Acalabrutinib and Cimetidine

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

By reducing the acidity level in the stomach, cimetidine may interfere with the absorption of acalabrutinib and reduce its effectiveness. You should generally take acalabrutinib at least two hours before cimetidine. Most antacids (but not medications that suppress acid production such as ranitidine (Zantac), famotidine (Pepcid), nizatidine or cimetidine) may also be taken two hours after a dose of acalabrutinib. Talk to your doctor or pharmacist if you have questions on how to take these or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

ADJUST DOSING INTERVAL: Coadministration with drugs that increase gastric pH may significantly decrease the oral bioavailability of acalabrutinib and reduce its concentrations in plasma. The solubility of acalabrutinib is pH-dependent and decreases with increasing pH. According to the product labeling, acalabrutinib is freely soluble in water at pH below 3 and practically insoluble at pH above 6. Coadministration with an antacid (1 gram calcium carbonate) decreased acalabrutinib systemic exposure (AUC) by 53% in healthy subjects, and coadministration with a proton pump inhibitor (omeprazole 40 mg for 5 days) decreased acalabrutinib AUC by 43%. Due to the long-lasting effect of proton pump inhibitors, separation of dosing may not eliminate the interaction with acalabrutinib.

MANAGEMENT: Concomitant use of acalabrutinib with proton pump inhibitors should generally be avoided. If acid suppression therapy is required, H2-receptor antagonists or antacids should be considered. The manufacturer recommends taking acalabrutinib 2 hours before H2-receptor antagonists and separating the dosing of antacids by at least 2 hours.

Acalabrutinib

Generic Name: acalabrutinib

Brand name: Calquence

Synonyms: n.a.

What is Acalabrutinib?

Cimetidine

Generic Name: cimetidine

Brand name: Tagamet HB, Tagamet

Synonyms: n.a.

What is Cimetidine?