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Comment: Concomitant use of proton pump inhibitors with erlotinib should be avoided if possible. Drugs that alter pH of upper GI tract may alter the solubility of erlotinib and reduce its bioavailability. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Acalabrutinib solubility decreases with increasing gastric pH. Due to the long-lasting effect of PPIs, separation of doses may not eliminate the interaction.

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Coadministration of apalutamide, a strong CYP2C19 inducer, with drugs that are CYP2C19 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Atazanavir solubility decreases as pH increases. Substantially reduced plasma concentrations of atazanavir are expected if PPIs are coadministered.

PPIs Dichlroide)- not recommended in treatment-experienced taking atazanavir. Concomitant use with a PPI decreases dacomitinib concentrations, which may reduce dacomitinib efficacy.

Avoid use of PPIs with dacomitinib. As an alternative to PPIs, use locally-acting antacids or an H2-receptor antagonist. Administer at least 6 hours before or 10 hours after taking an H2-receptor antagonist. Darolutamide is a BCRP inhibitor. Avoid coadministration with BCRP inhibitors. If use is Xofigo (Radium Ra 223 Dichloride)- Multum, closely monitor for adverse reactions and consider dose reduction of BCRP substrate (Rsdium (refer BCRP substrate prescribing information).

Comment: Actoplus MET, Actoplus MET XR (Pioglitazone Hcl and Metformin Hcl)- FDA inhibits BCRP in vitro.

Avoid coadministration of lasmiditan with BCRP substrates. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting (Rasium.

Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.

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