Neratinib with Omeprazole Interaction Details


Brand Names Associated with Neratinib

  • Neratinib
  • Nerlynx®

Brand Names Associated with Omeprazole

  • Omeprazole
  • Prilosec®
  • Prilosec® OTC
  • Talicia (as a combination product containing Amoxicillin, Omeprazole, Rifabutin)
  • Zegerid® (as a combination product containing Omeprazole, Sodium Bicarbonate)
  • Zegerid® OTC (as a combination product containing Omeprazole, Sodium Bicarbonate)

Medical Content Editor
Last updated Dec 29, 2023


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Interaction Effect

Decreased neratinib solubility, absorption, and exposure


Interaction Summary

Coadministration of neratinib with agents that increase the gastric pH, such as a proton pump inhibitor, may result in a decrease in neratinib plasma concentration and AUC resulting in reduced efficacy. Avoid concomitant use of neratinib with proton pump inhibitors. A single dose of neratinib given concomitantly with lansoprazole decreased the neratinib Cmax by 71% and the AUC by 65%.


Severity

Major


Onset

Unspecified


Evidence

Probable


How To Manage Interaction

Coadministration of neratinib with agents that increase the gastric pH, such as a proton pump inhibitor, may result in a decrease in neratinib plasma concentration and AUC resulting in reduced efficacy. Avoid concomitant use of neratinib with proton pump inhibitors.


Mechanism Of Interaction

Increased gastric pH by the proton pump inhibitor


Literature Reports

A) Coadministration of a single oral dose of neratinib 240 mg with lansoprazole 30 mg orally at steady state decreased the neratinib Cmax by 71% and the AUC by 65% in a drug interaction study in healthy subjects (N=15) .

Neratinib Overview

  • Neratinib is used to treat a certain type of hormone receptor-positive breast cancer (breast cancer that depends on hormones such as estrogen to grow) in adults after treatment with trastuzumab (Herceptin) and other medications. Neratinib is used along with capecitabine (Xeloda) to treat a certain type of advanced hormone receptor-positive breast cancer or breast cancer that has spread to other parts of the body after treatment with at least two other medications. Neratinib is in a class of medications called kinase inhibitors. It works by blocking the action of an abnormal protein that signals cancer cells to multiply. This helps slow or stop the spread of cancer cells.

See More information Regarding Neratinib

Omeprazole Overview

  • Prescription omeprazole is used alone or with other medications to treat the symptoms of gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and possible injury of the esophagus (the tube between the throat and stomach) in adults and children 1 year of age and older. Prescription omeprazole is used to treat damage from GERD in adults and children 1 month of age and older. Prescription omeprazole is used to allow the esophagus to heal and prevent further damage to the esophagus in adults and children 1 year of age and older with GERD. Prescription omeprazole is also used to treat conditions in which the stomach produces too much acid such as Zollinger-Ellison syndrome in adults. Prescription omeprazole is also used to treat ulcers (sores in the lining of the stomach or intestine) and it is also used with other medications to treat and prevent the return of ulcers caused by a certain type of bacteria (H. pylori) in adults. Nonprescription (over-the-counter) omeprazole is used to treat frequent heartburn (heartburn that occurs at least 2 or more days a week) in adults. Omeprazole is in a class of medications called proton-pump inhibitors. It works by decreasing the amount of acid made in the stomach.

See More information Regarding Omeprazole

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.


Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.


Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.


Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.


Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.


Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.


How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.


Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.


Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.