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Drug Interactions between Acid Reducer Maximum Strength and dacomitinib

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

famotidine dacomitinib

Applies to: Acid Reducer Maximum Strength (famotidine) and dacomitinib

ADJUST DOSING INTERVAL: Coadministration with proton pump inhibitors (PPIs) may decrease the plasma concentrations of dacomitinib. The proposed mechanism is a pH-dependent reduction in dissolution or absorption of dacomitinib due to prolonged gastric acid suppression induced by PPIs. When a single 45 mg dose of dacomitinib was coadministered with rabeprazole (40 mg once daily for 7 days) in 24 healthy subjects, dacomitinib peak plasma concentration (Cmax) and systemic exposure (AUC 0 to 96 hours) decreased by approximately 51% and 39%, respectively, compared to dacomitinib administered alone. By contrast, administration of dacomitinib with a local antacid (aluminum hydroxide-magnesium hydroxide 400 mg-400 mg/5 mL) did not cause clinically relevant changes in dacomitinib concentrations. The lack of a significant interaction may be due to the shorter duration of action of antacids relative to PPIs. The interaction has not been studied with H2-receptor antagonists. Based on pooled data in clinical study patients, H2-receptor antagonists had no apparent effect on steady-state trough concentration of dacomitinib.

MANAGEMENT: The manufacturer recommends taking dacomitinib at least 6 hours before or 10 hours after H2-receptor antagonists. As an alternative, locally-acting antacids may be considered. Concomitant use of dacomitinib with PPIs should generally be avoided.

References

  1. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  2. (2018) "Product Information. Vizimpro (dacomitinib)." Pfizer U.S. Pharmaceuticals Group

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Drug and food interactions

Minor

famotidine food

Applies to: Acid Reducer Maximum Strength (famotidine)

H2 antagonists may reduce the clearance of nicotine. Cimetidine, 600 mg given twice a day for two days, reduced clearance of an intravenous nicotine dose by 30%. Ranitidine, 300 mg given twice a day for two days, reduced clearance by 10%. The clinical significance of this interaction is not known. Patients should be monitored for increased nicotine effects when using the patches or gum for smoking cessation and dosage adjustments should be made as appropriate.

References

  1. Bendayan R, Sullivan JT, Shaw C, Frecker RC, Sellers EM (1990) "Effect of cimetidine and ranitidine on the hepatic and renal elimination of nicotine in humans." Eur J Clin Pharmacol, 38, p. 165-9

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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