Drug & supplement interaction

Bitter Melon + Pazopanib

Pazopanib brand name: Votrient.

Moderate Interaction
The bottom line Moderate

Pazopanib falls into 2 drug categories that Bitter Melon can interact with; the most serious is rated moderate. Theoretically, bitter melon might increase levels of P-glycoprotein substrates.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Bitter Melon and Pazopanib

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Bitter Melon interacts with whole categories of medication. Pazopanib falls into 2 of those categories, so it can interact with Bitter Melon in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

P-GLYCOPROTEIN SUBSTRATES

1 of 2

Why this applies to Pazopanib

Pazopanib falls under P-GLYCOPROTEIN SUBSTRATES — the group Bitter Melon interacts with.

Theoretically, bitter melon might increase levels of P-glycoprotein substrates.
Bitter melon might inhibit the p-glycoprotein (P-gp) intestinal pump and increase intracellular levels of P-gp substrates. In vitro research in intestinal cells shows that 1-monopalmitin, a constituent of bitter melon, increases levels of daunomycin, a P-gp substrate. Additionally, drinking bitter melon juice has been associated with a case of acute pancreatitis in a patient who had been taking pazopanib, a P-gp substrate, for 8 years. Researchers theorize that inhibition of P-gp led to increased levels of pazopanib, resulting in pazopanib-induced pancreatitis.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for Votrient (pazopanib). Your body uses a little 'pump' in the gut called P-glycoprotein to push some of the drug back out, which helps keep your levels in check. Bitter melon may block that pump, so more pazopanib could end up getting absorbed and building up in your system. Higher levels can mean stronger side effects, things like high blood pressure, diarrhea, liver irritation, fatigue, and in one reported case, inflammation of the pancreas (pancreatitis).

I want to be honest about the strength of this: it's mostly theoretical, based on lab cell studies plus a single patient report, so we don't know how often it really happens. Still, since pazopanib is a serious cancer medicine, I'd play it safe and check with your oncologist or pharmacist before adding bitter melon in any concentrated supplement form.

References
  1. Konishi T, Satsu H, Hatsugai Y, et al. Inhibitory effect of a bitter melon extract on the P-glycoprotein activity in intestinal Caco-2 cells. Br J Pharmacol. 2004;143(3):379-87. PubMed
  2. Unsal O, Sütcüoglu O, Yazici O. Dangerous interaction of bitter melon (Momordica charantia) with pazopanib: a case of acute pancreatitis. J Oncol Pharm Pract 2022;28(2):486-8.
Moderate

PAZOPANIB (Votrient)

2 of 2
Theoretically, bitter melon might increase levels of pazopanib, potentially increasing the risk of adverse effects.
In one case, a 65-year-old patient taking pazopanib for 8 years for renal cell carcinoma experienced signs and symptoms consistent with acute pancreatitis 4 days after drinking bitter melon juice at a dose of 100-150 mL daily. The patient's symptoms, amylase levels, and lipase levels improved upon discontinuation of bitter melon and pazopanib. Pazopanib treatment was re-initiated with no further evidence of pancreatitis. Researchers theorize that inhibition of P-glycoprotein by bitter melon led to increased levels of pazopanib, a P-glycoprotein substrate, resulting in pazopanib-induced pancreatitis.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with pairing bitter melon with your pazopanib (Votrient). Pazopanib relies on a cellular pump called P-glycoprotein to help move it out of the body. Bitter melon may block that pump, which could let pazopanib build up to higher levels than intended. When levels climb, the usual side effects can hit harder, things like high blood pressure, nausea, diarrhea, fatigue, liver enzyme changes, and in one reported case, inflammation of the pancreas (pancreatitis).

I want to be honest about the evidence here. This is theoretical and rests mostly on a single case report involving concentrated bitter melon juice, not everyday food amounts. It's worth a conversation, not panic. Please don't change anything on your own. Check with your oncologist or pharmacist before using bitter melon supplements or juice while on pazopanib.

References
  1. Unsal O, Sütcüoglu O, Yazici O. Dangerous interaction of bitter melon (Momordica charantia) with pazopanib: a case of acute pancreatitis. J Oncol Pharm Pract 2022;28(2):486-8.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Bitter Melon Also Interacts With Other Medications

Bitter Melon has 281 moderate known drug interactions in our database — the Pazopanib one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Bitter Melon

Covers the 2,830 medications we’ve checked against Bitter Melon. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Pazopanib

This page covers Bitter Melon only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pazopanib page lists 349 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Asarabacca (major) and Beer (major).

By severity: 14 major · 297 moderate · 38 minor.

From our pharmacist’s overview on the Pazopanib page

“Take a careful look before mixing supplements with pazopanib (Votrient), an oral pill for advanced kidney cancer and certain sarcomas. Fourteen of the 349 ingredients on file are rated major, grapefruit among them, since it can raise pazopanib levels enough to intensify side effects.”

Reviewed by 2 · Jul 18, 2026

Open the Pazopanib interaction page

One more smart check

Taking Bitter Melon as Part of a Dietary Supplement Product? Check It for Interactions

We hold 736 real supplement products containing Bitter Melon, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bitter Melon. Your product may carry other ingredients that interact with Pazopanib too, on top of Bitter Melon — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Bitter Melon and Pazopanib Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Bitter Melon
Top 25%

#238 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Pazopanib
Steady interest

#2,599 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Bitter Melon

What is Bitter Melon?

Bitter Melon
  • Blood sugar support
  • Diabetes
  • Digestive complaints
  • Antioxidant source
  • Skin conditions

Bitter melon is a tropical fruit eaten as food and used in traditional medicine, most often for blood sugar control. While some small studies hint it may modestly lower blood sugar, the evidence is limited and inconsistent, so it should not replace proven diabetes treatment. Talk with your pharmacist or doctor before using it, especially if you take diabetes medicines or are pregnant.

Read the full Bitter Melon monograph & all interactions
Medication

About Pazopanib

What Is Pazopanib Used For?

Brand name: Votrient

Pazopanib tablets — sold as the brand Votrient and as generic pazopanib — are used to treat two types of advanced cancer in adults: advanced renal cell carcinoma (RCC), the most common form of kidney cancer, and advanced soft tissue sarcoma (STS) in patients who have already received prior chemotherapy.

Important limitation: Pazopanib has not been shown to work in adipocytic soft tissue sarcoma (a subtype involving fat cells) or in gastrointestinal stromal tumors (GISTs), so it is not used for those cancers.

See full Pazopanib drug information
Keep checking

Other Drugs & Bitter Melon

Browse every other medication we’ve checked against Bitter Melon — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
281Moderate
0Minor
2,548No known interaction
Moderate

281 interactions

Showing 60 of 281 moderate interactions — see all 281 on the Bitter Melon page.

No interaction 2,548 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Bitter Melon and Pazopanib Together: Common Questions

Can you take Bitter Melon with Pazopanib?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Bitter Melon and Pazopanib?
Pazopanib belongs to more than one drug category, and Bitter Melon interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Bitter Melon and Pazopanib interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.