Esomeprazole (MUPS preparation) interactions
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Medicines
178 documented
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Acalabrutinib | Major | Absorption | Coadministration with proton pump inhibitors may significantly decrease the oral bioavailability of acalabrutinib and reduce its concentrations in plasma. The… | 2 sources — open the full entry |
| Citalopram Hydrobromide | Major | Metabolism | Coadministration with CYP450 2C19 inhibitors may increase the plasma concentrations of citalopram, which is partially metabolized by the isoenzyme. Cases of QT… | 9 sources — open the full entry |
| Clopidogrel + Aspirin | Major | Absorption · Metabolism | Coadministration with proton pump inhibitors (PPIs) may reduce the cardioprotective effects of clopidogrel. The proposed mechanism is PPI inhibition of the…2 documented mechanisms | 29 sources — open the full entry |
| Clopidogrel Bisulphate | Major | Metabolism | Coadministration with proton pump inhibitors (PPIs) may reduce the cardioprotective effects of clopidogrel. The proposed mechanism is PPI inhibition of the… | 24 sources — open the full entry |
| Dacomitinib | Major | Absorption | Coadministration with proton pump inhibitors (PPIs) may decrease the plasma concentrations of dacomitinib. The proposed mechanism is a pH-dependent reduction… | 2 sources — open the full entry |
| Dasatinib | Major | Absorption | Nonclinical data indicate that the solubility of dasatinib is pH-dependent. Therefore, long-term suppression of gastric acid secretion by H2-receptor… | 4 sources — open the full entry |
| Erlotinib | Major | Absorption | Concurrent administration of agents that increase gastric pH such as proton pump inhibitors may decrease the oral bioavailability of erlotinib and reduce its… | 6 sources — open the full entry |
| Mavacamten | Major | Metabolism | Coadministration with inhibitors of CYP450 2C19 or CYP450 3A4 may increase the plasma concentrations of mavacamten. Because mavacamten reduces systolic… | 1 sources — open the full entry |
| Methotrexate | Major | Excretion | Coadministration with proton pump inhibitors (PPIs) may increase the serum concentrations of methotrexate (MTX) and its potentially active 7-hydroxy… | 7 sources — open the full entry |
| Nelfinavir | Major | Absorption | Concurrent use of proton pump inhibitors may decrease the oral bioavailability of nelfinavir and reduce its concentrations in plasma. Nelfinavir solubility may… | 2 sources — open the full entry |
| Neratinib Maleate | Major | Absorption | Coadministration with proton pump inhibitors or H2-receptor antagonists may significantly decrease the oral bioavailability of neratinib. The solubility of… | 5 sources — open the full entry |
| Pazopanib Hydrochloride | Major | Absorption | Coadministration with proton pump inhibitors or H2-receptor antagonists may significantly decrease the oral bioavailability of pazopanib and reduce its… | 7 sources — open the full entry |
| Selpercatinib | Major | Absorption | Coadministration with drugs that increase gastric pH may significantly decrease the oral bioavailability of selpercatinib and reduce its concentrations in… | 2 sources — open the full entry |
| Sofosbuvir + Velpatasvir | Major | Absorption | Coadministration of velpatasvir with proton pump inhibitors may reduce its gastrointestinal absorption. Velpatasvir exhibits pH-dependent solubility, with…2 documented mechanisms | 4 sources — open the full entry |
| Sotorasib | Major | Absorption | Coadministration with drugs that increase gastric pH may significantly decrease the oral bioavailability of sotorasib and reduce its concentrations in plasma. | 2 sources — open the full entry |
| Tacrolimus MonohydrateOralTopical | Major | Metabolism · Synergy | Coadministration with some proton pump inhibitors (PPIs) may significantly increase the whole blood concentrations of tacrolimus, particularly in patients with… | 25 sources — open the full entry |
| Abametapir | Moderate | Metabolism | Based on in vitro inhibition data, a single topical application of abametapir lotion may increase plasma concentrations of drugs that are substrates of CYP450… | 1 sources — open the full entry |
| Amikacin | Moderate | Synergy | Chronic use of proton pump inhibitors (PPIs) may induce hypomagnesemia, and the risk may be increased during concomitant use of diuretics or other agents that… | 3 sources — open the full entry |
| Amlodipine Besilate + Atorvastatin | Moderate | Absorption · Metabolism | A case report suggests that coadministration with esomeprazole may increase the plasma concentrations of atorvastatin and the associated risk of myopathy. The… | 13 sources — open the full entry |
| Amphotericin B | Moderate | Synergy | Chronic use of proton pump inhibitors (PPIs) may induce hypomagnesemia, and the risk may be increased during concomitant use of diuretics or other agents that… | 3 sources — open the full entry |
| Apalutamide | Moderate | Absorption · Metabolism | Coadministration with apalutamide may decrease the plasma concentrations and therapeutic effects of drugs that are substrates of CYP450 3A4, 2C9, 2C19, breast… | 5 sources — open the full entry |
| Armodafinil | Moderate | Metabolism | Coadministration with modafinil (the racemate) or armodafinil (the R-enantiomer) may increase the plasma concentrations of drugs that are primarily metabolized… | 9 sources — open the full entry |
| Atenolol + Chlorthalidone | Moderate | Synergy | Chronic use of proton pump inhibitors (PPIs) may induce hypomagnesemia, and the risk may be increased during concomitant use of diuretics or other agents that… | 3 sources — open the full entry |
| Atorvastatin + Ezetimibe | Moderate | Absorption · Metabolism | A case report suggests that coadministration with esomeprazole may increase the plasma concentrations of atorvastatin and the associated risk of myopathy. The… | 13 sources — open the full entry |
| Atorvastatin Calcium | Moderate | Absorption · Metabolism | A case report suggests that coadministration with esomeprazole may increase the plasma concentrations of atorvastatin and the associated risk of myopathy. The… | 13 sources — open the full entry |
| Azilsartan Medoxomil + Chlorthalidone | Moderate | Synergy | Chronic use of proton pump inhibitors (PPIs) may induce hypomagnesemia, and the risk may be increased during concomitant use of diuretics or other agents that… | 3 sources — open the full entry |
| Bendamustine | Moderate | Metabolism | Coadministration with inducers of CYP450 1A2 may decrease the plasma concentrations of bendamustine and increase the plasma concentrations of its… | 1 sources — open the full entry |
| Betamethasone + Clotrimazole + Gentamicin | Moderate | Synergy | Chronic use of proton pump inhibitors (PPIs) may induce hypomagnesemia, and the risk may be increased during concomitant use of diuretics or other agents that… | 3 sources — open the full entry |
| Betamethasone + Neomycin Sulphate (Ophthalmic) | Moderate | Synergy | Chronic use of proton pump inhibitors (PPIs) may induce hypomagnesemia, and the risk may be increased during concomitant use of diuretics or other agents that… | 3 sources — open the full entry |
| Bisoprolol Fumarate + Hydrochlorothiazide | Moderate | Synergy | Chronic use of proton pump inhibitors (PPIs) may induce hypomagnesemia, and the risk may be increased during concomitant use of diuretics or other agents that… | 3 sources — open the full entry |
| Bumetanide | Moderate | Synergy | Chronic use of proton pump inhibitors (PPIs) may induce hypomagnesemia, and the risk may be increased during concomitant use of diuretics or other agents that… | 3 sources — open the full entry |
| Candesartan Cilexetil + Hydrochlorothiazide | Moderate | Synergy | Chronic use of proton pump inhibitors (PPIs) may induce hypomagnesemia, and the risk may be increased during concomitant use of diuretics or other agents that… | 3 sources — open the full entry |
| Carbonyl Iron + Folic Acid | Moderate | Absorption | The profound hypochlorhydria induced by proton pump inhibitors (PPIs) may impair the gastrointestinal absorption of nonheme iron, a process that is dependent… | 12 sources — open the full entry |
| Carbonyl Iron + Folic Acid + Zinc Sulfate | Moderate | Absorption | The profound hypochlorhydria induced by proton pump inhibitors (PPIs) may impair the gastrointestinal absorption of nonheme iron, a process that is dependent… | 12 sources — open the full entry |
| Carbonyl Iron + Folic Acid + Zinc Sulfate + Vitamin B Complex + Vitamin C | Moderate | Absorption | The profound hypochlorhydria induced by proton pump inhibitors (PPIs) may impair the gastrointestinal absorption of nonheme iron, a process that is dependent… | 12 sources — open the full entry |
| Carboplatin | Moderate | Synergy | Chronic use of proton pump inhibitors (PPIs) may induce hypomagnesemia, and the risk may be increased during concomitant use of diuretics or other agents that… | 3 sources — open the full entry |
| Cefditoren | Moderate | Absorption | Coadministration with H2-receptor antagonists or other agents that reduce stomach acid (e.g., proton pump inhibitors) may decrease the oral absorption and… | 2 sources — open the full entry |
| Cefpodoxime Proxetil | Moderate | Absorption | The coadministration with H2-receptor antagonists, proton pump inhibitors, or other agents that can increase gastric pH may reduce the oral bioavailability of… | 4 sources — open the full entry |
| Cefpodoxime Proxetil + Clavulanic Acid | Moderate | Absorption | The coadministration with H2-receptor antagonists, proton pump inhibitors, or other agents that can increase gastric pH may reduce the oral bioavailability of… | 4 sources — open the full entry |
| Cefuroxime Axetil | Moderate | Absorption | The coadministration with H2-receptor antagonists, proton pump inhibitors, or other agents that can increase gastric pH may reduce the oral bioavailability of… | 4 sources — open the full entry |
| Cefuroxime Axetil + Clavulanic Acid | Moderate | Absorption | The coadministration with H2-receptor antagonists, proton pump inhibitors, or other agents that can increase gastric pH may reduce the oral bioavailability of… | 4 sources — open the full entry |
| Cenobamate | Moderate | Metabolism | Coadministration with cenobamate may increase the plasma concentrations and therapeutic effects of drugs that are substrates of CYP450 2C19. The proposed… | 3 sources — open the full entry |
| Ceritinib | Moderate | Absorption | Drugs that alter the pH of the upper gastrointestinal tract may affect the solubility of ceritinib and reduce its bioavailability. The interaction has not been… | 2 sources — open the full entry |
| Cetuximab | Moderate | Synergy | Chronic use of proton pump inhibitors (PPIs) may induce hypomagnesemia, and the risk may be increased during concomitant use of diuretics or other agents that… | 3 sources — open the full entry |
| Chlorthalidone | Moderate | Synergy | Chronic use of proton pump inhibitors (PPIs) may induce hypomagnesemia, and the risk may be increased during concomitant use of diuretics or other agents that… | 3 sources — open the full entry |
| Cilostazol | Moderate | Metabolism | Coadministration with inhibitors of CYP450 3A4 and/or 2C19 may increase the plasma concentrations of cilostazol and or its pharmacologically active… | 11 sources — open the full entry |
| Cinchocaine + Hydrocortisone + Framycetin + Esculin | Moderate | Synergy | Chronic use of proton pump inhibitors (PPIs) may induce hypomagnesemia, and the risk may be increased during concomitant use of diuretics or other agents that… | 3 sources — open the full entry |
| Cinchocaine + Hydrocortisone + Neomycin + Esculin | Moderate | Synergy | Chronic use of proton pump inhibitors (PPIs) may induce hypomagnesemia, and the risk may be increased during concomitant use of diuretics or other agents that… | 3 sources — open the full entry |
| Cisplatin | Moderate | Synergy | Chronic use of proton pump inhibitors (PPIs) may induce hypomagnesemia, and the risk may be increased during concomitant use of diuretics or other agents that… | 3 sources — open the full entry |
| Clobazam | Moderate | Metabolism | Coadministration of clobazam with inhibitors of CYP450 2C19 may significantly increase the plasma concentrations of its active metabolite, N-desmethylclobazam… | 7 sources — open the full entry |
Food & lifestyle
food
ModerateAbsorption
Food may interfere with the absorption of esomeprazole. The manufacturer reports that the area under the concentration-time curve for esomeprazole following a single 40 mg dose was 33% to 53% lower when administered after food intake as opposed to during fasting conditions.
What to do: Esomeprazole should be taken at least one hour before meals. When administered to patients receiving continuous enteral nutrition, some experts recommend that the tube feeding should be interrupted for at least 1 hour before and 1 hour after the dose of esomeprazole is given.
2 sources
- "Product Information. Nexium (esomeprazole)." Astra-Zeneca Pharmaceuticals (2001):
- Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm 66 (2009): 1438-67
Conditions
Conditions in which Esomeprazole (MUPS preparation) needs care, as documented in this source.
Clostridium Infections
MajorPublished observational studies suggest that proton pump inhibitor (PPI) use may be associated with an increased risk of Clostridium difficile-associated diarrhea (CDAD), especially in hospitalized patients. This diagnosis should be considered for diarrhea that does not improve. It is recommended that patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated. Close monitoring is recommended in patients with diarrhea and in those taking antibacterial agents as CDAD has been reported with the use of nearly all these agents. Treatment with antibacterial agents alters the normal flora of the colon, leading to overgrowth of C. difficile. C. difficile produces toxins A and B, which contribute to the development of CDAD. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.
8 sources
- "Product Information. PriLOSEC (omeprazole)." Merck & Co., Inc (2022):
- "Product Information. Prevacid (lansoprazole)." TAP Pharmaceuticals Inc (2001):
- "Product Information. Aciphex (rabeprazole)." Janssen Pharmaceuticals (2001):
- "Product Information. Protonix (pantoprazole)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Protonix IV (pantoprazole)." Wyeth-Ayerst Laboratories
- "Product Information. Kapidex (dexlansoprazole)." Takeda Pharmaceuticals America (2009):
- "Product Information. NexIUM I.V. (esomeprazole)." Astra-Zeneca Pharmaceuticals (2014):
- "Product Information. Esomeprazole Strontium (esomeprazole)." Amneal Pharmaceuticals (2014):
Fractures, Bone
ModerateVarious published observational studies have reported that PPI therapy may be associated with an increased risk for osteoporosis related fractures of the hip, wrist or spine. The risk was increased in patients who received high doses (multiple daily doses), and long term treatment (a year or longer). Patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated. Caution should be used in patients at risk for osteoporosis related fractures and should be managed according to established treatment guidelines.
6 sources
- "Product Information. Prevacid (lansoprazole)." TAP Pharmaceuticals Inc (2001):
- "Product Information. Aciphex (rabeprazole)." Janssen Pharmaceuticals (2001):
- "Product Information. Protonix (pantoprazole)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Nexium (esomeprazole)." Astra-Zeneca Pharmaceuticals (2001):
- "Product Information. Omeprazole (omeprazole)." Mylan Pharmaceuticals Inc (2003):
- "Product Information. Kapidex (dexlansoprazole)." Takeda Pharmaceuticals America (2009):
Hypomagnesemia 1, Intestinal
ModerateSymptomatic and asymptomatic hypomagnesemia has been reported rarely in patients treated with PPIs for at least 3 months, in most cases after a year of therapy. Serious adverse events can include tetany, seizures, and arrhythmias. Caution should be used in patients prone to magnesium imbalances such as patients taking other medications that can cause hypomagnesemia (e.g., diuretics). Regular monitoring is recommended.
6 sources
- "Product Information. Prevacid (lansoprazole)." TAP Pharmaceuticals Inc (2001):
- "Product Information. Aciphex (rabeprazole)." Janssen Pharmaceuticals (2001):
- "Product Information. Protonix (pantoprazole)." Wyeth-Ayerst Laboratories (2001):
- "Product Information. Nexium (esomeprazole)." Astra-Zeneca Pharmaceuticals (2001):
- "Product Information. Omeprazole (omeprazole)." Mylan Pharmaceuticals Inc (2003):
- "Product Information. Kapidex (dexlansoprazole)." Takeda Pharmaceuticals America (2009):
Liver Diseases
ModerateEsomeprazole is primarily metabolized by the liver. In patients with mild to moderate hepatic impairment (Child Pugh Class A and B), little drug accumulation has been observed following once-daily, multiple-dose administration. No dosage adjustments are necessary in these patients. In severe hepatic impairment (Child Pugh Class C), however, substantial increases in plasma drug concentrations have been demonstrated. The manufacturer recommends a maximum dosage of 20 mg once daily in patients with severe liver disease.
1 source
- "Product Information. Nexium (esomeprazole)." Astra-Zeneca Pharmaceuticals (2001):
Therapeutic duplication
Drug classes that overlap with Esomeprazole (MUPS preparation), so taking both doubles up the same effect. This source publishes no per-row citations for duplication.
acid suppressant agents
The recommended maximum number of medicines in the 'acid suppressant agents' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'acid suppressant agents' category.
Example product in the source data (US market): Prevpac
acid suppressant agents
The recommended maximum number of medicines in the 'acid suppressant agents' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'acid suppressant agents' category.
Example product in the source data (US market): Amoxicillin/clarithromycin/omeprazole
acid suppressant agents
The recommended maximum number of medicines in the 'acid suppressant agents' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'acid suppressant agents' category.
Example product in the source data (US market): Voquezna triple pak
acid suppressant agents
The recommended maximum number of medicines in the 'acid suppressant agents' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'acid suppressant agents' category.
Example product in the source data (US market): Aspirin/omeprazole