PARTNERS WITH
Pazopanib
Tyrosine kinase inhibitors
MECHANISM OF ACTION
VEGF receptor TKI. Tyrosine kinase inhibitor with VEGF inhibitory properties leading to decreased angiogenesis.
MECHANISM OF KIDNEY INJURY
TMA (thrombotic microangiopathy) (systemic/kidney limited), Glomerular injury
CLINICAL KIDNEY SYNDROME
AKI, Proteinuria/Albuminuria, Hypertension, Cardiac arrhythmia
CARDIOVASCULAR ADVERSE EFFECTS
Heart failure - PMID: 31547750, hypertension, QT interval prolongation, Myocardial Ischemia. --PMID: 29706106
LYTE ABNORMALITIES
Hypophosphatemia, Hypomagnesemia
RISK FACTORS
MITIGATION STRATEGIES
unclear
SUGGESTIONS
Check UA with urine culture, Check urine analysis for cyrstals, WBC, RBC, etc, Check urine protein creatinine ratio, Check TMA work up (send haptoglobin, peripheral smear, LDH), Dose adjustment (details in notes section below), Hold therapy if nephrotic or proteinuria >3g. Usually there is a dose dependent response, consider decreasing dose.
NOTES/COMMENTS
> 99%
PHARMACOKINETICS
Molecular Weight
437.517 g/mol
Volume of Distribution
22.3 L
Plasma Protein Binding
Metabolism
Hepatic: via CYP3A4 (major); CYP1A2 and CYP2C8 (minor)
Bioavailability
14 to 39%
Half-life elimination
31 hours
Time to peak
2 to 4 hours
Excretion
Feces (primarily); urine (<4%)
Dialyzable?
No
REF:
PMID: 25505255
PATHOLOGY SLIDES:
ENTRY UPDATES:
Raad Chowdhury
MN/USA
Sep 25, 2022