Drug interactions
Neratinib + Rabeprazole
Severity: Major
Neratinib and Rabeprazole: 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 gastric pH rises, and proton pump inhibitors markedly lower neratinib exposure. This may reduce the efficacy of adjuvant breast cancer therapy.
What this interaction means in plain words
Neratinib and Rabeprazole 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; Rabeprazole belongs to Gastrointestinal Tract.
Why it happens
Increased gastric pH reduces pH-dependent dissolution and absorption of neratinib.
What to do
Avoid concurrent proton pump inhibitors. If acid reduction is needed, use an H2 antagonist with neratinib taken at least 2 hours before it, or an antacid taken 3 hours after neratinib.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Neratinib and Rabeprazole, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Rabeprazole
- Rabeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Rabeprazole Major
- Atazanavir + Rabeprazole Major
- Dacomitinib + Rabeprazole Major
- Dasatinib + Rabeprazole Major
- Erlotinib + Rabeprazole 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 Rabeprazole?
MediHelp rates the interaction as major. Neratinib and Rabeprazole 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 gastric pH rises, and proton pump inhibitors markedly lower neratinib exposure. This may reduce the efficacy of adjuvant breast cancer therapy.
How serious is the interaction between Neratinib and Rabeprazole?
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 concurrent proton pump inhibitors. If acid reduction is needed, use an H2 antagonist with neratinib taken at least 2 hours before it, or an antacid taken 3 hours after neratinib.
What other medicines interact with Rabeprazole?
MediHelp also lists interactions of Rabeprazole with, for example, Rilpivirine, Acalabrutinib, Atazanavir. The full list is on the Rabeprazole page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
