Drug General Information (ID: DDIY9JW0QR)
Drug Name			Ranitidine (bismuth citrate)		Drug Info		Bosutinib		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiulcer Agents				Antineoplastics
Structure

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

Recommended Action
Management		To minimize the potential for interaction, H2-receptor antagonists or antacids should be administered at least 2 hours before or 2 hours after the bosutinib dose.

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