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Clin Pharmacokinet. 2017 Jul;56(7):683-688. doi: 10.1007/s40262-016-0503-3.

Tyrosine Kinase Inhibitors and Proton Pump Inhibitors: An Evaluation of Treatment Options.

Author information

1
Department of Medical Oncology, Erasmus MC Cancer InstituteErasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. r.w.f.vanleeuwen@erasmusmc.nl.
2
Department of Hospital Pharmacy, Erasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. r.w.f.vanleeuwen@erasmusmc.nl.
3
Department of Clinical Pharmacy, Deventer Hospital, Nico Bolkesteinlaan 75, 7416 SE, Deventer, The Netherlands.
4
Department of Pharmacotherapy, Epidemiology and Economics, University of Groningen, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
5
Department of Hospital Pharmacy, Erasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
6
Department of Intensive Care, Erasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
7
Department of Pulmonary Medicine, Erasmus MC Cancer Institute, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
8
Department of Medical Oncology, University Medical Center Groningen, A. Deusinglaan 1, 9712 CP, Groningen, The Netherlands.
9
Department of Medical Oncology, Deventer Hospital, Nico Bolkesteinlaan 75, 7416 SE, Deventer, The Netherlands.
10
Department of Internal Medicine, Erasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
11
Department of Medical Oncology, Erasmus MC Cancer InstituteErasmus University Medical Center, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.

Abstract

Tyrosine kinase inhibitors (TKIs) have rapidly become an established factor in oncology, and have been shown to be effective in a wide variety of solid and hematologic malignancies. Use of the oral administration route of TKIs offers flexibility and is convenient for the patient; however, despite these advantages, the oral route of administration also causes a highly relevant new problem. Acid-inhibitory drugs, such as proton pump inhibitors (PPIs), increase the intragastric pH, which may subsequently decrease TKI solubility, bioavailability, and treatment efficacy. Clear and practical advice on how to manage PPI use during TKI therapy is currently not available in the literature. Since PPIs are extensively used during TKI therapy, prescribers are presented with a big dilemma as to whether or not to continue the combined treatment, resulting in patients possibly being deprived of optimal therapy. When all pharmacological characteristics and data of either TKIs and PPIs are considered, practical and safe advice on how to manage this drug combination can be given.

PMID:
28101705
PMCID:
PMC5488129
DOI:
10.1007/s40262-016-0503-3
[Indexed for MEDLINE]
Free PMC Article

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