Medical Oncologist
Managing Pazopanib Side Effects
Diarrhoea and High Blood Pressure — on Pazopanib: What to Watch For
Both diarrhoea and raised blood pressure are common on pazopanib. Most people manage both at home with some adjustments, but both can escalate — and knowing which signs need a call today versus going to hospital now is the practical knowledge that keeps you safe.
Medically reviewed by Dr. T. Raghavender Reddy, Medical Oncologist, MBBS · DM (Medical Oncology) · MD (Radiation Oncology) · Last reviewed August 2026
- Expected, not unusual — Most people on pazopanib experience one or both of these effects. They do not mean the treatment is harming you or not working.
- Home management usually works — Mild diarrhoea and a moderately raised blood pressure can often be managed with guidance from your team, without stopping treatment.
- Both can cross a threshold quickly — That is why your team monitors both — a reading or pattern that looks manageable today can worsen by tomorrow.
- Some signs are emergencies — Sudden severe headache, vision changes, chest pain, or blood in your stool all need hospital assessment now, not a callback.
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Both diarrhoea and raised blood pressure are expected side effects of pazopanib. Neither is automatically dangerous, but both need monitoring. NCCN guidance classifies severe or sudden blood pressure rise and persistent watery diarrhoea as needing prompt clinical assessment, not home management alone. Tell your team about either symptom at your next appointment, or sooner if they worsen.
Can I manage diarrhoea and high blood pressure at home?
Both are common enough on pazopanib that your team will have discussed them before you started. Most people manage both without needing to stop treatment.
For diarrhoea, drink extra water or oral rehydration fluid through the day. Eat smaller, plainer meals and avoid spicy, oily, or high-fibre food until symptoms settle. Do not take an over-the-counter anti-diarrhoeal medicine without asking your team first — it can mask a worsening that your team needs to see.
For blood pressure, your team may ask you to check it at home and keep a record of the readings. If you have been prescribed blood pressure medication as part of your care plan, take it as directed and do not adjust the dose yourself.
Call your team if either symptom is not settling within a day or two, or if it is getting worse rather than better.
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When does a side effect need a same-day call?
| Feature | Manageable at home | Call your team today — do not wait |
|---|---|---|
| Diarrhoea frequency | A mild increase that settles within one to two days | Clearly more than your usual pattern, lasting beyond 24 hours, or worsening each day |
| Diarrhoea appearance | Loose or watery, no blood | Any blood or mucus — call the same day |
| Ability to keep fluids down | Drinking normally, passing urine as usual | Cannot keep enough fluid down, feeling dizzy on standing, or very dark urine |
| Blood pressure symptoms | Raised reading but you feel well | Persistent or worsening headache, or any change in your vision |
| Typically starts | Diarrhoea: often within the first few weeks of treatment | Blood pressure: can rise early and stay elevated throughout — readings matter even when you feel well |
Did you know?
Raised blood pressure is reported by NCCN and ESMO as one of the most common side effects of pazopanib, occurring in a substantial proportion of patients. Both bodies recommend that blood pressure is checked and well controlled before the first dose — and monitored throughout treatment.
Uncontrolled hypertension is one of the clearest reasons a dose may need to be held. Controlling it early usually means treatment can continue without interruption.
Source: NCCN Guidelines: Renal Cell Carcinoma; ESMO Clinical Practice Guidelines for Renal Cell Carcinoma
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Common questions
Frequently asked questions
Can I take anti-diarrhoeal tablets like loperamide on pazopanib?
Ask your team before taking anything, including loperamide (Imodium). The concern is that it can settle the symptom while the underlying cause continues, which hides exactly the pattern your team is watching for. Some teams recommend it for mild, early diarrhoea; others prefer to assess first. The right advice depends on your specific situation and whether you have other symptoms alongside it.
Do I need to check my blood pressure at home while on pazopanib?
Your team will usually advise this, yes. Home readings give a clearer picture than a single clinic reading, which can be affected by the stress of the appointment. Keep a simple log of the date, time, and both numbers. Share it at every appointment, and call between appointments if you notice a reading that worries you or that is higher than your team has told you to watch for.
Will diarrhoea or high blood pressure mean my pazopanib dose has to be reduced?
Not necessarily. Many people manage both effects with supportive treatment — anti-diarrhoeal medicine, fluid replacement, blood pressure medication — without any change to the pazopanib dose. A dose reduction or temporary hold is considered only when a side effect becomes severe or does not respond to management. Early reporting gives your oncologist the most options.
Is it normal to have both diarrhoea and high blood pressure at the same time on pazopanib?
Yes. Both are listed by NCCN and ESMO as commonly occurring with pazopanib, and having more than one side effect at once is not unusual. Dehydration from diarrhoea can itself affect your blood pressure readings, which is one more reason your team needs to know about both. Always mention both when you call or come in for an appointment.
How long do these side effects usually last on pazopanib?
Diarrhoea can often be controlled with medication and diet changes, and may improve over time, though it sometimes continues for as long as treatment does. Raised blood pressure tends to persist throughout treatment and usually needs ongoing management rather than resolving on its own. Neither is a reason to expect treatment to stop — but both are reasons to stay in regular contact with your team and not manage them silently.