Drug interactions
Erlotinib + Esomeprazole
Severity: Major
Erlotinib and Esomeprazole: 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
Erlotinib dissolves best at low gastric pH, and esomeprazole suppresses gastric acid so much that erlotinib absorption falls substantially (AUC reduction of about half with omeprazole). Tumour exposure may be inadequate.
What this interaction means in plain words
Erlotinib and Esomeprazole 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.
Erlotinib belongs to Oncology; Esomeprazole belongs to Gastrointestinal Tract.
Why it happens
Raised gastric pH reduces erlotinib solubility and absorption
What to do
Avoid PPIs; if acid suppression is needed, give erlotinib 2 hours before or 10 hours after an H2 antagonist, or use antacids separated by several hours.
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?
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Other interactions of Esomeprazole
- Esomeprazole + Mavacamten Contraindicated
- Esomeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Esomeprazole Major
- Atazanavir + Esomeprazole Major
- Citalopram + Esomeprazole Major
- Clopidogrel + Esomeprazole Major
Other interactions of Erlotinib
- Amobarbital + Erlotinib Major
- Apalutamide + Erlotinib Major
- Carbamazepine + Erlotinib Major
- Cobicistat + Erlotinib Major
- Darunavir + Erlotinib Major
- Dexlansoprazole + Erlotinib Major
Frequently asked questions
Can I take Erlotinib with Esomeprazole?
MediHelp rates the interaction as major. Erlotinib and Esomeprazole 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. Erlotinib dissolves best at low gastric pH, and esomeprazole suppresses gastric acid so much that erlotinib absorption falls substantially (AUC reduction of about half with omeprazole). Tumour exposure may be inadequate.
How serious is the interaction between Erlotinib and Esomeprazole?
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 PPIs; if acid suppression is needed, give erlotinib 2 hours before or 10 hours after an H2 antagonist, or use antacids separated by several hours.
What other medicines interact with Esomeprazole?
MediHelp also lists interactions of Esomeprazole with, for example, Mavacamten, Rilpivirine, Acalabrutinib. The full list is on the Esomeprazole page.
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