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**Pyrotinib + montmorillonite** is a combination of the small molecule tyrosine kinase inhibitor pyrotinib and the anti-diarrheal, adsorbent clay mineral montmorillonite powder. Pyrotinib is an irreversible dual inhibitor of Epidermal Growth Factor Receptor (EGFR) and Human Epidermal Growth Factor Receptor 2 (HER2), developed primarily for the treatment of HER2-positive cancers[2]. Montmorillonite powder is used as an adsorbent and protective agent in the gastrointestinal tract for the symptomatic management of drug-induced diarrhea, forming a protective coating over the mucosa[2]. When administered together, montmorillonite powder significantly reduces the systemic exposure of pyrotinib by decreasing its absorption (AUC decreased by 32.4%, Cmax by 26.7%)[2]. This pharmacokinetic interaction is clinically significant and montmorillonite powder should generally not be co-administered with pyrotinib or any drug requiring optimal absorption[1][2][4]. Mechanism of action for the combination is primarily dictated by the individual actions of pyrotinib (EGFR/HER2 inhibition) and montmorillonite (gastrointestinal adsorption/protection/coating). Pyrotinib was developed by Jiangsu Hengrui Pharmaceuticals[1][2]. Montmorillonite is produced by various pharmaceutical companies as a generic substance.
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