Simvastatin and Pazopanib: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 4, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Pazopanib
Simvastatin
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.
You've been prescribed pazopanib (a cancer medicine) and simvastatin (a cholesterol medicine). Both of these drugs can stress the liver on their own, and when they're taken together, the chance of your liver showing signs of stress goes up. Doctors watch for this by checking a blood test called ALT, which rises when liver cells are irritated.
In studies, people taking both drugs had ALT go up more often than people taking pazopanib alone. The good news is this is very manageable. Your care team will keep an eye on your liver with regular blood tests and can adjust things if needed. Please don't stop either medicine on your own, just talk with your oncologist or pharmacist about the best plan.
Effect: Increased risk of ALT elevation with concurrent pazopanib and simvastatin.
- Direction/magnitude: ALT >3x ULN occurred in 27% (11/41) of patients on concomitant simvastatin vs 14% (126/895) not on statins. Additive hepatotoxicity.
- Mechanism: Unknown; both agents carry independent hepatotoxic potential. (Neither is a prodrug relevant here.)
- Onset: Unspecified. Evidence: Established.
- Management: Monitor ALT closely at baseline and periodically. Pazopanib dose reduction, interruption, or discontinuation may be required if transaminases rise; consider an alternative statin or alternative to pazopanib per label guidance.
What happens
Increased risk of ALT elevation
Interaction Deep Dive
Taking pazopanib together with simvastatin can lead to increases in ALT. Among patients treated with pazopanib, ALT elevations (defined as ALT above 3 times the ULN) occurred at a rate of 27% (11 of 41) in those also taking simvastatin, versus 14% (126 of 895) among patients not on any statin. When these two agents are given together, exercise caution and monitor ALT levels carefully. Should ALT elevations occur, it may be necessary to reduce the dose of pazopanib, pause it, or stop it altogether. Choosing a different option in place of pazopanib may likewise be appropriate1.
Why it happens (mechanism)
Unknown
How to manage this interaction
This combination is manageable when your team keeps an eye on your liver.
- Keep taking both exactly as prescribed unless your doctor tells you otherwise.
- Expect regular liver blood tests (ALT) so your team can catch any changes early.
- If your ALT rises, your care team may adjust, pause, or change your pazopanib dose, or consider a different medicine option. These decisions will be individualized for you.
- Tell your pharmacist or prescriber about any yellowing of skin or eyes, dark urine, unusual tiredness, or right-side belly pain.
Bring up any concerns about your statin at your next visit.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Simvastatin and Pazopanib together?
Taking pazopanib with simvastatin raises the chance of liver enzyme (ALT) elevations, so your care team will monitor your liver more closely and may adjust your pazopanib if needed. Keep taking both as prescribed and report symptoms like yellowing skin or unusual fatigue. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Simvastatin 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 Simvastatin and Pazopanib interaction managed?
This combination is manageable when your team keeps an eye on your liver. Keep taking both exactly as prescribed unless your doctor tells you otherwise. Expect regular liver blood tests (ALT) so your team can catch any changes early. If your ALT rises, your care team may adjust, pause, or change your pazopanib dose, or consider a different medicine option. These decisions will be individualized fo… Management is individual — always follow your own care team's guidance.
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 Simvastatin 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 (1)
- Product Information: VOTRIENT oral tablets, pazopanib oral tablets. GlaxoSmithKline (per FDA), Research Triangle Park, NC, 2012. DailyMed
Keep reading about Pazopanib
Keep reading about Simvastatin
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.
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