4.1 Article

Dangerous interaction of bitter melon (Momordica charantia) with pazopanib: A case of acute pancreatitis

Journal

JOURNAL OF ONCOLOGY PHARMACY PRACTICE
Volume 28, Issue 2, Pages 486-488

Publisher

SAGE PUBLICATIONS LTD
DOI: 10.1177/10781552211040725

Keywords

Acute pancreatitis; bitter melon; M omordica charantia; Pazopanib; renal cell carcinoma

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This report describes a 65-year-old patient with renal cell carcinoma who was admitted to the hospital with symptoms of acute pancreatitis after 8 years of Pazopanib treatment. The patient had taken Bitter Melon extract prior to the onset of symptoms, and it is suggested that an interaction between Bitter Melon extract and Pazopanib may have led to acute pancreatitis.
Introduction Acute pancreatitis associated with Pazopanib has been reported in the literature. Bitter Melon (Momordica Charantia) is traditionally used as a folk medicine in many regions. In this report, we describe a 65-year-old patient with a diagnosis of renal cell carcinoma, admitted to the hospital with symptoms of acute pancreatitis at the 8th year of pazopanib treatment. Case Report The patient diagnosed with renal cell carcinoma was admitted to the hospital with the complaint of abdominal pain, nausea, and vomiting in the 8th year of Pazopanib treatment. It was noticed from the patient's history that he had received Bitter Melon extract for 4 days prior to the beginning of his complaints (100-150 ml/day). Levels of serum amylase and lipase were measured as 9163 U/L and 14,206 U/L, respectively. Management & Outcome Pazopanib drug was held. The patient was treated for acute pancreatitis. Pazopanib treatment was started again after the clinical condition of the patient had improved and levels of serum amylase and lipase had returned to normal levels. Levels of serum amylase and lipase did not increase again after re-administration of pazopanib treatment. Discussion It is thought that Bitter Melon extract and pazopanib interaction might have led to acute pancreatitis. To the best of our knowledge, this case is the first to highlight the interaction of Bitter Melon extract with pazopanib. The Drug Interaction Probability Scale indicates that there is a probable association between bitter melon and acute pancreatitis.

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