Nizatidine and Rilzabrutinib: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Rilzabrutinib
Nizatidine
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 rilzabrutinib exposure and reduced efficacy of rilzabrutinib
Interaction Deep Dive
Coadministration of rilzabrutinib with gastric acid reducing agents, such as histamine-2-blockers may reduce rilzabrutinib exposure, which may reduce efficacy of rilzabrutinib. Administer the dose of rilzabrutinib at least 2 hours before administration of an antacid. Rilzabrutinib exhibits pH-dependent solubility. In a drug interaction study, coadministration of famotidine (H2 receptor antagonist) two hours after the evening dose of rilzabrutinib decreased the next morning dose of rilzabrutinib Cmax by 35% and AUC by 28%1.
Why it happens (mechanism)
Changes in gastric pH
Literature reports
1 report — tap to read
a) In a drug interaction study, coadministration of famotidine (H2 receptor antagonist) two hours after the evening dose of rilzabrutinib decreased the next morning dose of rilzabrutinib Cmax by 35% and AUC by 28% 1.
Common questions
Can I take Nizatidine and Rilzabrutinib together?
Reduced rilzabrutinib exposure and reduced efficacy of rilzabrutinib Always confirm with your pharmacist or prescriber before making any change.
How serious is the Nizatidine and Rilzabrutinib 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 Nizatidine or Rilzabrutinib 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)
- Product Information: WAYRILZ™ oral tablets, rilzabrutinib oral tablets. Genzyme Corporation (per FDA), Cambridge, MA, 2025. DailyMed
Keep reading about Rilzabrutinib
Keep reading about Nizatidine
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:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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