I need a definitive answer on this. Just got back from an upper GI endoscopy and the doc found reflux esophagitis and wants me to do an 8-week course of a PPI (Prilosec, or omeprazole.) I just started Scemblix about 7 weeks ago, and I haven't yet had a PCR to let me know how I'm doing. I really don't want to mess things up! The Scemblix patient insert info doesn't list this as a contraindication, and my GI guy says he's not aware of any reason not to do it. But, AI and Google say no, no, no. You need the acid in your stomach for absorption of the Scemblix. My mother and her mother both died of esophageal cancer, so I started being followed by a gastroenterologist (and having periodic endoscopies) when I got to middle age. I've always had a bit of erythema, but not like this report. Plus, I have increasingly had reflux symptoms. I can remember vividly my grandmother's continually clearing her throat - I do this a LOT now. I have a persistent mostly morning cough. My speaking voice is shot. So, you can see that I am certainly scared and motivated to follow through on healing the esophagitis and taking next (preventive) steps. I've got an email in to my onc. But I'll ask here: What's the truth on taking these two drugs in the same day? The PPI is extended release, so that kind of nixes separating them being the answer. Thanks for any help!
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Scemblix and Prilosec (Omeprazole)
You are fine to take a proton pump inhibitor with asciminib. I know that’s not the case with a lot of TKIs, but it is fine with asciminib.
I have had this confirmed with a consultant haematology pharmacist here in the UK, but even more definitive than that you can read from the horses mouth:
https://www.novartis.com/ca-en/sites/novartis_ca/files/scemblix_pm_20250...
> “Effect of acid-reducing agents on asciminib: Co-administration of a proton pump inhibitor,
rabeprazole, had no effect on the AUC and Cmax of asciminib.”
David.
Thanks, David. The reading I've done on this overnight is just all over the place. Also, I'm no chemist! I appreciate your checking with the pharmacist and sending the link. In Section 9.2 they go over the interaction with CYP3A4, which is the problem with asciminib. It seems that the uptake is affected, even for asciminib. I think CYP2C9 is also a problem between the two. At any rate, I heard from my onc early this morning that he definitely doesn't like the situation, but thinks I'll be OK if I separate them by 12 hours. This is like a living Rubik's cube! My levothyroxine doc wants me to take that completely alone and fasting, candesartan (hypertension) is better at bedtime, asciminib has to be fasting, etc. I guess if I stay up all day and night, never eat anything, and take a pill separately every 3 hours, I'll be fine. LOL