Selected Kinase Inhibitors/H2 Antagonists Interactions

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:

Moderate. These medicines may cause some risk when taken together. 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 antagonists change the pH (acidity) in 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.If your cancer medicine is erlotinib, neratinib, nilotinib, or pexidartinib, take your cancer medicine at least 10 hours after and 2 hours before your H2 antagonist.If your cancer medicine is dacomitinib, take your cancer medicine at lease 10 hours after and 6 hours before your H2 antagonist.If your cancer medicine is gefitinib, take your cancer medicine at least 6 hours before or after your H2 antagonist.If you need to use an antacid while on bosutinib, nilotinib, or pexidartinib, take the antacid at least 2 hours before or 2 hours after your bosutinib, nilotinib, or pexidartinib.If you need to use an antacid while on gefitinib, take the antacid at least 6 hours before or after your gefitinib.If you need to use an antacid while on neratinib, take the antacid at least 3 hours before your neratinib.If you need to use an antacid while on dacomitinib, erlotinib, neratinib, or pazopanib, separate the doses of the antacid and your cancer medicine by several hours.If you have questions about how to schedule your medicines, ask your pharmacist.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.

  • 1.Bosulif (bosutinib) US prescribing information. Pfizer Inc. November 18, 2018.
  • 2.Vizimpro (dacomitinib) US prescribing information. Pfizer, Inc. September, 2018.
  • 3.Tarceva (erlotinib) US prescribing information. Genentech, Inc. October, 2016.
  • 4.Iressa (gefitinib) US prescribing information. AstraZeneca March 6, 2012. 5.Nerlynx (neratinib) US prescribing information. Puma Biotechnology, Inc. June, 2018.
  • 5.Tasigna (nilotinib) US prescribing information. Novartis Pharmaceuticals Corporation March, 2018.
  • 6.Turalio (pexidartinib) US prescribing information. Daiichi Sankyo, Inc. August, 2019.
  • 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.
  • 8.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.
  • 9.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.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.