Drug General Information (ID: DDI2JTZK6I)
Drug Name			Rabeprazole		Drug Info		Dacomitinib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiulcer Agents				Antineoplastics/Her2 Inhibitors
Structure

Mechanism of Rabeprazole-Dacomitinib Interaction (Severity Level: Major)
Altered gastric pH Click to Show/Hide Mechanism Graph
Drug Name		Rabeprazole				Dacomitinib
Mechanism		Gastric alkalinizer				Gastric pH sensitive
Key Mechanism Factor 1
		Factor Name		Gastric pH
		Factor Description		The normal pH range of gastric acid is between 1.5 and 3.5 and is highly acidic, consisting mainly of hydrochloric acid. Changes in the pH of the stomach can alter the absorption of drugs.
Mechanism Description		Decreased absorption of Dacomitinib due to altered gastric pH caused by Rabeprazole

Recommended Action
Management		Concomitant use of dacomitinib with PPIs should generally be avoided. If acid suppression therapy is required, locally-acting antacids or H2-receptor antagonists may be considered. The manufacturer recommends taking dacomitinib at least 6 hours before or 10 hours after H2-receptor antagonists.

References
1	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2	Product Information. Vizimpro (dacomitinib). Pfizer U.S. Pharmaceuticals Group, New York, NY.