Drug interactions
Fluconazole + Pazopanib
Severity: Major
Fluconazole and Pazopanib: major interaction.
Last updated Sources: Health Canada product monograph
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Fluconazole inhibits CYP3A4 and can raise pazopanib exposure, increasing hepatotoxicity, hypertension and QT prolongation risk. Pazopanib itself prolongs QT, so both pharmacokinetic and pharmacodynamic concerns apply.
What this interaction means in plain words
Fluconazole and Pazopanib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Fluconazole belongs to Anti Fungals; Pazopanib belongs to Oncology.
Why it happens
Inhibition of CYP3A4-mediated pazopanib metabolism by fluconazole, plus additive QT effects.
What to do
Prefer an antifungal with less CYP3A4 inhibition. If coadministered, monitor liver tests and ECG and reduce the pazopanib dose if adverse effects emerge.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
Other interactions of Pazopanib
- Adagrasib + Pazopanib Major
- Amiodarone + Pazopanib Major
- Amisulpride + Pazopanib Major
- Amobarbital + Pazopanib Major
- Anagrelide + Pazopanib Major
- Apalutamide + Pazopanib Major
Frequently asked questions
Can I take Fluconazole with Pazopanib?
MediHelp rates the interaction as major. Fluconazole and Pazopanib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Fluconazole inhibits CYP3A4 and can raise pazopanib exposure, increasing hepatotoxicity, hypertension and QT prolongation risk. Pazopanib itself prolongs QT, so both pharmacokinetic and pharmacodynamic concerns apply.
How serious is the interaction between Fluconazole and Pazopanib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an antifungal with less CYP3A4 inhibition. If coadministered, monitor liver tests and ECG and reduce the pazopanib dose if adverse effects emerge.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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