Last update Nov. 6, 2022

Pazopanib Hydrochloride

High Risk

Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.

Inhibitor of BCR-ABL and SRC tyrosine kinase that is used for treatment of several neoplastic diseases (advanced renal cell carcinoma and advanced soft-tissue sarcoma). Oral administration once daily.  

At latest update, relevant published data on excretion into breast milk were not found.

Its very high plasma protein binding makes it difficult its excretion into breast milk in significant amounts.

Its long half-life could facilitate excretion in breast milk and, although oral bioavailability is low, it doubles when ingested with food, so it could have a systemic action in infants

The most common side effects of pazopanib are diarrhea and other gastrointestinal disorders. (Martindale) 

It is known from pharmacokinetics that after 3 elimination half-lives (T½) 87.5% of the drug is eliminated from the body; after 4 T½ it is 94%, after 5 T½, 96.9%, after 6 T½, 98.4% and after 7 T½ it is 99%. From 7 T½ the plasma concentrations of the drug in the body are negligible. In general, a period of at least five half-lives can be considered a safe waiting period before breastfeeding again.(Anderson 2016).

Taking the longest T½ published as a reference (35 hours), these 5 T½ would correspond to 175 hours (7 days). Meanwhile, express and discard milk from the breast regularly. This does not allow breastfeeding during treatment.

Abrupt weaning can be psychologically traumatic for both the mother and the infant. (Pistilli 2013). 

Until more published data is known about this drug in relation to breastfeeding, better known alternatives may be preferable, especially during the neonatal period and in the event of prematurity.

If used during lactation, it is advisable to monitor growth and the possible appearance of diarrhea in the infant.

Given the strong evidence that exists regarding the benefits of breastfeeding for the development of babies and the health of mothers, it is advisable to evaluate the risk-benefit of any maternal treatment, including chemotherapy, individually advising each mother who wishes to continue with breastfeeding. (Koren 2013)


See below the information of this related product:

  • Maternal Cancer ( Poorly safe. Evaluate carefully. Use safer alternative or interrupt breastfeeding 3 to 7 T ½ (elimination half-lives). Read the Comment.)

Alternatives

We do not have alternatives for Pazopanib Hydrochloride.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Pazopanib Hydrochloride in other languages or writings:

Groups

Pazopanib Hydrochloride belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Pazopanib Hydrochloride in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 21 (14 - 39) %
Molecular weight 474 daltons
Protein Binding > 99 %
VD 0.16 l/Kg
pKa 10.41 -
Tmax 2 - 4 hours
31 - 35 hours

References

  1. Royal Pharmaceutical Society. Martindale: The Complete Drug Reference Medicines Complete. available online from: https://www.medicinescomplete.com 2022 Abstract
  2. Anderson PO. Cancer Chemotherapy. Breastfeed Med. 2016 May;11:164-5. Abstract Full text (link to original source) Full text (in our servers)
  3. PDR.net. Pazopanib. Drug Summary. 2014 Full text (link to original source) Full text (in our servers)
  4. Pistilli B, Bellettini G, Giovannetti E, Codacci-Pisanelli G, Azim HA Jr, Benedetti G, Sarno MA, Peccatori FA. Chemotherapy, targeted agents, antiemetics and growth-factors in human milk: how should we counsel cancer patients about breastfeeding? Cancer Treat Rev. 2013 May;39(3):207-11. Abstract
  5. Deng Y, Sychterz C, Suttle AB, Dar MM, Bershas D, Negash K, Qian Y, Chen EP, Gorycki PD, Ho MY. Bioavailability, metabolism and disposition of oral pazopanib in patients with advanced cancer. Xenobiotica. 2013 Abstract
  6. Koren G, Carey N, Gagnon R, Maxwell C, Nulman I, Senikas V; Society of Obstetricians and Gynaecologists of Canada. Cancer chemotherapy and pregnancy. J Obstet Gynaecol Can. 2013 Mar;35(3):263-278. Abstract Full text (link to original source) Full text (in our servers)
  7. EMEA. Pazopanib. Ficha técnica. 2012 Full text (in our servers)
  8. Di Gion P, Kanefendt F, Lindauer A, Scheffler M, Doroshyenko O, Fuhr U, Wolf J, Jaehde U. Clinical pharmacokinetics of tyrosine kinase inhibitors: focus on pyrimidines, pyridines and pyrroles. Clin Pharmacokinet. 2011 Abstract

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