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Drug interactions

Cimetidine + Neratinib

Severity: Major

Cimetidine and Neratinib: major interaction.

Last updated

For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.

Summary

Neratinib solubility falls as pH rises, and H2 antagonists reduce its absorption. This may reduce efficacy in breast cancer treatment.

What this interaction means in plain words

Cimetidine and Neratinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Cimetidine belongs to Gastrointestinal Tract; Neratinib belongs to Oncology.

Evidence level: Moderate

Why it happens

Cimetidine raises gastric pH, decreasing neratinib dissolution and absorption.

What to do

Avoid H2 antagonists if possible; if needed, take neratinib at least 2 hours before the next H2 antagonist dose and at least 10 hours after the previous one.

What to ask your pharmacist

  • Does the benefit of taking both outweigh the risk in my case?
  • Do I need any blood test, ECG or other check while on both?
  • What early warning signs should I watch for, and what should I do if they appear?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Cimetidine with Neratinib?

MediHelp rates the interaction as major. Cimetidine and Neratinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Neratinib solubility falls as pH rises, and H2 antagonists reduce its absorption. This may reduce efficacy in breast cancer treatment.

How serious is the interaction between Cimetidine and Neratinib?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid H2 antagonists if possible; if needed, take neratinib at least 2 hours before the next H2 antagonist dose and at least 10 hours after the previous one.

What other medicines interact with Cimetidine?

MediHelp also lists interactions of Cimetidine with, for example, Dofetilide, Fezolinetant, Alfentanil. The full list is on the Cimetidine page.

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