Drug General Information (ID: DDID17U9P2)
Drug Name			Dexlansoprazole		Drug Info		Acalabrutinib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Proton Pump Inhibitors				Antineoplastics/Bruton Tyrosine Kinase Inhibitor
Structure

Mechanism of Dexlansoprazole-Acalabrutinib Interaction (Severity Level: Major)
Altered gastric pH Click to Show/Hide Mechanism Graph
Drug Name		Dexlansoprazole				Acalabrutinib
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 Acalabrutinib due to altered gastric pH caused by Dexlansoprazole

Recommended Action
Management		Concomitant use of acalabrutinib with proton pump inhibitors should generally be avoided. If acid suppression therapy is required, antacids and H2-receptor antagonists should be considered, with dosing separated by a couple hours from acalabrutinib dosing.

References
1	Product Information. Calquence (acalabrutinib). Astra-Zeneca Pharmaceuticals, Wilmington, DE.