Drug Interaction Report

Nirogacestat and Dexlansoprazole: Interaction Details

A pharmacist-reviewed analysis of the Nirogacestat and Dexlansoprazole interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Dexlansoprazole

Dexilant Dexilant® (formerly available as Kapidex®)
+

Nirogacestat

Ogsiveo
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
LinkedIn
Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 55 documented Nirogacestat interactions, 53 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
probable
Severity
Major

What happens

Reduced nirogacestat/CYP2C19 substrate exposure and reduced efficacy of nirogacestat/CYP2C19 substrate

Interaction Deep Dive

Avoid concomitant use of nirogacestat with CYP2C19 substrates that are also proton pump inhibitors. Nirogacestat decreases exposure of CYP2C19 substrates, where decreased concentrations of CYP2C19 substrates may lead to significant decreases in efficacy of the CYP2C19 substrate. If concomitant use cannot be avoided, nirogacestat can be staggered with antacids (eg, administer nirogacestat 2 hours before or 2 hours after antacid use). Nirogacestat is poorly soluble at pH 6 or greater. Gastric acid reducing agents may decrease serum nirogacestat exposure, which may reduce the effectiveness of nirogacestat1.

Why it happens (mechanism)

Reduced gastric acidity; induction of CYP2C19-substrate metabolism by nirogacestat

Literature reports

2 reports — tap to read

a) Concomitant use of multiple doses of nirogacestat (150 mg twice daily) with a drug that is a sensitive substrate of CYP2C19 decreases the plasma concentrations of these substrates 1.

b) Concomitant administration of nirogacestat with proton pump inhibitors (eg, omeprazole) is expected to reduce concentrations of nirogacestat 1.

Common questions

Can I take Nirogacestat and Dexlansoprazole together?

Reduced nirogacestat/CYP2C19 substrate exposure and reduced efficacy of nirogacestat/CYP2C19 substrate Always confirm with your pharmacist or prescriber before making any change.

How serious is the Nirogacestat and Dexlansoprazole interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

  • Does my dose of Nirogacestat or Dexlansoprazole need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (1)

  1. Product Information: OGSIVEO(TM) oral tablets, nirogacestat oral tablets. SpringWorks Therapeutics, Inc. (per FDA), Stamford, CT, 2023. DailyMed
Was this write-up helpful?
Dexlansoprazole

Keep reading about Dexlansoprazole

All Dexlansoprazole interactions (77) Dexlansoprazole drug information
Also serious with: Rilpivirine Dacomitinib Octreotide Injection Amphetamine
Nirogacestat

Keep reading about Nirogacestat

All Nirogacestat interactions (55)
Also serious with: Entrectinib Clindamycin Topical Olaparib Abemaciclib
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Dexlansoprazole + Activated Charcoal Grapefruit St. John's Wort Acacia Rigidula Adrafinil African Wild Potato American Elder Artichoke + 145 more
Nirogacestat + Activated Charcoal Beer Grapefruit Siberian Cocklebur St. John's Wort Wine Acacia Rigidula Adrafinil + 160 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

Check another combination

Our instant two-drug interaction checker is almost here.

Coming soon

The instant two-drug checker is on its way.

In the meantime, browse the directory below to look up any drug and see its documented interactions.

Still have questions about this combination?

Every question gets a real answer from a licensed pharmacist — free, and usually within a day.

Ask the pharmacist
This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.