Drug General Information (ID: DDIFTV1OKY)
Drug Name			Magnesium hydroxide		Drug Info		Acalabrutinib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antacids/Laxatives				Antineoplastics/Bruton Tyrosine Kinase Inhibitor
Structure

Mechanism of Magnesium hydroxide-Acalabrutinib Interaction (Severity Level: Moderate)
Altered gastric pH Click to Show/Hide Mechanism Graph
Drug Name		Magnesium hydroxide				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 Magnesium hydroxide

Recommended Action
Management		Concomitant use of acalabrutinib with proton pump inhibitors should generally be avoided. If acid suppression therapy is required, H2-receptor antagonists or antacids should be considered. The manufacturer recommends taking acalabrutinib 2 hours before H2-receptor antagonists and separating the dosing of antacids by at least 2 hours.

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