Drug interactions
Neratinib + Omeprazole
Severity: Major
Neratinib and Omeprazole: 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 absorption falls at higher gastric pH, and PPIs can substantially lower its exposure. This may reduce its efficacy.
What this interaction means in plain words
Neratinib and Omeprazole 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 belongs to Oncology; Omeprazole belongs to Gastrointestinal Tract.
Why it happens
Increased gastric pH reduces neratinib solubility and absorption.
What to do
Avoid PPIs. If acid suppression is needed, use an H2 antagonist, taking neratinib at least 2 hours before or 10 hours after it, or use an antacid separated by 3 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 Omeprazole
- Mavacamten + Omeprazole Contraindicated
- Omeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Omeprazole Major
- Atazanavir + Omeprazole Major
- Citalopram + Omeprazole Major
- Clopidogrel + Omeprazole Major
Other interactions of Neratinib
- Amiodarone + Neratinib Major
- Amobarbital + Neratinib Major
- Aprepitant + Neratinib Major
- Armodafinil + Neratinib Major
- Bosentan + Neratinib Major
- Carbamazepine + Neratinib Major
Frequently asked questions
Can I take Neratinib with Omeprazole?
MediHelp rates the interaction as major. Neratinib and Omeprazole 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 absorption falls at higher gastric pH, and PPIs can substantially lower its exposure. This may reduce its efficacy.
How serious is the interaction between Neratinib and Omeprazole?
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, use an H2 antagonist, taking neratinib at least 2 hours before or 10 hours after it, or use an antacid separated by 3 hours.
What other medicines interact with Omeprazole?
MediHelp also lists interactions of Omeprazole with, for example, Mavacamten, Rilpivirine, Acalabrutinib. The full list is on the Omeprazole page.
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