Drug Interactions between macitentan / tadalafil and pazopanib

Do not consume grapefruit or grapefruit juice during treatment with PAZOPanib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of PAZOPanib, which may lead to an increased risk of serious side effects such as liver damage, irregular heart rhythm, bleeding, high blood pressure, heart attack, and stroke. Taking PAZOPanib with food can also significantly increase its absorption and levels in the blood. Therefore, you should take PAZOPanib on an empty stomach, at least one hour before or two hours after eating. Call your doctor immediately if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. You should also seek immediate medical attention if you experience signs and symptoms that could indicate cardiovascular problems such as sudden dizziness; lightheadedness; fainting; fast or pounding heartbeats; chest pain or tightness; pain in your arms, back, neck, or jaw; shortness of breath; numbness or weakness on one side of your body; and slurred speech or difficulty speaking. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Tadalafil can lower blood pressure, and combining it with alcohol may further increase this effect. You may be more likely to experience symptoms such as dizziness, lightheadedness, fainting, flushing, headache, and heart palpitations. You should avoid or limit the use of alcohol to not more than 4 alcohol-containing drinks during a small period of time while being treated with tadalafil, and use caution when getting up from a sitting or lying position. You may also want to avoid drinking large amounts of grapefruit juice, since it may increase the blood levels and effects of tadalafil. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.