Drug General Information (ID: DDI80ZGIOP)
Drug Name			Fluvastatin		Drug Info		Pazopanib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Statins/Antihyperlipidemic Agents				Vegf/Vegfr Inhibitors
Structure

Mechanism of Fluvastatin-Pazopanib Interaction (Severity Level: Moderate)
Increased risk of hepatotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Fluvastatin				Pazopanib
Mechanism		Hepatotoxicity				Hepatotoxicity
Key Mechanism Factor 1
		Factor Name		Hepatotoxicity
		Factor Description		Combination of drugs that can induce hepatotoxicity may increase the risk of liver injury. Symptoms vary depending on the level of exposure and the total extent of liver damage, and may cause few symptoms if the damage is mild, and eventually lead to liver failure in patients with severe damage.
Mechanism Description		Increased risk of hepatotoxicity by the combination of Fluvastatin and Pazopanib

Recommended Action
Management		Caution is advised if pazopanib is used in combination with simvastatin. Serum liver transaminases and bilirubin should be measured prior to initiation of pazopanib and regularly during treatment as recommended in the product labeling. If ALT elevations occur, simvastatin should be discontinued and guidelines for pazopanib dosage adjustments should be followed, or alternatives to pazopanib considered. Patients should be advised to seek medical attention if they experience potential signs and symptoms of hepatotoxicity such as fever, rash, itching, anorexia, nausea, vomiting, fatigue, malaise, right upper quadrant pain, dark urine, light colored stools, and jaundice. Insufficient data are available to assess the risk of pazopanib administered concomitantly with other HMG-CoA reductase inhibitors.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	Product Information. Votrient (pazopanib). GlaxoSmithKline, Research Triangle Park, NC.
3	Richter WO, Jacob BG, Schwandt P "Interaction between fibre and lovastatin." Lancet 338 (1991): 706. [PMID: 1679514]