Drug Interactions between Prevacid NapraPAC and Zykadia
This report displays the potential drug interactions for the following 2 drugs:
- Prevacid NapraPAC (lansoprazole/naproxen)
- Zykadia (ceritinib)
Interactions between your drugs
naproxen lansoprazole
Applies to: Prevacid NapraPAC (lansoprazole / naproxen) and Prevacid NapraPAC (lansoprazole / naproxen)
GENERALLY AVOID: Theoretically, proton pump inhibitors may decrease the gastrointestinal absorption of enteric-coated naproxen, which requires an acidic environment for dissolution. The proposed mechanism is an increase in gastric pH (i.e. decreased gastric acidity) induced by proton pump inhibitors. In patients treated with proton pump inhibitors, the possibility of a reduced or subtherapeutic response to enteric-coated naproxen should be considered.
MANAGEMENT: Concomitant use of these drugs is generally not recommended.
References
- (2002) "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc
lansoprazole ceritinib
Applies to: Prevacid NapraPAC (lansoprazole / naproxen) and Zykadia (ceritinib)
MONITOR: Drugs that alter the pH of the upper gastrointestinal tract may affect the solubility of ceritinib and reduce its bioavailability. The interaction has not been formally studied; however, the solubility of ceritinib has been found to be pH-dependent in vitro and the drug becomes poorly soluble as pH increases.
MANAGEMENT: Until more information is available, caution is advised if ceritinib is used with drugs that can alter the gastric pH such as proton pump inhibitors, H2-receptor antagonists, and antacids. The potential for diminished therapeutic effects of ceritinib should be considered, and pharmacologic response should be closely monitored.
References
- (2014) "Product Information. Zykadia (ceritinib)." Novartis Pharmaceuticals
Drug and food interactions
ceritinib food
Applies to: Zykadia (ceritinib)
GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of ceritinib. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruit. Because ceritinib is associated with concentration-dependent prolongation of the QT interval, increased levels may potentiate the risk of ventricular arrhythmias such as torsade de pointes and sudden death. Other, more common side effects such as diarrhea, nausea, vomiting, abdominal pain, hyperglycemia, and bradycardia may also increase.
ADJUST DOSING INTERVAL: Food increases the oral bioavailability of ceritinib. The mechanism of interaction is unknown. Compared to the fast state, administration of a single 500 mg dose of ceritinib with a high-fat meal (approximately 1000 calories; 58 grams of fat) increased ceritinib peak plasma concentration (Cmax) and systemic exposure (AUC) by 41% and 73%, respectively, and administration with a low-fat meal (approximately 330 calories; 9 grams of fat) increased ceritinib Cmax and AUC by 43% and 58%, respectively. A dose of 600 mg or higher taken with a meal is expected to produce systemic exposure exceeding that from a 750 mg dose taken in the fasted state, which may lead to increased adverse effects.
MANAGEMENT: Patients treated with ceritinib should avoid consumption of grapefruit, grapefruit juice, and any supplement containing grapefruit extract. Ceritinib should be administered on an empty stomach (i.e., avoid administration within 2 hours of a meal).
References
- (2014) "Product Information. Zykadia (ceritinib)." Novartis Pharmaceuticals
naproxen food
Applies to: Prevacid NapraPAC (lansoprazole / naproxen)
GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.
MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.
References
- (2002) "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn
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.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
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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