Capecitabine 做為口服化療藥物被用於治療多種實體腫瘤。事後分析研究及回 溯型研究指出，合併使用氫離子幫浦抑制劑 (proton pump inhibitors, PPIs) 可能減弱 capecitabine 的療效，推論兩者之間存有交互作用；可能機轉為 PPIs 增加胃液 pH 值 導致 capecitabine 溶解度及吸收度下降。Micromedex 及 Lexicomp 也因此在資料庫 建立該項交互作用警示，但卻做出不同的評論及建議；此外，對於適用 capecitabine 的消化道癌族群，使用 PPIs 仍有其必要性，造成臨床治療上的兩難；另一方面，也 有其他研究認為兩者之間是否具有交互作用是存疑的。因此，本文將依據現有文獻探 討，希望能夠協助臨床醫療人員做出更適合病人的決策。

 

Capecitabine is an oral antineoplastic drug administered in multiple malignancies. Post-hoc analysis and retrospective studies suggest that concomitant administration of proton pump inhibitors (PPIs) can negatively affect the efficacy of capecitabine. The drug-drug interaction can be attributed to the increase in gastric pH upon PPIs administration, thereby reducing the dissolution and absorption of capecitabine. Micromedex and Lexicomp have included this interaction in their databases but gave different severity levels and managements. Furthermore, PPIs might still be necessary to treat gastric symptoms for patients under capecitabine treatments, making the therapy problematic. However, some studies suggest that this interaction might be unlikely. Hence, this study aims to summarize the clinical evidence to help medical staff manage this interaction.

 

Summited for publication: 2021.8.19; Accepted for publication: 2022.3.26