Skip to main content

Drug Interactions between pazopanib and Sambucol

This report displays the potential drug interactions for the following 2 drugs:

Edit list (add/remove drugs)

Interactions between your drugs

Moderate

PAZOPanib elderberry

Applies to: pazopanib and Sambucol (elderberry)

Consumer information for this interaction is not currently available.

MONITOR: Coadministration of elderberry and pazopanib may increase the risk of pazopanib-related adverse effects. This interaction was suspected in a case report involving a 65-year-old woman diagnosed with localized intermediate-grade sarcoma initiated on pazopanib 400 mg orally daily while taking elderberry supplements at an unknown dose. Pazopanib was increased to 800 mg orally daily after one week. By week three on pazopanib, the patient reported intense nausea and frequent loose stools, requiring treatment and by the fourth week, laboratory tests indicated grade 3 liver injury. All medications, including elderberry supplements, were stopped and within four weeks, liver enzymes returned to baseline. At this time, pazopanib treatment was resumed at a lower dosage of 400 mg orally daily without the recurrence of adverse effects or liver injury. Although clinical evidence is limited, the potential mechanism for this interaction may be due to elderberry mediated inhibition of CYP450 3A4 which may occur at higher doses and lead to increased pazopanib exposure.

MANAGEMENT: Caution is advised if elderberry is used concomitantly with pazopanib. If coadministration is required, patients should be more closely monitored for pazopanib-related adverse effects such as hepatotoxicity, nausea, vomiting, and diarrhea.

Drug and food interactions

Major

PAZOPanib food

Applies to: pazopanib

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.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


Report options

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.