.). Hand-foot syndrome
National Cancer Institute. (2022). Targeted therapy to treat cancer.
National Comprehensive Cancer Network. (2023). Soft tissue sarcoma.
National Comprehensive Cancer Network. (2024). Kidney cancer.
National Heart, Lung, and Blood Institute. (2022). Thrombotic thrombocytopenic purpura (TTP).
National Kidney Foundation. (n.d.). Hemolytic uremic syndrome (HUS).
Novartis Pharmaceuticals Corporation. (2024). Votrient- pazopanib hydrochloride tablet, film coated [package insert]. DailyMed.
Šeparović, R., et al. (2018). Rapid hair depigmentation in patient treated with pazopanib. British Medical Journal Case Reports.
Shibuya, M. (2011). Vascular endothelial growth factor (VEGF) and its receptor (VEGFR) signaling in angiogenesis: A crucial target for anti- and pro-angiogenic therapies. Genes & Cancer.
Sternberg, C. N., et al. (2010). Pazopanib in locally advanced or metastatic renal cell carcinoma: Results of a randomized phase III trial. Journal of Clinical Oncology.
Thomson, R. J., et al. (2023). Tyrosine kinase inhibitors. StatPearls.
Triplett, J. D., et al. (2022). Posterior reversible encephalopathy syndrome (PRES): Diagnosis and management. Practical Neurology.
Wolter, P., et al. (2011). Incidence of thyroid dysfunction in renal cell carcinoma (RCC) patients treated with pazopanib in prospective clinical trials. Journal of Clinical Oncology.
Yun, H. J., et al. (2015). Gray hair associated with the multitargeted receptor tyrosine kinase inhibitor pazopanib. Annals of Dermatology.
Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.