Drug interactions between Gleevec and Prevacid
Results for the following 2 drugs: |
|
|---|---|
| Gleevec (imatinib) | |
| Prevacid (lansoprazole) | |
Interactions between your selected drugs
lansoprazole ⇔ imatinib
Applies to: Prevacid (lansoprazole) and Gleevec (imatinib)
MONITOR: Theoretically, coadministration with imatinib may increase the plasma concentrations of lansoprazole. The proposed mechanism is imatinib inhibition of lansoprazole metabolism via CYP450 2C9 and 3A4. There has also been a reported case of a patient with gastrointestinal stromal tumors who developed severe cutaneous adverse reactions during treatment with imatinib and lansoprazole. The patient had been receiving imatinib 400 mg/day alone for two months without incident. Ten days after lansoprazole 15 mg/day was added for dyspepsia, the patient exhibited bilateral palpebral edema with hyperemic conjunctivae and labial edema. The drugs were immediately withdrawn and were restarted five days later, whereupon the symptoms reappeared promptly within 24 hours. The patient was treated with a piperazine antihistamine but subsequently developed mucocutaneous lesions that led to her hospitalization with a diagnosis of Stevens-Johnson syndrome. The patient recovered following discontinuation of the drugs and treatment with methylprednisolone and desloratadine for 30 days. A reintroduction of imatinib at 300 mg/day, along with methylprednisolone and desloratadine, resulted in a third episode of cutaneous adverse reactions when the patient failed to inform her physicians that she had taken a dose of lansoprazole the day before. The drugs were withdrawn and the patient once again recovered. The mechanism of this potential interaction is unknown, but involvement of CYP450 3A4 metabolism is suspected.
MANAGEMENT: Until more data are available, caution is advised if imatinib must be used in combination with lansoprazole.
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