Votrient (pazopanib) has potential interactions with other medications and some supplements. These interactions could affect how well the drug works or cause harmful effects.
Votrient is used in adults to treat:
- advanced* renal cell carcinoma, a type of kidney cancer
- advanced soft tissue sarcoma (STS), in adults who have received chemotherapy for this condition
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions. Keep reading to learn about Votrient’s possible interactions.
* “Advanced” means the cancer has spread beyond its original site to other body parts.
Boxed warning: Risk of liver damage
Votrient has a boxed warning about the risk of liver damage. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.
Treatment with Votrient can cause liver damage as a side effect. This side effect wasn’t common in studies, but it can be severe or even life threatening in severe cases.
Due to this risk, your doctor will order liver function tests to check your liver health throughout the treatment with Votrient. If these tests show confirmed or potential liver damage, your doctor may temporarily or permanently stop your Votrient treatment. While taking Votrient, immediately tell your doctor if you notice symptoms of liver damage such as jaundice (yellowing of your skin or the whites of your eyes), pain in the right side of your abdomen, or dark-colored urine.
For more information on this warning, talk with your doctor or pharmacist.
Before you start taking Votrient, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions.
To learn whether Votrient interacts with herbs, vitamins, or supplements, see the “Are there other interactions with Votrient?” section.
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The following table lists drugs that may interact with Votrient. Keep in mind that this table does not include all drugs that may interact with Votrient. For more information about some of these interactions, see the “Drug interactions explained” section.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| antipsychotic medications | • ziprasidone (Geodon) • haloperidol (Haldol) | can increase the risk of long QT syndrome as a side effect of Votrient and antipsychotic medications |
| medications that decrease stomach acid | • proton pump inhibitors, such as esomeprazole (Nexium) • H2 receptor blockers, such as famotidine (Pepcid AC) • antacids, such as calcium carbonate (Tums) | can make Votrient less effective |
| certain antibiotics | • clarithromycin • azithromycin (Zithromax) | can increase the risk of side effects of Votrient |
| certain antidepressants | • citalopram (Celexa) • amitriptyline | can increase the risk of long QT syndrome as a side effect of Votrient and certain antidepressants |
| certain antiepileptic drugs | • carbamazepine (Tegretol, others) • phenytoin (Dilantin) | can make Votrient less effective |
| certain antifungals | • ketoconazole • itraconazole (Sporanox, Tolsura) | can increase the risk of Votrient side effects |
| certain heart medications | • the calcium channel blockers diltiazem (Cardizem, others) and verapamil (Verelan) • antiarrhythmic drugs, such as amiodarone (Pacerone) | can increase the risk of Votrient side effects |
| treatments that contain ritonavir (Norvir) or cobicistat (Tybost) | • Paxlovid (ritonavir/nirmatrelvir) • Genvoya (cobicistat/elvitegravir/emtricitabine/tenofovir alafenamide fumarate) | can increase the risk of Votrient side effects |
| cyclosporine (Gengraf, others) | — | can increase the risk of Votrient side effects |
| simvastatin (Zocor, FloLipid) | — | can increase the risk of liver-related Votrient and simvastatin side effects |
Your doctor may advise you to limit or avoid alcohol consumption while you’re taking Votrient.
Votrient and alcohol both can cause liver damage. Votrient has a boxed warning about the risk of liver damage. To learn more about this warning, see the introduction of this article. Consuming alcohol while you’re taking Votrient can increase your risk of this side effect.
Votrient and alcohol can also cause other similar side effects, such as headache and nausea. So you may be more likely to experience these side effects if you drink alcohol during your Votrient treatment.
If you have questions about consuming alcohol during Votrient treatment, talk with your doctor or pharmacist.
Learn more about certain drug interactions that can occur with Votrient.
Interaction with medications that reduce stomach acid
Votrient interacts with medications that reduce stomach acid, which are used to treat acid reflux and gastroesophageal reflux disease (GERD), as well as some other conditions related to excessive stomach acid.
Stomach acid is necessary for your body to properly absorb Votrient after you take a dose. Medications that reduce stomach acid can cause your body to absorb less Votrient after each dose, which can make Votrient less effective.
Here are some medications that reduce stomach acid, which may interact with Votrient:
- proton pump inhibitors, such as:
- esomeprazole (Nexium)
- omeprazole (Prilosec)
- H2 receptor blockers, such as famotidine (Pepcid AC)
- antacids, such as:
- calcium carbonate (Tums)
- aluminum hydroxide/magnesium hydroxide
What you can do
Due to this interaction, your doctor will likely suggest you avoid using a proton pump inhibitor or H2 receptor blocker while you’re taking Votrient.
Your doctor may also advise you to avoid using antacids while you’re taking Votrient. If this combination cannot be avoided, your doctor will likely tell you to separate the dose of Votrient and the antacid by at least several hours. Antacids reduce stomach acid, but they don’t work for very long. Separating the dose of Votrient and an antacid can help avoid this interaction.
Talk with your doctor if you have questions about Votrient and its interaction with medications that reduce stomach acid.
Interaction with certain antidepressants
Votrient interacts with certain antidepressants. These medications are prescribed to treat conditions related to mental health, such as clinical depression and anxiety disorders.
Both Votrient and certain antidepressants can lengthen the QT interval (a part of your heart’s rhythm) as a side effect. Taking these medications together can increase the risk of long QT syndrome as a side effect of Votrient and the antidepressant.
Here are some antidepressants that may interact with Votrient:
What you can do
Due to this risk, your doctor will likely avoid prescribing Votrient together with an antidepressant that increases the QT interval. Instead, they can review other antidepressants that are safer to take with Votrient. Since other antidepressants have other interactions, your doctor and pharmacist can review for other interactions with medications you take or medical conditions you have.
If this interaction cannot be avoided, your doctor will likely want to closely monitor your heart rhythm. This can include routine electrocardiogram (EKG) monitoring at a lab or at home. If you take Votrient and an antidepressant that increases the QT interval together, tell your doctor right away if you have symptoms of long QT syndrome. These may include a fluttering feeling in your chest, noisy gasping during sleep, and passing out for no apparent reason.
Talk with your doctor if you have questions about taking an antidepressant and Votrient together. They can advise on the safety of this combination based on the specific antidepressant you’re prescribed.
Interaction with certain antiepileptic drugs
Votrient interacts with certain antiepileptic drugs, which are prescribed to treat seizures.
After you take Votrient, your body relies on an enzyme (a special type of protein) called cytochrome P450 3A4 (CYP3A4) to break down the medication. Certain antiepileptic drugs increase CYP3A4 activity in the body. This can decrease the amount of Votrient in your system, which can make the medication less effective.
Here are some antiepileptic drugs that may interact with Votrient:
- carbamazepine (Tegretol, others)
- phenytoin (Dilantin)
What you can do
Due to the risk of making Votrient less effective, doctors typically won’t prescribe Votrient along with carbamazepine or phenytoin. Instead, your doctor can discuss alternative antiepileptic drugs or alternatives to Vortrient that you can use instead.
Votrient may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests.
Here are additional interactions that may occur with Votrient. Note that this is not a full list of all other possible interactions with Votrient.
Does Votrient interact with supplements?
Before you start taking Votrient, talk with your doctor and pharmacist about any herbs, vitamins, or supplements you take. Sharing this information with them may help you avoid possible interactions.
In addition to interactions mentioned in the following sections, Votrient interacts with sodium bicarbonate when used as a supplement. Some people use sodium bicarbonate as a supplement to improve exercise performance. Taking sodium bicarbonate and Votrient at the same time can decrease the amount of Votrient in your system, which can make the medication less effective. Due to this risk, your doctor may advise you to avoid using sodium bicarbonate as a supplement while you’re taking Votrient. Or, they’ll advise you to separate doses of Votrient and sodium bicarbonate by several hours.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Votrient interactions with herbs
Votrient can interact with St. John’s wort, which is used to treat symptoms of depression and certain other conditions.
Taking St. John’s wort can speed up how quickly your body breaks down Votrient. This can make Votrient less effective. Due to this, your doctor will likely advise you not to use St. John’s wort supplements if they prescribe Votrient to you.
Votrient interactions with vitamins
There are currently no reports of Votrient interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.
For this reason, it’s important to check with your doctor or pharmacist before taking any of these products while taking Votrient.
Does Votrient interact with food?
It’s important to note that you should not eat food at least 1 hour before and 2 hours after taking Votrient. If you take Votrient with food, the interaction could increase the level of the drug in your body. You may experience more side effects from Votrient as a result.
In addition, Votrient interacts with grapefruit and grapefruit juice. Consuming grapefruit or grapefruit juice while taking Votrient can cause the medication level to build up in your body. This can raise your risk of side effects of Votrient. Due to this risk, your doctor will likely advise you to avoid consuming grapefruit or grapefruit juice during Votrient treatment.
Does Votrient interact with vaccines?
The prescribing information for Votrient doesn’t specifically recommend avoiding live vaccines or any vaccines. However, since Votrient can affect the immune system and may increase the risk of infections, your doctor may be cautious about giving live vaccines while you’re taking this medication.
Live vaccines contain weakened versions of the bacteria or virus they’re meant to protect against. This means getting a live vaccine while taking Votrient may increase your risk of infection. It’s also possible that the vaccine may not work as well.
Examples of live vaccines include cholera, measles, mumps, rubella (MMR), rotavirus, and chickenpox. If you need to receive a vaccine, talk with your doctor first to make sure it’s safe.
Does Votrient interact with lab tests?
There are currently no reports of Votrient interacting with lab tests. If you have questions about having certain lab tests during your treatment with Votrient, talk with the healthcare professional ordering the test.
Does Votrient interact with cannabis or CBD?Cannabis (commonly called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Votrient. Using cannabis or cannabis products can increase the level of Votrient in your system. This can raise your risk of Votrient side effects.
Before you start treatment with Votrient, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Votrient. Before taking Votrient, talk with your doctor about your health history. They’ll determine whether Votrient is right for you.
Health conditions or other factors that might interact with Votrient include:
Coughed up blood within the past 6 months: Bleeding, including hemorrhage (severe bleeding), is a possible side effect of Votrient. Clinical trials of Votrient did not include people who had coughed up blood in the previous 6 months, so it’s not known whether it’s safe to take Votrient in this situation. Talk with your doctor to learn more about whether treatment with Votrient is right for you.
Heart problem, including arrhythmia or high blood pressure: Votrient can cause heart-related side effects, including long QT syndrome and other arrhythmias, and increased blood pressure. If you have an existing heart problem, you may be at higher risk of heart-related side effects if you take Votrient. Taking Votrient could also worsen your existing condition. Your doctor can determine whether Votrient is safe for you to take based on your heart health.
Kidney problem (besides renal cell carcinoma): Having a kidney problem besides renal cell carcinoma (a condition Votrient is used to treat), such as chronic kidney disease, may raise your risk of tumor lysis syndrome (TLS) as a side effect of Votrient. If your doctor prescribes Votrient to you, they’ll likely want to closely monitor for symptoms of TLS. These can include restlessness, fatigue or weakness, and numbness or tingling in your body.
Liver condition: Votrient has a boxed warning regarding the risk of liver damage. You may be at higher risk of this side effect if you have a liver condition. To learn more about this warning, see the introduction of this article. If your doctor prescribes Votrient to you, they may prescribe a lower dosage.
Past bleeding or tears (perforations) in your digestive tract: Votrient can cause bleeding, including hemorrhage (serious bleeding), as a side effect. This includes bleeding in the digestive tract. Digestive perforations (tears) are another known Votrient side effect. If you’ve experienced bleeding or perforations in your digestive tract in the past, you may be at higher risk of these side effects if you take Votrient. Talk with your doctor to learn more about the benefits and risks of treatment based on your medical history.
Past blood clot in a vein or your lungs: Blood clots are a possible side effect of Votrient. It’s not known if having a blood clot in the past increases your risk of this side effect if you take Votrient. Clinical studies of Votrient did not include people who had experienced certain blood clots within 6 months of the study. Due to this, talk with your doctor about any past blood clots you’ve had before you begin taking Votrient.
Past stroke: Stroke is a possible side effect that Votrient can cause. It’s not known whether having a stroke in the past increases your risk of this side effect if you take Votrient. Talk with your doctor to learn more about the benefits and risks you can expect while taking Votrient.
Recent or upcoming surgery: Treatment with Votrient can affect how well your body heals wounds. Due to this, your doctor may temporarily pause your Votrient treatment if you need to have surgery. This may include pausing treatment both before and after surgery. This will depend on the specific surgery, so be sure to discuss any recent or planned surgeries with your doctor before you start taking Votrient. If you need to have surgery during treatment, make sure your surgeon is aware you’re taking Votrient.
Thyroid condition: Treatment with Votrient can affect your thyroid function, which can worsen thyroid conditions such as hypothyroidism. Due to this, your doctor may adjust the dosage of any medication you take to treat a thyroid condition. They may also order thyroid function tests throughout treatment with Votrient.
Pregnancy: It’s not known whether Votrient is safe to take during pregnancy. Based on animal studies and how Votrient works, it may cause harm if taken during pregnancy. But it’s important to note that animal studies don’t always predict the effects a drug will have in humans. If you’re pregnant or may become pregnant, talk with your doctor before taking Votrient.
Breastfeeding: Your doctor will likely advise you not to breastfeed while taking Votrient. It isn’t known whether the drug passes into breast milk or whether the drug may cause side effects in a child who is breastfed. But due to the risk of serious side effects in a breastfed child, breastfeeding while taking Votrient is not recommended. Your doctor will also likely advise you to avoid breastfeeding for at least 2 weeks after your last Votrient dose. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.
Allergic reaction: If you’ve had an allergic reaction to Votrient or any of its ingredients, your doctor will likely not prescribe Votrient. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better for you.
Taking certain steps can help you avoid interactions with Votrient. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- whether you drink alcohol or use cannabis
- the
list of medications you take, as well as any vitamins, supplements, and herbs - what to do if you start taking a new drug during your Votrient treatment
It’s also important to understand Votrient’s
If you did not get paperwork with Votrient, ask your pharmacist to print a copy for you. If you have difficulty reading or understanding this information, your doctor or pharmacist can help.
Taking Votrient exactly as prescribed can also help prevent interactions.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.