Drug General Information (ID: DDIYK7JDI8)
Drug Name			Pazopanib		Drug Info		Calcium carbonate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Vegf/Vegfr Inhibitors				Antacids/Minerals And Electrolytes
Structure

Mechanism of Pazopanib-Calcium carbonate Interaction (Severity Level: Moderate)
Altered gastric pH Click to Show/Hide Mechanism Graph
Drug Name		Pazopanib				Calcium carbonate
Mechanism		Gastric pH sensitive				Gastric alkalinizer
Key Mechanism Factor 1
		Factor Name		Gastric pH
		Factor Description		The normal pH range of gastric acid is between 1.5 and 3.5 and is highly acidic, consisting mainly of hydrochloric acid. Changes in the pH of the stomach can alter the absorption of drugs.
Mechanism Description		Decreased absorption of Pazopanib due to altered gastric pH caused by Calcium carbonate

Recommended Action
Management		Concomitant use of pazopanib with drugs that increase gastric pH should generally be avoided. If acid-suppression therapy is required, short-acting antacids should be considered, with dosing separated by several hours from pazopanib dosing.

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2	EMEA. European Medicines Agency "EPARs. European Union Public Assessment Reports.".
3	Product Information. Votrient (pazopanib). GlaxoSmithKline, Research Triangle Park, NC.
4	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 71 (2013): 1635-43. [PMID: 23636448]
5	van Leeuwen RW, van Gelder T, Mathijssen RH, Jansman FG "Drug-drug interactions with tyrosine-kinase inhibitors: a clinical perspective." Lancet Oncol 15 (2014): e315-e326. [PMID: 24988935]
6	Yu G, Zheng QS, Wang DX, Zhou HH, Li GF "Drug interactions between tyrosine-kinase inhibitors and acid suppressive agents: more than meets the eye." Lancet Oncol 15 (2014): e469-70. [PMID: 25281461]