Drug General Information (ID: DDIOUD6HXI)
Drug Name			Ranitidine (bismuth citrate)		Drug Info		Ceritinib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiulcer Agents				Multikinase Inhibitors
Structure

Mechanism of Ranitidine (bismuth citrate)-Ceritinib Interaction (Severity Level: Moderate)
Altered gastric pH Click to Show/Hide Mechanism Graph
Drug Name		Ranitidine (bismuth citrate)				Ceritinib
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 Ceritinib due to altered gastric pH caused by Ranitidine (bismuth citrate)

Recommended Action
Management		Until more information is available, caution is advised if ceritinib is used with drugs that can alter the gastric pH such as proton pump inhibitors, H2-receptor antagonists, and antacids. The potential for diminished therapeutic effects of ceritinib should be considered, and pharmacologic response should be closely monitored.

References
1	Product Information. Zykadia (ceritinib). Novartis Pharmaceuticals, East Hanover, NJ.