Drug interactions
Pazopanib + St john's wort
Severity: Major
Pazopanib and St john's wort: major interaction.
Last updated
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
St John's wort induces CYP3A4 and P-gp and may reduce pazopanib concentrations. This can compromise anticancer efficacy.
What this interaction means in plain words
Pazopanib and St john's wort 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.
Why it happens
Induction of CYP3A4 and P-gp by hyperforin increases pazopanib metabolism and efflux.
What to do
Avoid concurrent use and stop St John's wort before starting pazopanib. Counsel patients about herbal products.
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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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 Pazopanib with St john's wort?
MediHelp rates the interaction as major. Pazopanib and St john's wort 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. St John's wort induces CYP3A4 and P-gp and may reduce pazopanib concentrations. This can compromise anticancer efficacy.
How serious is the interaction between Pazopanib and St john's wort?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use and stop St John's wort before starting pazopanib. Counsel patients about herbal products.
What other medicines interact with Pazopanib?
MediHelp also lists interactions of Pazopanib with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Pazopanib page.
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