Table 6.

KI interactions with drugs and food are listed. In general, when antacids are used, avoid concurrent intake with KIs to maximize KI absorption.

Kinase Inhibitor	Food Effect	CYP 3A4 inducer	CYP 3A4 Inhibitor	Effect on Concurrent Medications	Proton Pump Inhibitor	Statin	Warfarin
Axitinib	No	Decrease KI level; avoid inducer	Increase KI level; Reduce KI dose	Does not inhibit CYP3A4	No adjustment
Bosutinib	With food	Decrease KI level; avoid inducer	Increase KI level; Avoid inhibitor		Decrease KI level; use antacid, H2 2 hr later
Cabozantinib	Empty Stomach	Decrease KI level; avoid inducer	Increase KI level; Avoid inhibitor	CYP3A4 substrate increase
Crizotinib	No	Decrease KI level; avoid inducer	Increase KI level; Avoid inhibitor	CYP3A4 substrate increase
Dasatinib	No	Decrease KI level; increase KI dose	Increase KI level; Reduce KI dose	CYP3A4 substrate increase	Do not use PPI, H2; use antacid 2 hr later	Simvastatin's AUC increase
Erlotinib	Empty stomach	Decrease KI level; increase KI dose	Increase KI level; Reduce KI dose	CYP3A4 substrate increase	Do not use PPI; take erlotinib 10 hr later or 2 hr before H2; use antacid 2 hr later		High INR
Gefitinib	No	Decrease KI level; increase dose to 500 mg	Increase KI level; Avoid inhibitor		H2 reduced AUC
Imatinib	With food	Decrease KI level; increase KI dose	Increase KI level; Avoid inhibitor	CYP3A4 substrate increase		Simvastatin's AUC increase
Lapatinib	Empty stomach	Decrease KI level; increase KI dose	Increase KI level; Reduce KI dose	CYP3A4 substrate increase	Esomeprazole did not reduce KI level
Nilotinib	Empty stomach	Decrease KI level; avoid inducer	Increase KI level; Reduce KI dose	CYP3A4 substrate increase	Decrease KI level;use antacid, H2, 2 hr later; gastrectomy decrease KI level		No change
Pazopanib	Empty Stomach	Decrease KI level; avoid inducer	Increase KI level; Reduce KI dose	CYP3A4 substrate change			No change
Regorafenib	With food	Decrease KI level; avoid inducer	Increase KI level; Avoid inhibitor	CYP3A4 substrate increase
Ruxolitinib	No	No adjustment	Increase KI level; Reduce KI dose
Sorafenib	Empty stoma ch	Decrease KI level; avoid inducer	Ketoconazole, no effect	Not inhibit CYP3A4
Sunitinib	No	Decrease KI level; increase KI dose	Increase KI level; Reduce KI dose	No effect on major CYP
Vandetanib	No	Decrease KI level; avoid inducer	Itraconazole, no effect	Avoid; QT prolonging/ar rhythmic
Vemurafenib	No	Decrease KI level; avoid inducer	Increase KI level; Avoid inhibitor	CYP3A4 substrate change			Warfarin AUC 18% increase
Vismodegib	No	No effect	No effect		PPI, H2, and antacid may decrease KI level
Ponatinib	No	avoid inducer	Increase KI level; Reduce to 30mg	No effect on major CYP	Not evaluated; antiacid may reduce KI level

Abbreviations: AUC, area under the curve; H2, Histamine H2 receptor blocker; HR, hour; KI, kinase inhibitor