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 or nilotinib, 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 nilotinib, take the antacid at least 2 hours before or 2 hours after your nilotinib.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 dacomitinib or erlotinib, 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.Vizimpro (dacomitinib) US prescribing information. Pfizer, Inc. September, 2018.
  • 2.Tarceva (erlotinib) US prescribing information. Genentech, Inc. October, 2016.
  • 3.Iressa (gefitinib) US prescribing information. AstraZeneca March 6, 2012.
  • 4.Tasigna (nilotinib) US prescribing information. Novartis Pharmaceuticals Corporation September, 2021.
  • 5.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.
  • 6.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.

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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.