Nizatidine and Nilotinib: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Nilotinib
No brand names on recordNizatidine
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.
What happens
Reduced nilotinib exposure
Interaction Deep Dive
The solubility of nilotinib is pH-dependent, and absorption and subsequent bioavailability may be reduced when coadministered with a H2 blocker, which raises the pH of the upper gastrointestinal tract. In healthy subjects, when a single 400 mg dose of nilotinib was administered 2 hours before and 10 hours after famotidine (an H2 blocker) there were no significant changes in nilotinib pharmacokinetics1. There was also no significant change in the efficacy of nilotinib observed with concurrent administration of a proton pump inhibitor (PPI) or H2 blocker for any duration compared with patients with no PPI or H2 blocker use during a retrospective review of 2 clinical trials (n=748) in patients with Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase 3. If concurrent use is required, it is recommended to administer the H2 blocker approximately 10 hours before or 2 hours after nilotinib 12.
Why it happens (mechanism)
Reduced solubility and absorption of nilotinib due to increased pH of the upper gastrointestinal tract caused by H2 blockers
Literature reports
3 reports — tap to read
a) Major molecular response (MMR) rates at 12 months were not affected by concurrent administration of proton pump inhibitors (PPI) or H2 blockers with nilotinib, according to a retrospective analysis of patients with newly diagnosed Philadelphia chromosome-positive chronic myelogenous leukemia in chronic phase enrolled in a phase 3 study (n=492). PPIs included esomeprazole, lansoprazole, omeprazole, pantoprazole, and RABEprazole; H2 blockers included cimetidine, famotidine, and raNITIdine. MMR at 12 months was achieved in 49.6% (59 of 119) of patients who received nilotinib and a PPI or H2 blocker for any duration compared with 41% (53 of 373) of patients who did not receive any PPI or H2 blocker (p=0.13). Median duration of concurrent use was 137 days for PPIs and 33 days for H2 blockers while on nilotinib therapy, with 9.3% (46 of 492) of patients receiving concurrent therapy for more than 50% of the study period 3.
b) Major cytogenic response (MCyR) and complete cytogenic response (CCyR) rates at 12 months were not affected by concurrent administration of proton pump inhibitors (PPI) or H2 blockers with nilotinib, according to a retrospective analysis of imatinib-experienced patients with Philadelphia chromosome-positive chronic myelogenous leukemia in chronic phase enrolled in a phase 2 study (n=256). PPIs included esomeprazole, lansoprazole, omeprazole, pantoprazole, and RABEprazole; H2 blockers included cimetidine, famotidine, and raNITIdine. MCyR at 12 months was achieved in 64% (55 of 86) of patients who received nilotinib and a PPI or H2 blocker for any duration compared with 57.6% (98 of 170) of patients who did not receive any PPI or H2 blocker (p=0.4), and CCyR at 12 months was achieved in 45.3% (39 of 86) and 38.2% (65 of 170) of patients (p=0.34), respectively. Median duration of concurrent use was 177 days for PPIs and 96 days for H2 blockers while on nilotinib therapy, with 23% (59 of 256) of patients receiving concurrent therapy for more than 50% of the study period 3.
c) In healthy subjects, when a single 400 mg dose of nilotinib was administered 2 hours before and 10 hours after famotidine (an H2 blocker) there were no significant changes in nilotinib pharmacokinetics 1.
Common questions
Can I take Nizatidine and Nilotinib together?
Reduced nilotinib exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Nizatidine and Nilotinib 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 "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Nizatidine or Nilotinib 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 (3)
- Product Information: TASIGNA(R) oral capsules, nilotinib oral capsules. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2024. DailyMed
- Product Information: DANZITEN oral tablets, nilotinib oral tablets. Azurity Pharmaceuticals, Inc. (per FDA), Woburn, MA, 2024. DailyMed
- Yin OQ, Giles FJ, Baccarani M, et al: Concurrent use of proton pump inhibitors or H2 blockers did not adversely affect nilotinib efficacy in patients with chronic myeloid leukemia. Cancer Chemother Pharmacol 2012; 70(2):345-350. PubMed
Keep reading about Nilotinib
Keep reading about Nizatidine
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