Acalabrutinib
Severe
Database
Drug interaction classified as: absorption
Source: DDInter
Drug reference
dexlansoprazole
Proton pump inhibitor · Antacid
Proton pump inhibitorAntacid
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
—
not curated
Top interactionssee all 12 →
- AcalabrutinibSevereDatabaseDDInter
- AtazanavirSevereDatabaseDDInter
- DacomitinibSevereDatabaseDDInter
- DasatinibSevereDatabaseDDInter
Mechanism
Proton pump inhibitors are prodrugs that require activation in an acid environment. They diffuse into parietal cells and accumulate in acidic secretory canaliculi, where they are activated to a sulfenamide. This activated form binds covalently with sulfhydryl groups of cysteines in the H+,K+-ATPase, irreversibly inactivating the pump molecule.
Indications
Gastroesophageal reflux diseaseErosive esophagitis
Dosing
- Adult
- 30 mg daily for 4 weeks (nonerosive GERD); erosive GERD: 60 mg daily up to 6 months, then 30 mg daily up to 6 months (maintenance therapy)
- Renal adjustment
- Chronic renal failure does not lead to drug accumulation with once-a-day dosing of the PPIs.
Pharmacokinetics
Half-life
0.5 to 3 h (parent compound)
Protein binding
Highly protein bound.
Metabolism
Extensively metabolized by hepatic CYPs, particularly CYP2C19 and CYP3A4.
Contraindications
- Not labeled for the treatment of active ulcers
Side effects
Common
HeadacheNauseaAbdominal painConstipationFlatulenceDiarrhea
Serious
- Subacute myopathy
- Arthralgias
- Interstitial nephritis
- Pharyngitis
- Skin rashes
- Increased risk of bone fracture
- Increased susceptibility to hospital-acquired pneumonia
- Increased susceptibility to community-acquired Clostridium difficile infection
- Increased susceptibility to spontaneous bacterial peritonitis (in patients with ascites)
- Hypomagnesemia
- Vitamin B12 (cobalamin) deficiency (with long-term use, >3 years)
- Hypergastrinemia leading to ECL hyperplasia and fundic gland polyposis
- Atrophic gastritis
Drug interactions
Atazanavir
Severe
Database
Substantially reduced atazanavir concentrations, leading to loss of antiviral effectiveness.
Proton pump inhibitors should be avoided in patients receiving atazanavir without ritonavir.
Source: DDInter
Dacomitinib
Severe
Database
Clinical effect not specified
Source: DDInter
Dasatinib
Severe
Database
Clinical effect not specified
Source: DDInter
Erlotinib
Severe
Database
Reduced plasma levels and potentially reduced efficacy of erlotinib.
Source: DDInter
Methotrexate
Severe
Database
Increased methotrexate levels, leading to increased treatment-related toxicity.
Monitor for toxicity if co-administered. Dose adjustment or alternative therapy may be required.
Source: DDInter
Nelfinavir
Severe
Database
Clinical effect not specified
Source: DDInter
Neratinib
Severe
Database
Clinical effect not specified
Source: DDInter
Pazopanib
Severe
Database
Clinical effect not specified
Source: DDInter
Pexidartinib
Severe
Database
Clinical effect not specified
Source: DDInter
Rilpivirine
Severe
Database
Reduced absorption and plasma concentrations of rilpivirine, potentially leading to loss of efficacy.
Should not be given with proton pump inhibitors.
Source: DDInter
Selpercatinib
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
Gastro-oesophageal reflux disease
ISG · Gastroenterology · 2022
Coeliac disease
OTHER · Gastroenterology · 2016
Inflammatory bowel disease
OTHER · Gastroenterology · 2015
Preventive care in inflammatory bowel disease
ACG · Gastroenterology · 2025
Chronic kidney disease — assessment and management
KDIGO · Nephrology · 2024
Ask House about dexlansoprazole
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e·Verified: 2026-05-10 · House clinical team