Bosutinib; Dasatinib; Erlotinib; Nilotinib/H2 Blockers; PPIs
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
The pH of your GI tract needs to be acidic for your cancer medicine to dissolve and be absorbed. H2 blockers and proton pump inhibitors change the pH (acidity) your GI tract.
What might happen:
The amount of cancer medicine in your blood may decrease and it may not work as well.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may instruct you to take antacids instead of your H2 blocker or proton pump inhibitor.If you need to use an antacid while on bosutinib or dasatinib, take the antacid at least 2 hours before or 2 hours after your bosutinib or dasatinib.If you need to use an antacid while on erlotinib or nilotinib, separate the doses of the antacid and your cancer medicine by several hours.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
References:
1.Bosulif (bosutinib) US prescribing information. Pfizer Inc. August, 2012.
2.Sprycel (dasatinib) US prescribing information. Bristol-Myers Squibb Company October, 2011.
3.Tarceva (erlotinib) US prescribing information. Genentech, Inc. April, 2012.
4.Tasigna (nilotinib) US prescribing information. Novartis Pharmaceuticals Corporation December, 2012.
5.Yin OQ, Gallagher N, Fischer D, Demirhan E, Zhou W, Golor G, Schran H. Effect of the Proton Pump Inhibitor Esomeprazole on the Oral Absorption and Pharmacokinetics of Nilotinib. J Clin Pharmacol 2010 May 24.
6.Quinn DI, Nemunaitis J, Fuloria J, Britten CD, Gabrail N, Yee L, Acharya M, Chan K, Cohen N, Dudov A. Effect of the cytochrome P450 2C19 inhibitor omeprazole on the pharmacokinetics and safety profile of bortezomib in patients with advanced solid tumours, non-Hodgkin's lymphoma or multiple myeloma. Clin Pharmacokinet 2009;48(3):199-209.
7.Ter Heine R, Fanggiday JC, Lankheet NA, Beijnen JH, Van Der Westerlaken MM, Staaks GH, Malingre MM. Erlotinib and pantoprazole: a relevant interaction or not?. Br J Clin Pharmacol 2010 Dec;70(6):908-11.
