Acalabrutnib and omeprazole

[Cheeseandchips]

Hi, I’m starting acalabrutinib on Friday.... I am also taking omeprazole daily. Is it ok to take both drugs at the same time. Or is there an order or time frame... I’m feeling very confused. My nurse said take omeprazole 2 hours before the acalabrutnib... but I’m not sure if that’s the correct way round. Is there anyone out there with the same dilemma. Thank you in advance x

[lankisterguy Volunteer]

Hi Cheeseandchips,

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This is something you need to take up in detail with your CLL doctor and / or your gastro doctor.

You may need to get help to change your acid reducing medicine to a different class of drug.

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Here is a link to the official version: calquencehcp.com/?source=cq...

SNIP:" Gastric Acid Reducing Agents: If treatment with a gastric acid reducing agent is required, consider using an H2-receptor antagonist or an antacid. Take CALQUENCE 2 hours before taking an H2-receptor antagonist. Separate dosing with an antacid by at least 2 hours.

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Avoid co-administration with proton pump inhibitors. Due to the long-lasting effect of proton pump inhibitors, separation of doses may not eliminate the interaction with CALQUENCE.

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And this: goodrx.com/blog/five-things.... Omeprazole (Prilosec) is a cheap, generic medication available both over the counter or with a prescription. It belongs to a class of medications known as proton-pump inhibitors (PPIs) , and is one of the most popular medications in the U.S. It's used to treat heartburn, reflux disease (GERD), and ulcers.Mar 22, 2019

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Len

[Cheeseandchips in reply to lankisterguy]

Thank you for the info. Really useful x

[AussieNeil Partner Administrator in reply to Cheeseandchips]

Further to Len's reply, I had to change from omeprazole to a H2-receptor antagonist (Famotidine in my case) in order to join an Acalabrutinib clinical trial. Interesting enough, also in my case, a nurse suggested the same order as your nurse, which I questioned. After checking with a pharmacist, the order was corrected to what I expected; take the Acalabrutinib first, then two hours after the Acalabrutinib, take the H2-receptor antagonist. This provides you with about 10 hours for your stomach acid to recover from the H2-receptor antagonist reduction before your next Acalabrutinib dose, improving Acalabrutinib absorption.

Neil

[Cheeseandchips in reply to AussieNeil]

Thank you I’ll will be doing as you suggested x

[avzuclav in reply to AussieNeil]

Looks like some related subjects will be studied soon:

A Study to Evaluate Effects of Proton-pump Inhibitor on Acalabrutinib Capsule When Administered Orally With COCA-COLA in Healthy Participants clinicaltrials.gov/ct2/show...

A Study to Evaluate Relative Bioavailability, Proton Pump Inhibitor (PPI) (Rabeprazole) Effect, Food Effect and Particle Size Effect of New Acalabrutinib Tablet in Healthy Subjects clinicaltrials.gov/ct2/show...

[AussieNeil Partner Administrator in reply to avzuclav]

The first trial will be checking if the Coca-Cola acidity is enough to improve the absorption of Acalabrutinib when stomach acid pH has been reduced by the PPI. I was surprised to read that Coca-Cola has an acidity of 2.5!

[nvp815]

I was given the same advice as Neil. Acalabrutinib first and two hours later famotidine. Wishing you well on acala. It has been life-changing for me. Remember to stay well hydrated!

Nan

[Cheeseandchips in reply to nvp815]

Thank you x

[bigunwill2]

According to my doctor and pharmacologist no. It will make it less effective. I was changed to Pepcid and Tums that I took 2 hours before morning dose and 2 hours after evening dose. I occasionally would take Tums in middle of day but only 2 hours from Acalabrutinib.

[Cheeseandchips in reply to bigunwill2]

Thank you x

[DoriZett]

I am on Acalabrutinib and was taken off PPI's. I take famotidine for reflux and tums and have changed my diet to control the reflux. Reflux has been the major issue for me in CLL treatment but I have minimal other side effects from the medication and the treatment is controlling my CLL/SLL beautifully so it is worth any other inconvenience. Good luck!

[Cheeseandchips in reply to DoriZett]

Thank you for finding the time to reply. That makes lots of sense x

[Sschfarm]

I have used 0meprazole and acp196 was told to not 0meprazole use only tums or pepcid. I have been on acp for four year's still working blog counts good

[MikeHoff]

I have been on Ibrutinib for about 3 years. I take 40 mg of omeprazole daily prophylactically since I had gastric sleeve procedure about 5 years ago. My CLL specialist team us aware and has never indicated a problem or any recommendation of timing of daily doses.