Lansoprazole and Pazopanib: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Pazopanib
Lansoprazole
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Reduction in pazopanib bioavailability
Interaction Deep Dive
Oral pazopanib administered with a proton pump inhibitor may result in decreased pazopanib concentrations. When pazopanib and esomeprazole were coadministered, there was a decrease in mean AUC and Cmax of pazopanib. Since the absorption and solubility of pazopanib depends on an acidic environment and repeated administration of a proton pump inhibitor elevates gastric pH for an extended period, the absorption of pazopanib will be reduced with coadministration, which may result in subtherapeutic exposure of pazopanib in some patients. Concomitant use should be avoided. If coadministration is necessary, consider alternative dosing regimens that do not increase gastric pH at the time of pazopanib dosing (eg, late evening administration of pazopanib)1. However, in another study there were no significant effects on PFS or OS when coadministered in patients with metastatic renal cell carcinoma 3. Short acting antacids should be considered. Administration of pazopanib and antacids should be separated by several hours 2.
Why it happens (mechanism)
Decreased solubility and absorption of pazopanib due to increased gastric pH by proton pump inhibitors
Literature reports
2 reports — tap to read
a) In a retrospective cohort study in patients with metastatic renal cell carcinoma, concomitant use (n=66) of pazopanib and a proton pump inhibitor (esomeprazole, lansoprazole, omeprazole, pantoprazole) or a histamine-2 receptor antagonist (famotidine, ranitidine) compared with pazopanib alone (n=24) did not significantly reduce progression-free survival (PFS; 9 vs 11 months) or overall survival (OS; 28 vs 30.1 months). There was also no significant difference in patients receiving a proton pump inhibitor (n=57) compared with a histamine-2 receptor antagonist (n=9) on median PFS (11 vs 8 months) or median OS (27 vs 31 months) 3.
b) Coadministration of pazopanib and esomeprazole led to decreases in pazopanib mean AUC 24 hours post-dose (848 to 512 mcg x hr/mL) and mean Cmax (48.9 to 28.4 mcg/mL). Plasma samples were analyzed for 12 patients with advanced solid tumors who received oral pazopanib 800 mg once daily in the morning (at least 1 hour before or 2 hours after the morning meal) for 7 days and then received esomeprazole 40 mg once daily in the evening (at bedtime, about 3 hours after the evening meal) for 5 days. The mean AUC 24 hours post-dose and Cmax for pazopanib metabolites were also lower in the presence of esomeprazole. Concomitant use of esomeprazole may result in subtherapeutic exposure of pazopanib for some patients 1.
Common questions
Can I take Lansoprazole and Pazopanib together?
Reduction in pazopanib bioavailability Always confirm with your pharmacist or prescriber before making any change.
How serious is the Lansoprazole and Pazopanib interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Lansoprazole or Pazopanib need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (3)
- Tan AR, Gibbon DG, Stein MN, et al: Effects of ketoconazole and esomeprazole on the pharmacokinetics of pazopanib in patients with solid tumors. Cancer Chemother Pharmacol 2013; 71(6):1635-1643. PubMed
- Product Information: VOTRIENT(R) oral tablets, pazopanib oral tablets. GlaxoSmithKline (per FDA), Research Triangle Park, NC, 2014. DailyMed
- McAlister RK, Aston J, Pollack M, et al: Effect of concomitant ph-elevating medications with pazopanib on progression-free survival and overall survival in patients with metastatic renal cell carcinoma. Oncologist 2018; 23(6):686-692. PubMed
Keep reading about Pazopanib
Keep reading about Lansoprazole
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