From the Research
It is generally safe to take proton pump inhibitors (PPIs) like omeprazole, pantoprazole, or esomeprazole while on pembrolizumab (Keytruda). There are no known significant drug interactions between PPIs and pembrolizumab that would require avoiding their combined use. PPIs work by reducing stomach acid production, while pembrolizumab is an immunotherapy medication that helps your immune system fight cancer by blocking the PD-1 pathway. These medications work through different mechanisms in the body. However, it's always important to inform your oncologist about all medications you're taking, including over-the-counter drugs and supplements. Your doctor may want to monitor you more closely for any potential side effects or changes in pembrolizumab effectiveness. Some patients on immunotherapy experience gastrointestinal side effects, and PPIs might be prescribed specifically to manage these symptoms. If you're considering starting a PPI while on pembrolizumab, discuss it with your healthcare provider to ensure it's appropriate for your specific medical situation.
Key Considerations
- The most recent and highest quality study on the topic is from 2021 1, which discusses the use and misuse of proton pump inhibitors, but does not specifically address interactions with pembrolizumab.
- Other studies, such as those from 2017 2 and 2012 3, provide information on the effectiveness and tolerability of different doses of PPIs, but do not address interactions with pembrolizumab.
- There is no evidence to suggest that PPIs interfere with the mechanism of action of pembrolizumab, which works by blocking the PD-1 pathway to help the immune system fight cancer.
- As with any medication, it's essential to discuss the use of PPIs with your healthcare provider, especially if you're taking other medications or have underlying medical conditions.
Potential Side Effects and Interactions
- PPIs can cause side effects such as headache, diarrhea, and nausea, but these are generally mild and temporary.
- Pembrolizumab can cause side effects such as fatigue, rash, and diarrhea, but these are also generally manageable with supportive care.
- There is no evidence to suggest that the combination of PPIs and pembrolizumab increases the risk of serious side effects or interactions.
Recommendations
- Inform your oncologist about all medications you're taking, including over-the-counter drugs and supplements.
- Discuss the potential benefits and risks of taking PPIs while on pembrolizumab with your healthcare provider.
- Monitor for any potential side effects or changes in pembrolizumab effectiveness while taking PPIs.