Relugolix and Pazopanib: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Pazopanib
Relugolix
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.
Both pazopanib (a cancer medicine) and relugolix (used for prostate cancer) can affect the timing of your heartbeat. Doctors call this QT prolongation. When two medicines that both do this are taken together, the effect can add up and, in rare cases, lead to an irregular heartbeat.
The good news is that this is mostly a theoretical concern, and your care team knows how to keep an eye on it. They may check your heart with an ECG and run blood tests to make sure your minerals (like potassium and magnesium) stay in a healthy range. Please keep taking both exactly as prescribed and talk with your doctor or pharmacist before making any changes.
Effect: Additive QT-interval prolongation from concurrent pazopanib and relugolix. Both agents independently prolong the QT interval (pazopanib via direct QT effects; androgen deprivation from relugolix can prolong QT), so the risk is additive (PD interaction, not a metabolic/prodrug issue).
- Direction: Increased QT prolongation / torsades risk.
- Onset: Unspecified.
- Evidence: Theoretical.
- Severity: Major.
Management: Avoid combination when feasible. Weigh ADT benefit against risk in congenital long QT, CHF, or recurrent electrolyte disturbance. If coadministered, correct and maintain normal potassium/magnesium, avoid other QT-prolonging or electrolyte-depleting drugs, and consider periodic ECG and electrolyte monitoring.
What happens
Increased risk of QT interval prolongation
Interaction Deep Dive
When relugolix is given together with medications that prolong the QT interval, the effects on the QT interval are additive. The androgen deprivation produced by GnRH agonists and antagonists can itself prolong the QT interval. In patients who have congenital long QT syndrome, congestive heart failure, or recurrent electrolyte disturbances, as well as in those receiving drugs recognized to prolong the QT interval, weigh whether the benefits of androgen deprivation therapy such as relugolix outweigh the potential risks 1. Where feasible, do not use relugolix concurrently with QT prolonging agents. Should coadministration be necessary, refrain from using drugs that produce electrolyte abnormalities (that is, hypokalemia or hypomagnesemia) 2, correct any electrolyte abnormalities, and consider periodic monitoring of ECGs and electrolytes 1.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Your care team can manage this safely. Because both drugs can affect heart rhythm, here is what typically happens:
- They weigh the benefits of therapy against your personal heart risk factors (such as a history of long QT, heart failure, or frequent low potassium or magnesium).
- They may check ECGs and electrolytes from time to time.
- They will correct any low potassium or magnesium and try to avoid other medicines that lower these minerals.
What you should do: Keep taking both medicines as prescribed. Tell your pharmacist or doctor about any fainting, dizziness, or palpitations, and check before starting any new medicine.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) A study assessed male patients undergoing androgen deprivation therapy (ADT) using individual case safety reports from VigiBase, the international pharmacovigilance database, and identified 184 cases of acquired long-QT syndrome (aLQTS) and/or torsades de pointes (TdP; 11% fatal cases), along with 99 cases of sudden death linked to ADT. The majority of aLQTS/TdP cases (62%) and sudden death cases (88%) related to ADT arose without concurrent use of other agents known to elevate TdP risk; nevertheless, use of 1 drug and 2 or more drugs carrying conditional, possible, or known TdP risk was documented in a portion of aLQTS/TdP (23% or 43%) and sudden death (18% and 22%) events. The agents classified as ADTs included abiraterone, gonadotropin-releasing hormone agonists and antagonists, nonsteroidal androgen receptor inhibitors indicated for prostate cancer, and 5-alpha-reductase inhibitors indicated for androgenic alopecia and prostatism. Among the 10 ADTs assessed, 7 showed a disproportional association (reporting odds ratio, 1.4 to 4.7) with aLQTS, TdP, or sudden death, namely leuprorelin, goserelin, triptorelin, degarelix, bicalutamide, finasteride, and dutasteride. The median patient age was approximately 76 years, and the median time to onset was 170 days (range, 7 to 4884 days) for aLQTS/TdP events and 92 days (range, 0.25 to 4984 days) for sudden death events. Patients were primarily receiving ADT for prostate cancer, with some treated for prostatism and androgenic alopecia. Most patients were on ADT monotherapy (83%); 17% were receiving ADT combination therapy 3.
Common questions
Can I take Relugolix and Pazopanib together?
Combining pazopanib and relugolix can add up to affect heart rhythm (QT prolongation), so your team may monitor your ECG and electrolytes and avoid the combination when possible. Keep taking both as prescribed and report any dizziness, fainting, or palpitations. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Relugolix 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 is the Relugolix and Pazopanib interaction managed?
Your care team can manage this safely. Because both drugs can affect heart rhythm, here is what typically happens: They weigh the benefits of therapy against your personal heart risk factors (such as a history of long QT, heart failure, or frequent low potassium or magnesium). They may check ECGs and electrolytes from time to time. They will correct any low potassium or magnesium and try to avoid… Management is individual — always follow your own care team's guidance.
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 Relugolix 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)
- Product Information: ORGOVYX oral tablets, relugolix oral tablets. Sumitomo Pharma America, Inc (per FDA), Marlborough, MA, 2025. DailyMed
- Lyon AR, Lopez-Fernandez T, Couch LS, et al: 2022 ESC guidelines on cardio-oncology developed in collaboration with the European Hematology Association (EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS). Eur Heart J 2022; 43(41):4229-4361.
- Salem JE, Yang T, Moslehi JJ, et al: Androgenic effects on ventricular repolarization: a translational study from the international pharmacovigilance database to iPSC-cardiomyocytes. Circulation 2019; 140(13):1070-1080. PubMed
Keep reading about Pazopanib
Keep reading about Relugolix
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