Interaction between Erlotinib and Rabeprazole
Major
Absorption
| ID | DDInter667 and DDInter1559 |
| Interaction |
Concurrent administration of agents that increase gastric pH such as proton pump inhibitors may decrease the oral bioavailability of erlotinib and reduce its concentrations in plasma. The solubility of erlotinib decreases when the pH is over 5, resulting in reduced absorption. Moreover, since proton pump inhibitors affect pH of the upper gastrointestinal tract for an extended period, separation of doses may not eliminate the interaction.
alopecia
Amnesia
asthenia
bronchitis
dehydration
diarrhea
drowsiness
eczema
body temperature increased
hirsuitism
More
|
| Management | The concomitant use of erlotinib with proton pump inhibitors should generally be avoided. If acid-suppression therapy is required during erlotinib treatment, an H2-receptor antagonist such as ranitidine may be considered. Available pharmacokinetic data suggest that erlotinib should be administered once a day, at least 2 hours before or 10 hours after dosing of the H2-receptor antagonist. Additionally, the lowest effective dosage of the H2-receptor antagonist should be prescribed. |
| References | |
| Alternative for Erlotinib |
L01X
More
|
| Alternative for Rabeprazole |
A02B
M01A
More
|
Potential Metabolism Interactions
Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.