Livalo and Pazopanib

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

PAZOPanib may occasionally cause liver damage, and taking it with other medications that can also affect the liver such as pitavastatin may increase that risk. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Avoid or limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, light colored stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. 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.

MONITOR: Concomitant use of pazopanib with simvastatin may increase the risk of ALT elevations, possibly due to additive hepatotoxic effects. In clinical trials, potentially severe and life-threatening hepatotoxicity manifested as increases in serum transaminases (ALT, AST) and bilirubin was observed with pazopanib use. Transaminase elevations occurred early in the course of treatment, with 92.5% of all cases of any grade occurring in the first 18 weeks. Across all monotherapy studies with pazopanib (n=977), ALT exceeding 3 times the upper limit of normal (ULN) was reported in 14% of patients who received pazopanib and ALT exceeding 8 times ULN was reported in 4%. Concurrent elevations in ALT greater than 3 times ULN and bilirubin greater than 2 times ULN regardless of alkaline phosphatase levels were detected in 1% of patients. Four of these patients had no other explanation for the elevations. Two of the total 977 patients (0.2%) died with disease progression and hepatic failure. Of the 41 patients who had concomitant use of simvastatin, 11 (27%) developed ALT exceeding 3 times ULN.

MANAGEMENT: Caution is advised if pazopanib is used in combination with simvastatin. Serum liver transaminases and bilirubin should be measured prior to initiation of pazopanib and regularly during treatment as recommended in the product labeling. If ALT elevations occur, simvastatin should be discontinued and guidelines for pazopanib dosage adjustments should be followed, or alternatives to pazopanib considered. Patients should be advised to seek medical attention if they experience potential signs and symptoms of hepatotoxicity such as fever, rash, itching, anorexia, nausea, vomiting, fatigue, malaise, right upper quadrant pain, dark urine, light colored stools, and jaundice. Insufficient data are available to assess the risk of pazopanib administered concomitantly with other HMG-CoA reductase inhibitors.

Livalo

Generic Name: pitavastatin

Brand name: Livalo, Zypitamag

Synonyms: n.a.

What is Livalo?

Pazopanib

Generic Name: pazopanib

Brand name: Votrient

Synonyms: n.a.

What is Pazopanib?