pazopanib (Rx)

Advanced Renal Cell Carcinoma

Indicated for advanced renal cell carcinoma (RCC)

800 mg PO qDay on empty stomach (at least 1 hr ac or 2 hr pc)

Continue until disease progression or unacceptable toxicity

Soft Tissue Sarcomas

Indicated for advanced soft tissue sarcoma (STS) who have received prior chemotherapy

800 mg PO qDay on empty stomach (at least 1 hr ac or 2 hr pc)

Continue until disease progression or unacceptable toxicity

Dosage Modification

Dose reductions for adverse reactions

• RCC

  • First dose reduction: 400 mg PO qDay
  • Second dose reduction: 200 mg PO qDay
  • Unable to tolerate second reduction: Permanently discontinue

• STS

  • First dose reduction: 600 mg PO qDay
  • Second dose reduction: 400 mg PO qDay
  • Unable to tolerate second reduction: Permanently discontinue

Hepatic toxicity

• Isolated ALT elevations (3-8x ULN): Continue and monitor liver function weekly until ALT returns to Grade 1 or baseline

• Isolated ALT elevations >8x

  • Withhold until improvement to Grade 1 or baseline
  • If potential benefit for resuming treatment is considered to outweigh the risk for hepatotoxicity, then resume at a reduced dose of no more than 400 mg PO qDay and measure serum liver tests weekly for 8 weeks
  • Permanently discontinue if ALT elevations >3x ULN recur despite dose reduction(s)

• ALT elevations >3x ULN AND bilirubin elevations >2x ULN

  • Permanently discontinue and continue to monitor until resolution
  • Manage per recommendations for isolated ALT elevations in patients with only a mild, indirect (unconjugated) hyperbilirubinemia, known as Gilbert’s syndrome, and ALT elevations >3x ULN

Left ventricular systolic dysfunction

• Symptomatic or Grade 3: Withhold until improvement to Grade <3; resume treatment based on medical judgement
• Grade 4: Permanently discontinue

Hemorrhagic events

• Grade 2: Withhold until improvement to Grade ≤1; resume at reduced dose
• Grade 2 recurs after dose interruption and reduction, Grade 3 or 4: Permanently discontinue

Venous thromboembolic events

• Grade 3: Withhold and resume at same dose if managed with appropriate therapy for at least 1 week
• Grade 4: Permanently discontinue

Gastrointestinal fistula

• Grade 2 or 3: Withhold and resume based on medical judgement
• Grade 4: Permanently discontinue

Hypertension

• Grade 2 or 3: Reduce dose (see above) and initiate or adjust antihypertensive therapy
• Grade 3 recurs despite dose reduction(s) and adjustment of antihypertensive therapy, Grade 4 or hypertensive crisis: Permanently discontinue

Proteinuria

• 24-hr urine protein ≥3 grams

  • Withhold until improvement to Grade ≤1; resume at a reduced dose (see above)
  • Permanently discontinue if 24-hr urine protein ≥3 grams does not improve or recurs despite dose reductions

• Confirmed nephrotic syndrome

  • Permanently discontinue

Permanently discontinue if these adverse reactions occur at any grade

• Arterial thromboembolic events
• Thrombotic microangiopathy
• Gastrointestinal perforation
• Gastrointestinal fistula
• Interstitial lung disease (ILD)/pneumonitis
• Posterior reversible encephalopathy syndrome (PRES)

CYP3A4 inhibitors or inducers

• Strong CYP3A4 inhibitors

  • Avoid coadministration; use an alternative with no or minimal potential to inhibit CYP3A4
  • If coadministration is warranted, decrease pazopanib dose to 400 mg/day; further dose reduction may be needed if adverse effects occur

• Strong CYP3A4 inducers

  • Avoid coadministration; use alternant medication with no or minimal potential to induce CYP3A4
  • Pazopanib not recommended in patients who cannot avoid chronic use of strong CYP3A4 inducers

Gastric acid-reducing agents

• Avoid coadministration
• If use cannot be avoided, consider short-acting antacid in place of proton pump inhibitors (PPIs) and H2-receptor antagonists; separate short-acting antacid and pazopanib dosing by several hours

Renal impairment

• All severities: No dosage adjustment required

Hepatic impairment

• Mild (bilirubin <1.5x ULN and any ALT): No dosage adjustment necessary
• Moderate (bilirubin ≥1.5-3x ULN and any ALT): Reduce dose to 200 mg PO qDay
• Severe (bilirubin >3x ULN and any ALT): Not recommended

Dosing Considerations

Limitation of use

• Efficacy not demonstrated in adipocytic soft tissue sarcoma or gastrointestinal stromal tumors

Ovarian Cancer (Orphan)

Orphan designation for treatment of ovarian cancer

Orphan sponsor

• Novartis Pharmaceuticals Corp; One Health Plaza, 337/B17.5F; East Hanover, New Jersey 07936

Hereditary Hemorrhagic Telangiectasia (Orphan)

Orphan designation for treatment of hereditary hemorrhagic telangiectasia

Sponsor

• HHT Foundation International (d/b/a Cure HHT); 8 Henderson Hill Ct; Monkton, Maryland 21111

Safety and efficacy not established; not indicated for use in pediatric patients

Based on its mechanism of action, pazopanib may have severe effects on organ growth and maturation during early postnatal development, particularly in children younger than 2 years

Contraindicated (5)

• aluminum hydroxide

  aluminum hydroxide will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Contraindicated. Avoid coadministration of pazopanib with drugs that raise gastric pH; may use short-acting antacids in place of PPIs and H2 antagonists, but separate antacid and pazopanib dosing by several hours

• atorvastatin

  atorvastatin increases toxicity of pazopanib by P-glycoprotein (MDR1) efflux transporter. Contraindicated.

• chloroquine

  chloroquine increases toxicity of pazopanib by QTc interval. Contraindicated.

• elagolix

  pazopanib will increase the level or effect of elagolix by Other (see comment). Contraindicated. Concomitant use of elagolix and strong OATP1B1 inhibitors is contraindicated.

• lefamulin

  lefamulin will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lefamulin is contraindicated with CYP3A substrates know to prolong the QT interval.

Serious - Use Alternative (137)

• abametapir

  abametapir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.

• adagrasib

  adagrasib, pazopanib. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.

• alfuzosin

  alfuzosin and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• aluminum hydroxide/magnesium carbonate

  aluminum hydroxide/magnesium carbonate will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; may use short-acting antacids in place of PPIs and H2 antagonists, but separate antacid and pazopanib dosing by several hours

• aluminum hydroxide/magnesium trisilicate

  aluminum hydroxide/magnesium trisilicate will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; may use short-acting antacids in place of PPIs and H2 antagonists, but separate antacid and pazopanib dosing by several hours

• amisulpride

  amisulpride and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.

• anagrelide

  anagrelide and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• apalutamide

  apalutamide will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

• apomorphine

  apomorphine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• aprepitant

  aprepitant will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• aripiprazole

  aripiprazole and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• artemether

  artemether and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• asenapine

  asenapine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• asenapine transdermal

  asenapine transdermal and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• atazanavir

  atazanavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• atomoxetine

  atomoxetine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine

  buprenorphine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine buccal

  buprenorphine buccal and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine subdermal implant

  buprenorphine subdermal implant and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine transdermal

  buprenorphine transdermal and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine, long-acting injection

  buprenorphine, long-acting injection and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• calcium carbonate

  calcium carbonate will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; may use short-acting antacids in place of PPIs and H2 antagonists, but separate antacid and pazopanib dosing by several hours

• carbamazepine

  carbamazepine will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• ceritinib

  ceritinib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.
  
  ceritinib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• chloramphenicol

  chloramphenicol will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• cimetidine

  cimetidine will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• citric acid/sodium bicarbonate

  citric acid/sodium bicarbonate will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; may use short-acting antacids in place of PPIs and H2 antagonists, but separate antacid and pazopanib dosing by several hours

• clarithromycin

  clarithromycin will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• clozapine

  clozapine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• cobicistat

  cobicistat will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• conivaptan

  conivaptan will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• crizotinib

  crizotinib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• darifenacin

  darifenacin will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• darolutamide

  darolutamide will increase the level or effect of pazopanib by Other (see comment). Avoid or Use Alternate Drug. Darolutamide is a BCRP inhibitor. Avoid coadministration with BCRP inhibitors. If use is unavoidable, closely monitor for adverse reactions and consider dose reduction of BCRP substrate drug (refer BCRP substrate prescribing information).

• darunavir

  darunavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• dasatinib

  dasatinib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• deferiprone

  deferiprone, pazopanib. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid use of deferiprone with other drugs known to be associated with neutropenia or agranulocytosis; if an alternative is not possible, monitor absolute neutrophil count more frequently.

• degarelix

  degarelix and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• desflurane

  desflurane and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• dexlansoprazole

  dexlansoprazole will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• donepezil

  donepezil and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• dronedarone

  dronedarone will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• efavirenz

  efavirenz and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• eliglustat

  eliglustat and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• eluxadoline

  pazopanib increases levels of eluxadoline by decreasing metabolism. Avoid or Use Alternate Drug. Decrease eluxadoline dose to 75 mg PO BID if coadministered with OATP1B1 inhibitors. .

• encorafenib

  encorafenib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• entrectinib

  pazopanib and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.

• enzalutamide

  enzalutamide will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• erdafitinib

  erdafitinib will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If coadministration unavoidable, separate administration by at least 6 hr before or after administration of P-gp substrates with narrow therapeutic index.

• eribulin

  eribulin and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin base

  erythromycin base will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• erythromycin ethylsuccinate

  erythromycin ethylsuccinate will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• erythromycin lactobionate

  erythromycin lactobionate will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• erythromycin stearate

  erythromycin stearate will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• escitalopram

  escitalopram increases toxicity of pazopanib by QTc interval. Avoid or Use Alternate Drug.

• esomeprazole

  esomeprazole will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• famotidine

  famotidine will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• fexinidazole

  fexinidazole and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
  
  fexinidazole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.

• fingolimod

  fingolimod and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• fluconazole

  fluconazole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• fluvoxamine

  fluvoxamine will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If it must be coadminister, decrease pazotinib dose to 400 mg/day

• fosamprenavir

  fosamprenavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• fosaprepitant

  fosaprepitant will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• gemifloxacin

  gemifloxacin and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• gilteritinib

  gilteritinib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• glasdegib

  pazopanib and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.

• granisetron

  granisetron and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• grapefruit

  grapefruit will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• hydroxychloroquine sulfate

  hydroxychloroquine sulfate and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• hydroxyzine

  hydroxyzine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• ibuprofen/famotidine

  ibuprofen/famotidine will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• idelalisib

  idelalisib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• indinavir

  indinavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• inotuzumab

  inotuzumab and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.

• isoflurane

  isoflurane and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• itraconazole

  itraconazole and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce pazopanib dose to 400 mg PO qDay; closely monitor for QT prolongation

• ivosidenib

  ivosidenib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.
  
  ivosidenib will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

• ketoconazole

  ketoconazole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• lansoprazole

  lansoprazole will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• lapatinib

  lapatinib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• lasmiditan

  lasmiditan increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.
  
  lasmiditan increases levels of pazopanib by Other (see comment). Avoid or Use Alternate Drug. Comment: Lasmiditan inhibits BCRP in vitro. Avoid coadministration of lasmiditan with BCRP substrates.

• lenacapavir

  lenacapavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• leniolisib

  leniolisib will increase the level or effect of pazopanib by Other (see comment). Avoid or Use Alternate Drug. Leniolisib, a BCRP inhibitor, may increase systemic exposure of BCRP substrates

• levoketoconazole

  levoketoconazole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• lithium

  lithium and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• lonafarnib

  pazopanib will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.

• lopinavir

  lopinavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• macimorelin

  macimorelin and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.

• magnesium hydroxide

  magnesium hydroxide will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; may use short-acting antacids in place of PPIs and H2 antagonists, but separate antacid and pazopanib dosing by several hours

• mefloquine

  mefloquine increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

• mifepristone

  mifepristone will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• mirtazapine

  mirtazapine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• mobocertinib

  mobocertinib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.

• nefazodone

  nefazodone will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• nelfinavir

  nelfinavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• nilotinib

  nilotinib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• nizatidine

  nizatidine will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• olanzapine

  olanzapine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• omeprazole

  omeprazole will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• ondansetron

  pazopanib and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.

• oxaliplatin

  oxaliplatin and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• palifermin

  palifermin increases toxicity of pazopanib by Other (see comment). Avoid or Use Alternate Drug. Comment: Palifermin should not be administered within 24 hr before, during infusion of, or within 24 hr after administration of antineoplastic agents. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis.

• panobinostat

  pazopanib and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.

• pantoprazole

  pantoprazole will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• posaconazole

  posaconazole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• primaquine

  primaquine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• quinupristin/dalfopristin

  quinupristin/dalfopristin will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• rabeprazole

  rabeprazole will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• revefenacin

  pazopanib increases levels of revefenacin by Other (see comment). Avoid or Use Alternate Drug. Comment: OATP1B1 and OATP1B3 transport inhibitors may increase systemic exposure of revefenacin's active metabolite. Coadministration not recommended.

• ribociclib

  ribociclib increases toxicity of pazopanib by QTc interval. Avoid or Use Alternate Drug.

• rifabutin

  rifabutin will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• rifampin

  rifampin will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• ritonavir

  ritonavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• ropeginterferon alfa 2b

  ropeginterferon alfa 2b, pazopanib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.

• saquinavir

  saquinavir increases levels of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Potential for increased toxicity. Increased risk of QT prolongation and cardiac arrhythmias.

• sertraline

  sertraline and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• sevoflurane

  sevoflurane and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• siponimod

  siponimod and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• sotorasib

  sotorasib will decrease the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If use is unavoidable, refer to the prescribing information of the P-gp substrate for dosage modifications.

• St John's Wort

  St John's Wort will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• sulbactam/durlobactam

  pazopanib will increase the level or effect of sulbactam/durlobactam by Other (see comment). Avoid or Use Alternate Drug. Sulbactam is predicted to have active secretion by OATP1 as a significant portion of total clearance; therefore, inhibition of OAT1 may increase sulbactam plasma concentrations

• sunitinib

  sunitinib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• tacrolimus

  tacrolimus and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• tepotinib

  tepotinib will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If concomitant use unavoidable, reduce the P-gp substrate dosage if recommended in its approved product labeling.

• tetrabenazine

  tetrabenazine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• tipranavir

  tipranavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• toremifene

  pazopanib and toremifene both increase QTc interval. Avoid or Use Alternate Drug. Concurrent use of toremifene with agents causing QT prolongation should be avoided. If concomitant use is required it's recommended that toremifene be interrupted. If interruption not possible, patients requiring therapy with a drug that prolongs QT should be closely monitored. ECGs should be obtained for high risk patients.

• tucatinib

  tucatinib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.

• umeclidinium bromide/vilanterol inhaled

  pazopanib increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

• vandetanib

  pazopanib, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.

• vemurafenib

  vemurafenib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended. Pazopanib may also increase levels of vemurafenib.

• verapamil

  verapamil will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• vilanterol/fluticasone furoate inhaled

  pazopanib increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

• voriconazole

  voriconazole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• vorinostat

  vorinostat and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• voxelotor

  voxelotor will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.

• zafirlukast

  zafirlukast will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

Monitor Closely (185)

• acalabrutinib

  acalabrutinib increases levels of pazopanib by Other (see comment). Use Caution/Monitor. Comment: Acalabrutinib may increase exposure to coadministered BCRP substrates by inhibition of intestinal BCRP.
  
  acalabrutinib, pazopanib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may increase risk of myelosuppressive effects.

• albuterol

  albuterol and pazopanib both increase QTc interval. Use Caution/Monitor.

• alfuzosin

  pazopanib and alfuzosin both increase QTc interval. Use Caution/Monitor.

• amiodarone

  amiodarone and pazopanib both increase QTc interval. Modify Therapy/Monitor Closely.

• amitriptyline

  amitriptyline and pazopanib both increase QTc interval. Use Caution/Monitor.

• amobarbital

  amobarbital will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• amoxapine

  amoxapine and pazopanib both increase QTc interval. Use Caution/Monitor.

• apalutamide

  apalutamide will decrease the level or effect of pazopanib by increasing elimination. Use Caution/Monitor. Apalutamide weakly induces BCRP and may decrease systemic exposure of drugs that are BCRP substrates.

• arformoterol

  arformoterol and pazopanib both increase QTc interval. Use Caution/Monitor.

• armodafinil

  armodafinil will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• arsenic trioxide

  arsenic trioxide and pazopanib both increase QTc interval. Modify Therapy/Monitor Closely.

• artemether/lumefantrine

  artemether/lumefantrine will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  artemether/lumefantrine and pazopanib both increase QTc interval. Use Caution/Monitor.

• atogepant

  pazopanib will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  pazopanib will increase the level or effect of atogepant by Other (see comment). Modify Therapy/Monitor Closely. Recommended dosage of atogepant (an OATP1B1 substrate) with concomitant use of OATP inhibitors is 10 mg or 30 mg qDay.

• atorvastatin

  pazopanib increases toxicity of atorvastatin by Other (see comment). Use Caution/Monitor. Comment: OATP1B1 inhibitors may increase risk of myopathy.

• avanafil

  pazopanib will increase the level or effect of avanafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• avapritinib

  pazopanib will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• axitinib

  pazopanib increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• bedaquiline

  pazopanib and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely

• berotralstat

  berotralstat will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor or titrate P-gp substrate dose if coadministered.

• bosentan

  bosentan will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• bosutinib

  bosutinib increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• budesonide

  budesonide will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• butabarbital

  butabarbital will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• butalbital

  butalbital will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• cenobamate

  cenobamate will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.

• chlorpromazine

  chlorpromazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• citalopram

  pazopanib and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

• clarithromycin

  clarithromycin and pazopanib both increase QTc interval. Use Caution/Monitor.

• clomipramine

  clomipramine and pazopanib both increase QTc interval. Use Caution/Monitor.

• cortisone

  cortisone will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• crizotinib

  crizotinib increases levels of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
  
  crizotinib increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

• crofelemer

  crofelemer increases levels of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.

• cyclosporine

  cyclosporine will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• dabrafenib

  dabrafenib will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• deferasirox

  deferasirox will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• denosumab

  pazopanib, denosumab. Other (see comment). Use Caution/Monitor. Comment: Caution should be taken in patients on concomitant immunosuppressants or with impaired immune systems because of increased risk for serious infections.

• desipramine

  desipramine and pazopanib both increase QTc interval. Use Caution/Monitor.

• deutetrabenazine

  deutetrabenazine and pazopanib both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).

• dexamethasone

  dexamethasone will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• dextromethorphan

  pazopanib increases levels of dextromethorphan by decreasing metabolism. Use Caution/Monitor.

• DHEA, herbal

  DHEA, herbal will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• diltiazem

  diltiazem will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• disopyramide

  disopyramide and pazopanib both increase QTc interval. Modify Therapy/Monitor Closely.

• dofetilide

  dofetilide and pazopanib both increase QTc interval. Use Caution/Monitor.

• doxepin

  doxepin and pazopanib both increase QTc interval. Use Caution/Monitor.

• dronedarone

  dronedarone and pazopanib both increase QTc interval. Use Caution/Monitor.

• droperidol

  droperidol and pazopanib both increase QTc interval. Use Caution/Monitor.

• duvelisib

  duvelisib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate.

• efavirenz

  efavirenz will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• elagolix

  elagolix will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  
  elagolix decreases levels of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.

• eliglustat

  eliglustat increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the P-gp substrate and titrate to clinical effect.

• elvitegravir/cobicistat/emtricitabine/tenofovir DF

  elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.

• encorafenib

  encorafenib, pazopanib. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.
  
  encorafenib will increase the level or effect of pazopanib by Other (see comment). Modify Therapy/Monitor Closely. Encorafenib (a BCRP inhibitor) may increase the concentration and toxicities of BCRP substrates. Closely monitor for signs and symptoms of increased exposure and consider adjusting the dose of these substrates.

• erythromycin base

  erythromycin base and pazopanib both increase QTc interval. Use Caution/Monitor.

• erythromycin ethylsuccinate

  erythromycin ethylsuccinate and pazopanib both increase QTc interval. Use Caution/Monitor.

• erythromycin lactobionate

  erythromycin lactobionate and pazopanib both increase QTc interval. Use Caution/Monitor.

• erythromycin stearate

  erythromycin stearate and pazopanib both increase QTc interval. Use Caution/Monitor.

• eslicarbazepine acetate

  eslicarbazepine acetate will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• etravirine

  etravirine will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• ezogabine

  ezogabine, pazopanib. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.

• fedratinib

  fedratinib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

• finerenone

  pazopanib will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Adjust finererone dosage as needed.

• fingolimod

  pazopanib increases effects of fingolimod by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Concomitant therapy is expected to increase the risk of immunosuppression. Use caution when switching patients from long-acting therapies with immune effects. .

• flibanserin

  pazopanib will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.

• fluconazole

  fluconazole and pazopanib both increase QTc interval. Use Caution/Monitor.

• fluphenazine

  fluphenazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• fluvastatin

  pazopanib increases toxicity of fluvastatin by Other (see comment). Use Caution/Monitor. Comment: OATP1B1 inhibitors may increase risk of myopathy.

• formoterol

  formoterol and pazopanib both increase QTc interval. Use Caution/Monitor.

• fosphenytoin

  fosphenytoin will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• fostamatinib

  fostamatinib will increase the level or effect of pazopanib by Other (see comment). Use Caution/Monitor. Concomitant use of fostamatinib may increase concentrations of P-gp/BCRP substrate drugs. Monitor for toxicities of P-gp/BCRP substrate drug that may require dosage reduction when given concurrently with fostamatinib.

• fostemsavir

  fostemsavir will increase the level or effect of pazopanib by Other (see comment). Modify Therapy/Monitor Closely. Fostemsavir inhibits BCRP transporters. If possible, avoid coadministration or modify dose of BCRP substrate coadministered with fostemsavir.
  
  pazopanib and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

• gemtuzumab

  pazopanib and gemtuzumab both increase QTc interval. Use Caution/Monitor.

• glecaprevir/pibrentasvir

  pazopanib will increase the level or effect of glecaprevir/pibrentasvir by decreasing metabolism. Use Caution/Monitor. Caution when coadministering glecaprevir/pibrentasvir with OATP1B1/OATP1B3 inhibitors
  
  glecaprevir/pibrentasvir will increase the level or effect of pazopanib by Other (see comment). Use Caution/Monitor. Glecaprevir/pibrentasvir may increase plasma concentration of P-gp and BCRP substrates.

• goserelin

  goserelin increases toxicity of pazopanib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• griseofulvin

  griseofulvin will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• haloperidol

  haloperidol and pazopanib both increase QTc interval. Use Caution/Monitor.

• histrelin

  histrelin increases toxicity of pazopanib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• hydrocortisone

  hydrocortisone will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• ibutilide

  ibutilide and pazopanib both increase QTc interval. Modify Therapy/Monitor Closely.

• iloperidone

  iloperidone increases levels of pazopanib by affecting hepatic enzyme CYP2E1 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.

• imipramine

  imipramine and pazopanib both increase QTc interval. Use Caution/Monitor.

• indacaterol, inhaled

  indacaterol, inhaled, pazopanib. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.

• indapamide

  indapamide and pazopanib both increase QTc interval. Modify Therapy/Monitor Closely.

• isavuconazonium sulfate

  pazopanib will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• isoniazid

  isoniazid will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• istradefylline

  istradefylline will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.
  
  istradefylline will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of P-gp substrates in clinical trials. Consider dose reduction of sensitive P-gp substrates.

• ivacaftor

  ivacaftor increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Ivacaftor and its M1 metabolite has the potential to inhibit P-gp; may significantly increase systemic exposure to sensitive P-gp substrates with a narrow therapeutic index.

• ketoconazole

  ketoconazole and pazopanib both increase QTc interval. Use Caution/Monitor.

• lemborexant

  pazopanib will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.

• lenvatinib

  pazopanib and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.

• letermovir

  pazopanib increases levels of letermovir by decreasing metabolism. Use Caution/Monitor. Coadminstration of letermovir, an OATP1B1/3 substrate, with OATP1B1/3 inhibitors may increase letermovir plasma concentrations.

• leuprolide

  leuprolide increases toxicity of pazopanib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• levoketoconazole

  levoketoconazole and pazopanib both increase QTc interval. Use Caution/Monitor.

• lofepramine

  lofepramine and pazopanib both increase QTc interval. Use Caution/Monitor.

• lomitapide

  pazopanib increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.
  
  lomitapide increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing dose when used concomitantly with lomitapide.

• lonafarnib

  lonafarnib will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Lonafarnib is a weak P-gp inhibitor. Monitor for adverse reactions if coadministered with P-gp substrates where minimal concentration changes may lead to serious or life-threatening toxicities. Reduce P-gp substrate dose if needed.

• lorlatinib

  lorlatinib will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• lumefantrine

  lumefantrine will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  lumefantrine and pazopanib both increase QTc interval. Use Caution/Monitor.

• maprotiline

  maprotiline and pazopanib both increase QTc interval. Use Caution/Monitor.

• marijuana

  marijuana will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• metronidazole

  metronidazole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• midazolam

  pazopanib increases levels of midazolam by decreasing metabolism. Use Caution/Monitor.

• midazolam intranasal

  pazopanib will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.

• mifepristone

  mifepristone will increase the level or effect of pazopanib by Other (see comment). Modify Therapy/Monitor Closely. Inhibits CYP2C8/2C9; use smallest recommended doses for substrates and monitor; combination may increase QT interval. Use alternatives if available

• mitotane

  mitotane decreases levels of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.

• moxifloxacin

  moxifloxacin and pazopanib both increase QTc interval. Use Caution/Monitor.

• nafcillin

  nafcillin will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nevirapine

  nevirapine will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nifedipine

  nifedipine will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• nilotinib

  nilotinib and pazopanib both increase QTc interval. Use Caution/Monitor.

• nilutamide

  nilutamide will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• nortriptyline

  nortriptyline and pazopanib both increase QTc interval. Use Caution/Monitor.

• octreotide

  octreotide and pazopanib both increase QTc interval. Use Caution/Monitor.

• octreotide (Antidote)

  octreotide (Antidote) and pazopanib both increase QTc interval. Use Caution/Monitor.

• ofatumumab SC

  ofatumumab SC, pazopanib. Either increases effects of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with coadministration. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC.

• olodaterol inhaled

  pazopanib and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias

• osilodrostat

  osilodrostat and pazopanib both increase QTc interval. Use Caution/Monitor.

• osimertinib

  osimertinib and pazopanib both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.

• oteseconazole

  oteseconazole will increase the level or effect of pazopanib by Other (see comment). Modify Therapy/Monitor Closely. Otesezonale, a BCRP inhibitor, may increase the effects and risk of toxicities of BCRP substrates. Use lowest starting dose of BCRP substrate, or consider reducing BCRP substrate dose.

• oxaliplatin

  oxaliplatin, pazopanib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration with oxaliplatin may increase the risk of immunosuppression and myelosuppression.
  
  oxaliplatin will increase the level or effect of pazopanib by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.

• oxcarbazepine

  oxcarbazepine will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• ozanimod

  ozanimod and pazopanib both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.

• paclitaxel

  pazopanib increases levels of paclitaxel by decreasing metabolism. Use Caution/Monitor.

• paclitaxel protein bound

  pazopanib increases levels of paclitaxel protein bound by decreasing metabolism. Use Caution/Monitor.

• pasireotide

  pazopanib and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.

• pentamidine

  pazopanib and pentamidine both increase QTc interval. Modify Therapy/Monitor Closely.

• pentobarbital

  pentobarbital will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• perphenazine

  perphenazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• phenobarbital

  phenobarbital will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• phenytoin

  phenytoin will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• pimozide

  pazopanib and pimozide both increase QTc interval. Modify Therapy/Monitor Closely.

• pitavastatin

  pazopanib increases toxicity of pitavastatin by Other (see comment). Use Caution/Monitor. Comment: OATP1B1 inhibitors may increase risk of myopathy.

• ponatinib

  ponatinib increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• pravastatin

  pazopanib increases toxicity of pravastatin by Other (see comment). Use Caution/Monitor. Comment: OATP1B1 inhibitors may increase risk of myopathy.

• primidone

  primidone will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• procainamide

  pazopanib and procainamide both increase QTc interval. Modify Therapy/Monitor Closely.

• prochlorperazine

  prochlorperazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• promazine

  promazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• promethazine

  promethazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• protriptyline

  protriptyline and pazopanib both increase QTc interval. Use Caution/Monitor.

• quetiapine

  quetiapine, pazopanib. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.

• quinidine

  quinidine and pazopanib both increase QTc interval. Modify Therapy/Monitor Closely.

• quinine

  pazopanib and quinine both increase QTc interval. Use Caution/Monitor.

• regorafenib

  regorafenib will increase the level or effect of pazopanib by Other (see comment). Modify Therapy/Monitor Closely. Regorafenib likely inhibits BCRP (ABCG2) transport. Coadministration with a BCRP substrate may increase systemic exposure to the substrate and related toxicity.

• ribociclib

  ribociclib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• rifapentine

  rifapentine will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• rilpivirine

  rilpivirine increases toxicity of pazopanib by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsade de Pointes.

• romidepsin

  pazopanib and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.

• rosuvastatin

  pazopanib increases toxicity of rosuvastatin by Other (see comment). Use Caution/Monitor. Comment: OATP1B1 inhibitors may increase risk of myopathy.

• rucaparib

  rucaparib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.

• rufinamide

  rufinamide will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• sacubitril/valsartan

  pazopanib will increase the level or effect of sacubitril/valsartan by Other (see comment). Use Caution/Monitor. The results from an in vitro study with human liver tissue indicate that valsartan is a substrate of the hepatic uptake transporter OATP1B1; coadministration with OATP1B1 inhibitors may increase valsartan systemic exposure

• safinamide

  safinamide will increase the level or effect of pazopanib by Other (see comment). Use Caution/Monitor. Safinamide and its major metabolite may inhibit intestinal BCRP. Monitor BCRP substrates for increased pharmacologic or adverse effects.

• sarecycline

  sarecycline will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor for toxicities of P-gp substrates that may require dosage reduction when coadministered with P-gp inhibitors.

• secobarbital

  secobarbital will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• selpercatinib

  selpercatinib increases toxicity of pazopanib by QTc interval. Use Caution/Monitor.

• simvastatin

  simvastatin increases toxicity of pazopanib by Other (see comment). Use Caution/Monitor. Comment: Increased risk of elevated LFTs with pazopanib when coadministered with simvastatin.
  
  pazopanib will increase the level or effect of simvastatin by Other (see comment). Use Caution/Monitor. OATP1B1 inhibitors may increase risk of myopathy

• siponimod

  siponimod and pazopanib both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.

• sipuleucel-T

  pazopanib decreases effects of sipuleucel-T by pharmacodynamic antagonism. Modify Therapy/Monitor Closely.

• sodium zirconium cyclosilicate

  sodium zirconium cyclosilicate will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate.

• solifenacin

  solifenacin and pazopanib both increase QTc interval. Use Caution/Monitor.

• sorafenib

  sorafenib and pazopanib both increase QTc interval. Use Caution/Monitor.

• sotalol

  pazopanib and sotalol both increase QTc interval. Modify Therapy/Monitor Closely.

• stiripentol

  stiripentol, pazopanib. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.
  
  stiripentol will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing the dose of P-glycoprotein (P-gp) substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.
  
  stiripentol will increase the level or effect of pazopanib by Other (see comment). Modify Therapy/Monitor Closely. Stiripentol is a BCRP transport inhibitor. Consider dosage reduction for BCRP substrates if adverse effects are experienced when coadministered.

• tadalafil

  pazopanib will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• tafamidis

  tafamidis will increase the level or effect of pazopanib by Other (see comment). Use Caution/Monitor. Tafamidis inhibits breast cancer resistant protein (BCRP) in vitro and may increase exposure of BCRP substrates following tafamidis or tafamidis meglumine administration. Dosage adjustment of these BCRP substrates may be necessary.

• tafamidis meglumine

  tafamidis meglumine will increase the level or effect of pazopanib by Other (see comment). Use Caution/Monitor. Tafamidis inhibits breast cancer resistant protein (BCRP) in vitro and may increase exposure of BCRP substrates following tafamidis or tafamidis meglumine administration. Dosage adjustment of these BCRP substrates may be necessary.

• tazemetostat

  tazemetostat will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  pazopanib will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• tecovirimat

  tecovirimat will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.

• teriflunomide

  teriflunomide increases levels of pazopanib by Other (see comment). Use Caution/Monitor. Comment: Teriflunomide inhibits CYP2C8; caution when coadministered with CYP2C8 substrates.

• thioridazine

  thioridazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• tinidazole

  pazopanib will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• topiramate

  topiramate will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• trastuzumab

  trastuzumab, pazopanib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .

• trastuzumab deruxtecan

  trastuzumab deruxtecan, pazopanib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .

• trazodone

  trazodone and pazopanib both increase QTc interval. Use Caution/Monitor.

• triclabendazole

  triclabendazole and pazopanib both increase QTc interval. Use Caution/Monitor.

• trifluoperazine

  trifluoperazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• trimipramine

  trimipramine and pazopanib both increase QTc interval. Use Caution/Monitor.

• triptorelin

  triptorelin increases toxicity of pazopanib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• tucatinib

  tucatinib will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Consider reducing the dosage of P-gp substrates, where minimal concentration changes may lead to serious or life-threatening toxicities.

• valbenazine

  valbenazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• valsartan

  pazopanib will increase the level or effect of valsartan by Other (see comment). Use Caution/Monitor. The results from an in vitro study with human liver tissue indicate that valsartan is a substrate of the hepatic uptake transporter OATP1B1; coadministration with OATP1B1 inhibitors may increase valsartan systemic exposure

• voclosporin

  voclosporin, pazopanib. Either increases effects of the other by QTc interval. Use Caution/Monitor.

• ziprasidone

  pazopanib and ziprasidone both increase QTc interval. Use Caution/Monitor.

Minor (27)

• acetazolamide

  acetazolamide will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• anastrozole

  anastrozole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• azithromycin

  azithromycin and pazopanib both increase QTc interval. Minor/Significance Unknown.

• cyclophosphamide

  cyclophosphamide will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• dasatinib

  dasatinib and pazopanib both increase QTc interval. Minor/Significance Unknown.

• dolasetron

  dolasetron and pazopanib both increase QTc interval. Minor/Significance Unknown.

• flecainide

  flecainide and pazopanib both increase QTc interval. Minor/Significance Unknown.

• fluoxetine

  fluoxetine and pazopanib both increase QTc interval. Minor/Significance Unknown.

• foscarnet

  foscarnet and pazopanib both increase QTc interval. Minor/Significance Unknown.

• iloperidone

  iloperidone and pazopanib both increase QTc interval. Minor/Significance Unknown.

• lapatinib

  lapatinib and pazopanib both increase QTc interval. Minor/Significance Unknown.

• larotrectinib

  larotrectinib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• levofloxacin

  levofloxacin and pazopanib both increase QTc interval. Minor/Significance Unknown.

• methadone

  methadone and pazopanib both increase QTc interval. Minor/Significance Unknown.

• ofloxacin

  ofloxacin and pazopanib both increase QTc interval. Minor/Significance Unknown.

• paliperidone

  paliperidone and pazopanib both increase QTc interval. Minor/Significance Unknown.

• paroxetine

  paroxetine and pazopanib both increase QTc interval. Minor/Significance Unknown.

• posaconazole

  pazopanib and posaconazole both increase QTc interval. Minor/Significance Unknown.

• ranolazine

  pazopanib and ranolazine both increase QTc interval. Minor/Significance Unknown.

• risperidone

  pazopanib and risperidone both increase QTc interval. Minor/Significance Unknown.

• ruxolitinib

  pazopanib will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• ruxolitinib topical

  pazopanib will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• sulfamethoxazole

  sulfamethoxazole and pazopanib both increase QTc interval. Minor/Significance Unknown.

• telavancin

  pazopanib and telavancin both increase QTc interval. Minor/Significance Unknown.

• tropisetron

  pazopanib and tropisetron both increase QTc interval. Minor/Significance Unknown.

• venlafaxine

  pazopanib and venlafaxine both increase QTc interval. Minor/Significance Unknown.

• voriconazole

  pazopanib and voriconazole both increase QTc interval. Minor/Significance Unknown.

• abametapir

  Serious - Use Alternative (1)abametapir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.

• acalabrutinib

  Monitor Closely (2)acalabrutinib increases levels of pazopanib by Other (see comment). Use Caution/Monitor. Comment: Acalabrutinib may increase exposure to coadministered BCRP substrates by inhibition of intestinal BCRP.
  
  acalabrutinib, pazopanib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may increase risk of myelosuppressive effects.

• acetazolamide

  Minor (1)acetazolamide will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• adagrasib

  Serious - Use Alternative (1)adagrasib, pazopanib. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.

• albuterol

  Monitor Closely (1)albuterol and pazopanib both increase QTc interval. Use Caution/Monitor.

• alfuzosin

  Monitor Closely (1)pazopanib and alfuzosin both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)alfuzosin and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• aluminum hydroxide

  Contraindicated (1)aluminum hydroxide will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Contraindicated. Avoid coadministration of pazopanib with drugs that raise gastric pH; may use short-acting antacids in place of PPIs and H2 antagonists, but separate antacid and pazopanib dosing by several hours

• aluminum hydroxide/magnesium carbonate

  Serious - Use Alternative (1)aluminum hydroxide/magnesium carbonate will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; may use short-acting antacids in place of PPIs and H2 antagonists, but separate antacid and pazopanib dosing by several hours

• aluminum hydroxide/magnesium trisilicate

  Serious - Use Alternative (1)aluminum hydroxide/magnesium trisilicate will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; may use short-acting antacids in place of PPIs and H2 antagonists, but separate antacid and pazopanib dosing by several hours

• amiodarone

  Monitor Closely (1)amiodarone and pazopanib both increase QTc interval. Modify Therapy/Monitor Closely.

• amisulpride

  Serious - Use Alternative (1)amisulpride and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.

• amitriptyline

  Monitor Closely (1)amitriptyline and pazopanib both increase QTc interval. Use Caution/Monitor.

• amobarbital

  Monitor Closely (1)amobarbital will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• amoxapine

  Monitor Closely (1)amoxapine and pazopanib both increase QTc interval. Use Caution/Monitor.

• anagrelide

  Serious - Use Alternative (1)anagrelide and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• anastrozole

  Minor (1)anastrozole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• apalutamide

  Monitor Closely (1)apalutamide will decrease the level or effect of pazopanib by increasing elimination. Use Caution/Monitor. Apalutamide weakly induces BCRP and may decrease systemic exposure of drugs that are BCRP substrates.Serious - Use Alternative (1)apalutamide will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

• apomorphine

  Serious - Use Alternative (1)apomorphine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• aprepitant

  Serious - Use Alternative (1)aprepitant will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• arformoterol

  Monitor Closely (1)arformoterol and pazopanib both increase QTc interval. Use Caution/Monitor.

• aripiprazole

  Serious - Use Alternative (1)aripiprazole and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• armodafinil

  Monitor Closely (1)armodafinil will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• arsenic trioxide

  Monitor Closely (1)arsenic trioxide and pazopanib both increase QTc interval. Modify Therapy/Monitor Closely.

• artemether

  Serious - Use Alternative (1)artemether and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• artemether/lumefantrine

  Monitor Closely (2)artemether/lumefantrine will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  artemether/lumefantrine and pazopanib both increase QTc interval. Use Caution/Monitor.

• asenapine

  Serious - Use Alternative (1)asenapine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• asenapine transdermal

  Serious - Use Alternative (1)asenapine transdermal and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• atazanavir

  Serious - Use Alternative (1)atazanavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• atogepant

  Monitor Closely (2)pazopanib will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  pazopanib will increase the level or effect of atogepant by Other (see comment). Modify Therapy/Monitor Closely. Recommended dosage of atogepant (an OATP1B1 substrate) with concomitant use of OATP inhibitors is 10 mg or 30 mg qDay.

• atomoxetine

  Serious - Use Alternative (1)atomoxetine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• atorvastatin

  Contraindicated (1)atorvastatin increases toxicity of pazopanib by P-glycoprotein (MDR1) efflux transporter. Contraindicated.Monitor Closely (1)pazopanib increases toxicity of atorvastatin by Other (see comment). Use Caution/Monitor. Comment: OATP1B1 inhibitors may increase risk of myopathy.

• avanafil

  Monitor Closely (1)pazopanib will increase the level or effect of avanafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• avapritinib

  Monitor Closely (1)pazopanib will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• axitinib

  Monitor Closely (1)pazopanib increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• azithromycin

  Minor (1)azithromycin and pazopanib both increase QTc interval. Minor/Significance Unknown.

• bedaquiline

  Monitor Closely (1)pazopanib and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely

• berotralstat

  Monitor Closely (1)berotralstat will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor or titrate P-gp substrate dose if coadministered.

• bosentan

  Monitor Closely (1)bosentan will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• bosutinib

  Monitor Closely (1)bosutinib increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• budesonide

  Monitor Closely (1)budesonide will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• buprenorphine

  Serious - Use Alternative (1)buprenorphine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine buccal

  Serious - Use Alternative (1)buprenorphine buccal and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine subdermal implant

  Serious - Use Alternative (1)buprenorphine subdermal implant and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine transdermal

  Serious - Use Alternative (1)buprenorphine transdermal and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine, long-acting injection

  Serious - Use Alternative (1)buprenorphine, long-acting injection and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• butabarbital

  Monitor Closely (1)butabarbital will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• butalbital

  Monitor Closely (1)butalbital will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• calcium carbonate

  Serious - Use Alternative (1)calcium carbonate will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; may use short-acting antacids in place of PPIs and H2 antagonists, but separate antacid and pazopanib dosing by several hours

• carbamazepine

  Serious - Use Alternative (1)carbamazepine will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• cenobamate

  Monitor Closely (1)cenobamate will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.

• ceritinib

  Serious - Use Alternative (2)ceritinib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.
  
  ceritinib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• chloramphenicol

  Serious - Use Alternative (1)chloramphenicol will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• chloroquine

  Contraindicated (1)chloroquine increases toxicity of pazopanib by QTc interval. Contraindicated.

• chlorpromazine

  Monitor Closely (1)chlorpromazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• cimetidine

  Serious - Use Alternative (1)cimetidine will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• citalopram

  Monitor Closely (1)pazopanib and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.

• citric acid/sodium bicarbonate

  Serious - Use Alternative (1)citric acid/sodium bicarbonate will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; may use short-acting antacids in place of PPIs and H2 antagonists, but separate antacid and pazopanib dosing by several hours

• clarithromycin

  Monitor Closely (1)clarithromycin and pazopanib both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)clarithromycin will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• clomipramine

  Monitor Closely (1)clomipramine and pazopanib both increase QTc interval. Use Caution/Monitor.

• clozapine

  Serious - Use Alternative (1)clozapine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• cobicistat

  Serious - Use Alternative (1)cobicistat will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• conivaptan

  Serious - Use Alternative (1)conivaptan will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• cortisone

  Monitor Closely (1)cortisone will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• crizotinib

  Monitor Closely (2)crizotinib increases levels of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
  
  crizotinib increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.Serious - Use Alternative (1)crizotinib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• crofelemer

  Monitor Closely (1)crofelemer increases levels of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.

• cyclophosphamide

  Minor (1)cyclophosphamide will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• cyclosporine

  Monitor Closely (1)cyclosporine will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• dabrafenib

  Monitor Closely (1)dabrafenib will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• darifenacin

  Serious - Use Alternative (1)darifenacin will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• darolutamide

  Serious - Use Alternative (1)darolutamide will increase the level or effect of pazopanib by Other (see comment). Avoid or Use Alternate Drug. Darolutamide is a BCRP inhibitor. Avoid coadministration with BCRP inhibitors. If use is unavoidable, closely monitor for adverse reactions and consider dose reduction of BCRP substrate drug (refer BCRP substrate prescribing information).

• darunavir

  Serious - Use Alternative (1)darunavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• dasatinib

  Serious - Use Alternative (1)dasatinib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/dayMinor (1)dasatinib and pazopanib both increase QTc interval. Minor/Significance Unknown.

• deferasirox

  Monitor Closely (1)deferasirox will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• deferiprone

  Serious - Use Alternative (1)deferiprone, pazopanib. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid use of deferiprone with other drugs known to be associated with neutropenia or agranulocytosis; if an alternative is not possible, monitor absolute neutrophil count more frequently.

• degarelix

  Serious - Use Alternative (1)degarelix and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• denosumab

  Monitor Closely (1)pazopanib, denosumab. Other (see comment). Use Caution/Monitor. Comment: Caution should be taken in patients on concomitant immunosuppressants or with impaired immune systems because of increased risk for serious infections.

• desflurane

  Serious - Use Alternative (1)desflurane and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• desipramine

  Monitor Closely (1)desipramine and pazopanib both increase QTc interval. Use Caution/Monitor.

• deutetrabenazine

  Monitor Closely (1)deutetrabenazine and pazopanib both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).

• dexamethasone

  Monitor Closely (1)dexamethasone will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• dexlansoprazole

  Serious - Use Alternative (1)dexlansoprazole will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• dextromethorphan

  Monitor Closely (1)pazopanib increases levels of dextromethorphan by decreasing metabolism. Use Caution/Monitor.

• DHEA, herbal

  Monitor Closely (1)DHEA, herbal will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• diltiazem

  Monitor Closely (1)diltiazem will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• disopyramide

  Monitor Closely (1)disopyramide and pazopanib both increase QTc interval. Modify Therapy/Monitor Closely.

• dofetilide

  Monitor Closely (1)dofetilide and pazopanib both increase QTc interval. Use Caution/Monitor.

• dolasetron

  Minor (1)dolasetron and pazopanib both increase QTc interval. Minor/Significance Unknown.

• donepezil

  Serious - Use Alternative (1)donepezil and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• doxepin

  Monitor Closely (1)doxepin and pazopanib both increase QTc interval. Use Caution/Monitor.

• dronedarone

  Monitor Closely (1)dronedarone and pazopanib both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)dronedarone will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• droperidol

  Monitor Closely (1)droperidol and pazopanib both increase QTc interval. Use Caution/Monitor.

• duvelisib

  Monitor Closely (1)duvelisib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate.

• efavirenz

  Monitor Closely (1)efavirenz will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)efavirenz and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• elagolix

  Contraindicated (1)pazopanib will increase the level or effect of elagolix by Other (see comment). Contraindicated. Concomitant use of elagolix and strong OATP1B1 inhibitors is contraindicated.Monitor Closely (2)elagolix will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  
  elagolix decreases levels of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.

• eliglustat

  Monitor Closely (1)eliglustat increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the P-gp substrate and titrate to clinical effect.Serious - Use Alternative (1)eliglustat and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• eluxadoline

  Serious - Use Alternative (1)pazopanib increases levels of eluxadoline by decreasing metabolism. Avoid or Use Alternate Drug. Decrease eluxadoline dose to 75 mg PO BID if coadministered with OATP1B1 inhibitors. .

• elvitegravir/cobicistat/emtricitabine/tenofovir DF

  Monitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.

• encorafenib

  Monitor Closely (2)encorafenib, pazopanib. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.
  
  encorafenib will increase the level or effect of pazopanib by Other (see comment). Modify Therapy/Monitor Closely. Encorafenib (a BCRP inhibitor) may increase the concentration and toxicities of BCRP substrates. Closely monitor for signs and symptoms of increased exposure and consider adjusting the dose of these substrates.Serious - Use Alternative (1)encorafenib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• entrectinib

  Serious - Use Alternative (1)pazopanib and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.

• enzalutamide

  Serious - Use Alternative (1)enzalutamide will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• erdafitinib

  Serious - Use Alternative (1)erdafitinib will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If coadministration unavoidable, separate administration by at least 6 hr before or after administration of P-gp substrates with narrow therapeutic index.

• eribulin

  Serious - Use Alternative (1)eribulin and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin base

  Monitor Closely (1)erythromycin base and pazopanib both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)erythromycin base will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• erythromycin ethylsuccinate

  Monitor Closely (1)erythromycin ethylsuccinate and pazopanib both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)erythromycin ethylsuccinate will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• erythromycin lactobionate

  Monitor Closely (1)erythromycin lactobionate and pazopanib both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)erythromycin lactobionate will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• erythromycin stearate

  Monitor Closely (1)erythromycin stearate and pazopanib both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)erythromycin stearate will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• escitalopram

  Serious - Use Alternative (1)escitalopram increases toxicity of pazopanib by QTc interval. Avoid or Use Alternate Drug.

• eslicarbazepine acetate

  Monitor Closely (1)eslicarbazepine acetate will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• esomeprazole

  Serious - Use Alternative (1)esomeprazole will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• etravirine

  Monitor Closely (1)etravirine will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• ezogabine

  Monitor Closely (1)ezogabine, pazopanib. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.

• famotidine

  Serious - Use Alternative (1)famotidine will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• fedratinib

  Monitor Closely (1)fedratinib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

• fexinidazole

  Serious - Use Alternative (2)fexinidazole and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
  
  fexinidazole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.

• finerenone

  Monitor Closely (1)pazopanib will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Adjust finererone dosage as needed.

• fingolimod

  Monitor Closely (1)pazopanib increases effects of fingolimod by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Concomitant therapy is expected to increase the risk of immunosuppression. Use caution when switching patients from long-acting therapies with immune effects. .Serious - Use Alternative (1)fingolimod and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• flecainide

  Minor (1)flecainide and pazopanib both increase QTc interval. Minor/Significance Unknown.

• flibanserin

  Monitor Closely (1)pazopanib will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.

• fluconazole

  Monitor Closely (1)fluconazole and pazopanib both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)fluconazole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• fluoxetine

  Minor (1)fluoxetine and pazopanib both increase QTc interval. Minor/Significance Unknown.

• fluphenazine

  Monitor Closely (1)fluphenazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• fluvastatin

  Monitor Closely (1)pazopanib increases toxicity of fluvastatin by Other (see comment). Use Caution/Monitor. Comment: OATP1B1 inhibitors may increase risk of myopathy.

• fluvoxamine

  Serious - Use Alternative (1)fluvoxamine will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If it must be coadminister, decrease pazotinib dose to 400 mg/day

• formoterol

  Monitor Closely (1)formoterol and pazopanib both increase QTc interval. Use Caution/Monitor.

• fosamprenavir

  Serious - Use Alternative (1)fosamprenavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• fosaprepitant

  Serious - Use Alternative (1)fosaprepitant will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• foscarnet

  Minor (1)foscarnet and pazopanib both increase QTc interval. Minor/Significance Unknown.

• fosphenytoin

  Monitor Closely (1)fosphenytoin will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• fostamatinib

  Monitor Closely (1)fostamatinib will increase the level or effect of pazopanib by Other (see comment). Use Caution/Monitor. Concomitant use of fostamatinib may increase concentrations of P-gp/BCRP substrate drugs. Monitor for toxicities of P-gp/BCRP substrate drug that may require dosage reduction when given concurrently with fostamatinib.

• fostemsavir

  Monitor Closely (2)pazopanib and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
  
  fostemsavir will increase the level or effect of pazopanib by Other (see comment). Modify Therapy/Monitor Closely. Fostemsavir inhibits BCRP transporters. If possible, avoid coadministration or modify dose of BCRP substrate coadministered with fostemsavir.

• gemifloxacin

  Serious - Use Alternative (1)gemifloxacin and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• gemtuzumab

  Monitor Closely (1)pazopanib and gemtuzumab both increase QTc interval. Use Caution/Monitor.

• gilteritinib

  Serious - Use Alternative (1)gilteritinib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• glasdegib

  Serious - Use Alternative (1)pazopanib and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.

• glecaprevir/pibrentasvir

  Monitor Closely (2)pazopanib will increase the level or effect of glecaprevir/pibrentasvir by decreasing metabolism. Use Caution/Monitor. Caution when coadministering glecaprevir/pibrentasvir with OATP1B1/OATP1B3 inhibitors
  
  glecaprevir/pibrentasvir will increase the level or effect of pazopanib by Other (see comment). Use Caution/Monitor. Glecaprevir/pibrentasvir may increase plasma concentration of P-gp and BCRP substrates.

• goserelin

  Monitor Closely (1)goserelin increases toxicity of pazopanib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• granisetron

  Serious - Use Alternative (1)granisetron and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• grapefruit

  Serious - Use Alternative (1)grapefruit will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• griseofulvin

  Monitor Closely (1)griseofulvin will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• haloperidol

  Monitor Closely (1)haloperidol and pazopanib both increase QTc interval. Use Caution/Monitor.

• histrelin

  Monitor Closely (1)histrelin increases toxicity of pazopanib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• hydrocortisone

  Monitor Closely (1)hydrocortisone will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• hydroxychloroquine sulfate

  Serious - Use Alternative (1)hydroxychloroquine sulfate and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• hydroxyzine

  Serious - Use Alternative (1)hydroxyzine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• ibuprofen/famotidine

  Serious - Use Alternative (1)ibuprofen/famotidine will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• ibutilide

  Monitor Closely (1)ibutilide and pazopanib both increase QTc interval. Modify Therapy/Monitor Closely.

• idelalisib

  Serious - Use Alternative (1)idelalisib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• iloperidone

  Monitor Closely (1)iloperidone increases levels of pazopanib by affecting hepatic enzyme CYP2E1 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.Minor (1)iloperidone and pazopanib both increase QTc interval. Minor/Significance Unknown.

• imipramine

  Monitor Closely (1)imipramine and pazopanib both increase QTc interval. Use Caution/Monitor.

• indacaterol, inhaled

  Monitor Closely (1)indacaterol, inhaled, pazopanib. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.

• indapamide

  Monitor Closely (1)indapamide and pazopanib both increase QTc interval. Modify Therapy/Monitor Closely.

• indinavir

  Serious - Use Alternative (1)indinavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• inotuzumab

  Serious - Use Alternative (1)inotuzumab and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.

• isavuconazonium sulfate

  Monitor Closely (1)pazopanib will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• isoflurane

  Serious - Use Alternative (1)isoflurane and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• isoniazid

  Monitor Closely (1)isoniazid will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• istradefylline

  Monitor Closely (2)istradefylline will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.
  
  istradefylline will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of P-gp substrates in clinical trials. Consider dose reduction of sensitive P-gp substrates.

• itraconazole

  Serious - Use Alternative (1)itraconazole and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce pazopanib dose to 400 mg PO qDay; closely monitor for QT prolongation

• ivacaftor

  Monitor Closely (1)ivacaftor increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Ivacaftor and its M1 metabolite has the potential to inhibit P-gp; may significantly increase systemic exposure to sensitive P-gp substrates with a narrow therapeutic index.

• ivosidenib

  Serious - Use Alternative (2)ivosidenib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.
  
  ivosidenib will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

• ketoconazole

  Monitor Closely (1)ketoconazole and pazopanib both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)ketoconazole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• lansoprazole

  Serious - Use Alternative (1)lansoprazole will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• lapatinib

  Serious - Use Alternative (1)lapatinib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/dayMinor (1)lapatinib and pazopanib both increase QTc interval. Minor/Significance Unknown.

• larotrectinib

  Minor (1)larotrectinib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• lasmiditan

  Serious - Use Alternative (2)lasmiditan increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.
  
  lasmiditan increases levels of pazopanib by Other (see comment). Avoid or Use Alternate Drug. Comment: Lasmiditan inhibits BCRP in vitro. Avoid coadministration of lasmiditan with BCRP substrates.

• lefamulin

  Contraindicated (1)lefamulin will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lefamulin is contraindicated with CYP3A substrates know to prolong the QT interval.

• lemborexant

  Monitor Closely (1)pazopanib will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.

• lenacapavir

  Serious - Use Alternative (1)lenacapavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• leniolisib

  Serious - Use Alternative (1)leniolisib will increase the level or effect of pazopanib by Other (see comment). Avoid or Use Alternate Drug. Leniolisib, a BCRP inhibitor, may increase systemic exposure of BCRP substrates

• lenvatinib

  Monitor Closely (1)pazopanib and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.

• letermovir

  Monitor Closely (1)pazopanib increases levels of letermovir by decreasing metabolism. Use Caution/Monitor. Coadminstration of letermovir, an OATP1B1/3 substrate, with OATP1B1/3 inhibitors may increase letermovir plasma concentrations.

• leuprolide

  Monitor Closely (1)leuprolide increases toxicity of pazopanib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• levofloxacin

  Minor (1)levofloxacin and pazopanib both increase QTc interval. Minor/Significance Unknown.

• levoketoconazole

  Monitor Closely (1)levoketoconazole and pazopanib both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)levoketoconazole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• lithium

  Serious - Use Alternative (1)lithium and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• lofepramine

  Monitor Closely (1)lofepramine and pazopanib both increase QTc interval. Use Caution/Monitor.

• lomitapide

  Monitor Closely (2)pazopanib increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.
  
  lomitapide increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing dose when used concomitantly with lomitapide.

• lonafarnib

  Monitor Closely (1)lonafarnib will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Lonafarnib is a weak P-gp inhibitor. Monitor for adverse reactions if coadministered with P-gp substrates where minimal concentration changes may lead to serious or life-threatening toxicities. Reduce P-gp substrate dose if needed.Serious - Use Alternative (1)pazopanib will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.

• lopinavir

  Serious - Use Alternative (1)lopinavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• lorlatinib

  Monitor Closely (1)lorlatinib will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• lumefantrine

  Monitor Closely (2)lumefantrine will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  lumefantrine and pazopanib both increase QTc interval. Use Caution/Monitor.

• macimorelin

  Serious - Use Alternative (1)macimorelin and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.

• magnesium hydroxide

  Serious - Use Alternative (1)magnesium hydroxide will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; may use short-acting antacids in place of PPIs and H2 antagonists, but separate antacid and pazopanib dosing by several hours

• maprotiline

  Monitor Closely (1)maprotiline and pazopanib both increase QTc interval. Use Caution/Monitor.

• marijuana

  Monitor Closely (1)marijuana will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• mefloquine

  Serious - Use Alternative (1)mefloquine increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

• methadone

  Minor (1)methadone and pazopanib both increase QTc interval. Minor/Significance Unknown.

• metronidazole

  Monitor Closely (1)metronidazole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• midazolam

  Monitor Closely (1)pazopanib increases levels of midazolam by decreasing metabolism. Use Caution/Monitor.

• midazolam intranasal

  Monitor Closely (1)pazopanib will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.

• mifepristone

  Monitor Closely (1)mifepristone will increase the level or effect of pazopanib by Other (see comment). Modify Therapy/Monitor Closely. Inhibits CYP2C8/2C9; use smallest recommended doses for substrates and monitor; combination may increase QT interval. Use alternatives if availableSerious - Use Alternative (1)mifepristone will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• mirtazapine

  Serious - Use Alternative (1)mirtazapine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• mitotane

  Monitor Closely (1)mitotane decreases levels of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.

• mobocertinib

  Serious - Use Alternative (1)mobocertinib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.

• moxifloxacin

  Monitor Closely (1)moxifloxacin and pazopanib both increase QTc interval. Use Caution/Monitor.

• nafcillin

  Monitor Closely (1)nafcillin will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nefazodone

  Serious - Use Alternative (1)nefazodone will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• nelfinavir

  Serious - Use Alternative (1)nelfinavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• nevirapine

  Monitor Closely (1)nevirapine will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nifedipine

  Monitor Closely (1)nifedipine will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• nilotinib

  Monitor Closely (1)nilotinib and pazopanib both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)nilotinib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• nilutamide

  Monitor Closely (1)nilutamide will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• nizatidine

  Serious - Use Alternative (1)nizatidine will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• nortriptyline

  Monitor Closely (1)nortriptyline and pazopanib both increase QTc interval. Use Caution/Monitor.

• octreotide

  Monitor Closely (1)octreotide and pazopanib both increase QTc interval. Use Caution/Monitor.

• octreotide (Antidote)

  Monitor Closely (1)octreotide (Antidote) and pazopanib both increase QTc interval. Use Caution/Monitor.

• ofatumumab SC

  Monitor Closely (1)ofatumumab SC, pazopanib. Either increases effects of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Consider the risk of additive immune system effects when coadministering immunosuppressive therapies with coadministration. When switching from therapies with immune effects, take into account the duration and mechanism of action of these therapies when initiating ofatumumab SC.

• ofloxacin

  Minor (1)ofloxacin and pazopanib both increase QTc interval. Minor/Significance Unknown.

• olanzapine

  Serious - Use Alternative (1)olanzapine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• olodaterol inhaled

  Monitor Closely (1)pazopanib and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias

• omeprazole

  Serious - Use Alternative (1)omeprazole will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• ondansetron

  Serious - Use Alternative (1)pazopanib and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.

• osilodrostat

  Monitor Closely (1)osilodrostat and pazopanib both increase QTc interval. Use Caution/Monitor.

• osimertinib

  Monitor Closely (1)osimertinib and pazopanib both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.

• oteseconazole

  Monitor Closely (1)oteseconazole will increase the level or effect of pazopanib by Other (see comment). Modify Therapy/Monitor Closely. Otesezonale, a BCRP inhibitor, may increase the effects and risk of toxicities of BCRP substrates. Use lowest starting dose of BCRP substrate, or consider reducing BCRP substrate dose.

• oxaliplatin

  Monitor Closely (2)oxaliplatin, pazopanib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration with oxaliplatin may increase the risk of immunosuppression and myelosuppression.
  
  oxaliplatin will increase the level or effect of pazopanib by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.Serious - Use Alternative (1)oxaliplatin and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• oxcarbazepine

  Monitor Closely (1)oxcarbazepine will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• ozanimod

  Monitor Closely (1)ozanimod and pazopanib both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.

• paclitaxel

  Monitor Closely (1)pazopanib increases levels of paclitaxel by decreasing metabolism. Use Caution/Monitor.

• paclitaxel protein bound

  Monitor Closely (1)pazopanib increases levels of paclitaxel protein bound by decreasing metabolism. Use Caution/Monitor.

• palifermin

  Serious - Use Alternative (1)palifermin increases toxicity of pazopanib by Other (see comment). Avoid or Use Alternate Drug. Comment: Palifermin should not be administered within 24 hr before, during infusion of, or within 24 hr after administration of antineoplastic agents. Coadministration of palifermin within 24 hr of chemotherapy resulted in increased severity and duration of oral mucositis.

• paliperidone

  Minor (1)paliperidone and pazopanib both increase QTc interval. Minor/Significance Unknown.

• panobinostat

  Serious - Use Alternative (1)pazopanib and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.

• pantoprazole

  Serious - Use Alternative (1)pantoprazole will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• paroxetine

  Minor (1)paroxetine and pazopanib both increase QTc interval. Minor/Significance Unknown.

• pasireotide

  Monitor Closely (1)pazopanib and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.

• pentamidine

  Monitor Closely (1)pazopanib and pentamidine both increase QTc interval. Modify Therapy/Monitor Closely.

• pentobarbital

  Monitor Closely (1)pentobarbital will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• perphenazine

  Monitor Closely (1)perphenazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• phenobarbital

  Monitor Closely (1)phenobarbital will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• phenytoin

  Monitor Closely (1)phenytoin will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• pimozide

  Monitor Closely (1)pazopanib and pimozide both increase QTc interval. Modify Therapy/Monitor Closely.

• pitavastatin

  Monitor Closely (1)pazopanib increases toxicity of pitavastatin by Other (see comment). Use Caution/Monitor. Comment: OATP1B1 inhibitors may increase risk of myopathy.

• ponatinib

  Monitor Closely (1)ponatinib increases levels of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• posaconazole

  Serious - Use Alternative (1)posaconazole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/dayMinor (1)pazopanib and posaconazole both increase QTc interval. Minor/Significance Unknown.

• pravastatin

  Monitor Closely (1)pazopanib increases toxicity of pravastatin by Other (see comment). Use Caution/Monitor. Comment: OATP1B1 inhibitors may increase risk of myopathy.

• primaquine

  Serious - Use Alternative (1)primaquine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• primidone

  Monitor Closely (1)primidone will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• procainamide

  Monitor Closely (1)pazopanib and procainamide both increase QTc interval. Modify Therapy/Monitor Closely.

• prochlorperazine

  Monitor Closely (1)prochlorperazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• promazine

  Monitor Closely (1)promazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• promethazine

  Monitor Closely (1)promethazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• protriptyline

  Monitor Closely (1)protriptyline and pazopanib both increase QTc interval. Use Caution/Monitor.

• quetiapine

  Monitor Closely (1)quetiapine, pazopanib. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.

• quinidine

  Monitor Closely (1)quinidine and pazopanib both increase QTc interval. Modify Therapy/Monitor Closely.

• quinine

  Monitor Closely (1)pazopanib and quinine both increase QTc interval. Use Caution/Monitor.

• quinupristin/dalfopristin

  Serious - Use Alternative (1)quinupristin/dalfopristin will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• rabeprazole

  Serious - Use Alternative (1)rabeprazole will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with drugs that raise gastric pH; consider short-acting antacids in place of PPIs and H2 antagonists; separate antacid and pazopanib dosing by several hours

• ranolazine

  Minor (1)pazopanib and ranolazine both increase QTc interval. Minor/Significance Unknown.

• regorafenib

  Monitor Closely (1)regorafenib will increase the level or effect of pazopanib by Other (see comment). Modify Therapy/Monitor Closely. Regorafenib likely inhibits BCRP (ABCG2) transport. Coadministration with a BCRP substrate may increase systemic exposure to the substrate and related toxicity.

• revefenacin

  Serious - Use Alternative (1)pazopanib increases levels of revefenacin by Other (see comment). Avoid or Use Alternate Drug. Comment: OATP1B1 and OATP1B3 transport inhibitors may increase systemic exposure of revefenacin's active metabolite. Coadministration not recommended.

• ribociclib

  Monitor Closely (1)ribociclib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)ribociclib increases toxicity of pazopanib by QTc interval. Avoid or Use Alternate Drug.

• rifabutin

  Serious - Use Alternative (1)rifabutin will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• rifampin

  Serious - Use Alternative (1)rifampin will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• rifapentine

  Monitor Closely (1)rifapentine will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• rilpivirine

  Monitor Closely (1)rilpivirine increases toxicity of pazopanib by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsade de Pointes.

• risperidone

  Minor (1)pazopanib and risperidone both increase QTc interval. Minor/Significance Unknown.

• ritonavir

  Serious - Use Alternative (1)ritonavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• romidepsin

  Monitor Closely (1)pazopanib and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.

• ropeginterferon alfa 2b

  Serious - Use Alternative (1)ropeginterferon alfa 2b, pazopanib. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Myelosuppressive agents can produce additive myelosuppression. Avoid use and monitor patients receiving the combination for effects of excessive myelosuppression.

• rosuvastatin

  Monitor Closely (1)pazopanib increases toxicity of rosuvastatin by Other (see comment). Use Caution/Monitor. Comment: OATP1B1 inhibitors may increase risk of myopathy.

• rucaparib

  Monitor Closely (1)rucaparib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.

• rufinamide

  Monitor Closely (1)rufinamide will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• ruxolitinib

  Minor (1)pazopanib will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• ruxolitinib topical

  Minor (1)pazopanib will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• sacubitril/valsartan

  Monitor Closely (1)pazopanib will increase the level or effect of sacubitril/valsartan by Other (see comment). Use Caution/Monitor. The results from an in vitro study with human liver tissue indicate that valsartan is a substrate of the hepatic uptake transporter OATP1B1; coadministration with OATP1B1 inhibitors may increase valsartan systemic exposure

• safinamide

  Monitor Closely (1)safinamide will increase the level or effect of pazopanib by Other (see comment). Use Caution/Monitor. Safinamide and its major metabolite may inhibit intestinal BCRP. Monitor BCRP substrates for increased pharmacologic or adverse effects.

• saquinavir

  Serious - Use Alternative (1)saquinavir increases levels of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Potential for increased toxicity. Increased risk of QT prolongation and cardiac arrhythmias.

• sarecycline

  Monitor Closely (1)sarecycline will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor for toxicities of P-gp substrates that may require dosage reduction when coadministered with P-gp inhibitors.

• secobarbital

  Monitor Closely (1)secobarbital will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• selpercatinib

  Monitor Closely (1)selpercatinib increases toxicity of pazopanib by QTc interval. Use Caution/Monitor.

• sertraline

  Serious - Use Alternative (1)sertraline and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• sevoflurane

  Serious - Use Alternative (1)sevoflurane and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• simvastatin

  Monitor Closely (2)simvastatin increases toxicity of pazopanib by Other (see comment). Use Caution/Monitor. Comment: Increased risk of elevated LFTs with pazopanib when coadministered with simvastatin.
  
  pazopanib will increase the level or effect of simvastatin by Other (see comment). Use Caution/Monitor. OATP1B1 inhibitors may increase risk of myopathy

• siponimod

  Monitor Closely (1)siponimod and pazopanib both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Caution if coadministered because of additive immunosuppressive effects during such therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, consider the half-life and mode of action of these drugs to avoid unintended additive immunosuppressive effects.Serious - Use Alternative (1)siponimod and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• sipuleucel-T

  Monitor Closely (1)pazopanib decreases effects of sipuleucel-T by pharmacodynamic antagonism. Modify Therapy/Monitor Closely.

• sodium zirconium cyclosilicate

  Monitor Closely (1)sodium zirconium cyclosilicate will decrease the level or effect of pazopanib by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate.

• solifenacin

  Monitor Closely (1)solifenacin and pazopanib both increase QTc interval. Use Caution/Monitor.

• sorafenib

  Monitor Closely (1)sorafenib and pazopanib both increase QTc interval. Use Caution/Monitor.

• sotalol

  Monitor Closely (1)pazopanib and sotalol both increase QTc interval. Modify Therapy/Monitor Closely.

• sotorasib

  Serious - Use Alternative (1)sotorasib will decrease the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If use is unavoidable, refer to the prescribing information of the P-gp substrate for dosage modifications.

• St John's Wort

  Serious - Use Alternative (1)St John's Wort will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• stiripentol

  Monitor Closely (3)stiripentol, pazopanib. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.
  
  stiripentol will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing the dose of P-glycoprotein (P-gp) substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.
  
  stiripentol will increase the level or effect of pazopanib by Other (see comment). Modify Therapy/Monitor Closely. Stiripentol is a BCRP transport inhibitor. Consider dosage reduction for BCRP substrates if adverse effects are experienced when coadministered.

• sulbactam/durlobactam

  Serious - Use Alternative (1)pazopanib will increase the level or effect of sulbactam/durlobactam by Other (see comment). Avoid or Use Alternate Drug. Sulbactam is predicted to have active secretion by OATP1 as a significant portion of total clearance; therefore, inhibition of OAT1 may increase sulbactam plasma concentrations

• sulfamethoxazole

  Minor (1)sulfamethoxazole and pazopanib both increase QTc interval. Minor/Significance Unknown.

• sunitinib

  Serious - Use Alternative (1)sunitinib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• tacrolimus

  Serious - Use Alternative (1)tacrolimus and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• tadalafil

  Monitor Closely (1)pazopanib will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• tafamidis

  Monitor Closely (1)tafamidis will increase the level or effect of pazopanib by Other (see comment). Use Caution/Monitor. Tafamidis inhibits breast cancer resistant protein (BCRP) in vitro and may increase exposure of BCRP substrates following tafamidis or tafamidis meglumine administration. Dosage adjustment of these BCRP substrates may be necessary.

• tafamidis meglumine

  Monitor Closely (1)tafamidis meglumine will increase the level or effect of pazopanib by Other (see comment). Use Caution/Monitor. Tafamidis inhibits breast cancer resistant protein (BCRP) in vitro and may increase exposure of BCRP substrates following tafamidis or tafamidis meglumine administration. Dosage adjustment of these BCRP substrates may be necessary.

• tazemetostat

  Monitor Closely (2)tazemetostat will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  pazopanib will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• tecovirimat

  Monitor Closely (1)tecovirimat will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.

• telavancin

  Minor (1)pazopanib and telavancin both increase QTc interval. Minor/Significance Unknown.

• tepotinib

  Serious - Use Alternative (1)tepotinib will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If concomitant use unavoidable, reduce the P-gp substrate dosage if recommended in its approved product labeling.

• teriflunomide

  Monitor Closely (1)teriflunomide increases levels of pazopanib by Other (see comment). Use Caution/Monitor. Comment: Teriflunomide inhibits CYP2C8; caution when coadministered with CYP2C8 substrates.

• tetrabenazine

  Serious - Use Alternative (1)tetrabenazine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• thioridazine

  Monitor Closely (1)thioridazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• tinidazole

  Monitor Closely (1)pazopanib will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• tipranavir

  Serious - Use Alternative (1)tipranavir will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• topiramate

  Monitor Closely (1)topiramate will decrease the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• toremifene

  Serious - Use Alternative (1)pazopanib and toremifene both increase QTc interval. Avoid or Use Alternate Drug. Concurrent use of toremifene with agents causing QT prolongation should be avoided. If concomitant use is required it's recommended that toremifene be interrupted. If interruption not possible, patients requiring therapy with a drug that prolongs QT should be closely monitored. ECGs should be obtained for high risk patients.

• trastuzumab

  Monitor Closely (1)trastuzumab, pazopanib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .

• trastuzumab deruxtecan

  Monitor Closely (1)trastuzumab deruxtecan, pazopanib. Either increases toxicity of the other by immunosuppressive effects; risk of infection. Use Caution/Monitor. Neutropenia or febrile neutropenia incidence were increased when trastuzumab was coadministered with myelosuppressive chemotherapy. .

• trazodone

  Monitor Closely (1)trazodone and pazopanib both increase QTc interval. Use Caution/Monitor.

• triclabendazole

  Monitor Closely (1)triclabendazole and pazopanib both increase QTc interval. Use Caution/Monitor.

• trifluoperazine

  Monitor Closely (1)trifluoperazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• trimipramine

  Monitor Closely (1)trimipramine and pazopanib both increase QTc interval. Use Caution/Monitor.

• triptorelin

  Monitor Closely (1)triptorelin increases toxicity of pazopanib by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• tropisetron

  Minor (1)pazopanib and tropisetron both increase QTc interval. Minor/Significance Unknown.

• tucatinib

  Monitor Closely (1)tucatinib will increase the level or effect of pazopanib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Consider reducing the dosage of P-gp substrates, where minimal concentration changes may lead to serious or life-threatening toxicities.Serious - Use Alternative (1)tucatinib will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.

• umeclidinium bromide/vilanterol inhaled

  Serious - Use Alternative (1)pazopanib increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

• valbenazine

  Monitor Closely (1)valbenazine and pazopanib both increase QTc interval. Use Caution/Monitor.

• valsartan

  Monitor Closely (1)pazopanib will increase the level or effect of valsartan by Other (see comment). Use Caution/Monitor. The results from an in vitro study with human liver tissue indicate that valsartan is a substrate of the hepatic uptake transporter OATP1B1; coadministration with OATP1B1 inhibitors may increase valsartan systemic exposure

• vandetanib

  Serious - Use Alternative (1)pazopanib, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.

• vemurafenib

  Serious - Use Alternative (1)vemurafenib and pazopanib both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended. Pazopanib may also increase levels of vemurafenib.

• venlafaxine

  Minor (1)pazopanib and venlafaxine both increase QTc interval. Minor/Significance Unknown.

• verapamil

  Serious - Use Alternative (1)verapamil will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• vilanterol/fluticasone furoate inhaled

  Serious - Use Alternative (1)pazopanib increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.

• voclosporin

  Monitor Closely (1)voclosporin, pazopanib. Either increases effects of the other by QTc interval. Use Caution/Monitor.

• voriconazole

  Serious - Use Alternative (1)voriconazole will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/dayMinor (1)pazopanib and voriconazole both increase QTc interval. Minor/Significance Unknown.

• vorinostat

  Serious - Use Alternative (1)vorinostat and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.

• voxelotor

  Serious - Use Alternative (1)voxelotor will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.

• zafirlukast

  Serious - Use Alternative (1)zafirlukast will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

• ziprasidone

  Monitor Closely (1)pazopanib and ziprasidone both increase QTc interval. Use Caution/Monitor.