Drug Interactions between Stivarga and Votrient

Do not consume grapefruit or grapefruit juice during treatment with PAZOPanib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of PAZOPanib, which may lead to an increased risk of serious side effects such as liver damage, irregular heart rhythm, bleeding, high blood pressure, heart attack, and stroke. Taking PAZOPanib with food can also significantly increase its absorption and levels in the blood. Therefore, you should take PAZOPanib on an empty stomach, at least one hour before or two hours after eating. Call your doctor immediately if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. You should also seek immediate medical attention if you experience signs and symptoms that could indicate cardiovascular problems such as sudden dizziness; lightheadedness; fainting; fast or pounding heartbeats; chest pain or tightness; pain in your arms, back, neck, or jaw; shortness of breath; numbness or weakness on one side of your body; and slurred speech or difficulty speaking. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Depending on the amount of fat, food may help the absorption of regorafenib. You should take it with a low-fat breakfast at the same time everyday to maintain consistent blood levels and effects. Examples of a low-fat breakfast include: 2 slices of white toast with 1 tablespoon of low-fat margarine and 1 tablespoon of jelly, plus 8 ounces of skim milk (319 calories; 8.2 g fat); or 1 cup of cereal, 8 ounces of skim milk, 1 slice of toast with jam, apple juice, and 1 cup of coffee or tea (520 calories; 2 g fat). Avoid consuming grapefruit or grapefruit juice during treatment, as it may alter the blood levels and effects of the medication. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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The recommended maximum number of medicines in the 'VEGF/VEGFR inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'VEGF/VEGFR inhibitors' category:

• Stivarga (regorafenib)
• Votrient (pazopanib)

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.