Pazopanib and Nizatidine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Pazopanib
Nizatidine
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
Decreased pazopanib bioavailability
Interaction Deep Dive
Concomitant use of pazopanib and drugs that raise gastric pH, such as H2 blockers, should be avoided. The absorption and solubility of pazopanib depends on an acidic environment and will be reduced with coadministration, which may result in subtherapeutic exposure of pazopanib in some patients1. However, in another study there were no significant effects on PFS or OS when coadministered in patients with metastatic renal cell carcinoma 3. If a concomitant gastric acid agent is required, consider using short-acting antacids instead of the H2 blocker and allow several hours between dosing of pazopanib and the antacid 2. Or consider alternative dosing regimens that do not increase gastric pH at the time of pazopanib dosing or administer pazopanib at a time when gastric pH is expected to be low, such as late evening 1.
Why it happens (mechanism)
Decreased solubility and absorption of pazopanib due to increased gastric pH by H2 blockers
Literature reports
1 report — 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.
Common questions
Can I take Pazopanib and Nizatidine together?
Decreased pazopanib bioavailability Always confirm with your pharmacist or prescriber before making any change.
How serious is the Pazopanib and Nizatidine 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 "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Pazopanib or Nizatidine 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 Nizatidine
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist