Esomeprazole drug interactions
From Pubdrug
|
Authored by: Mldutka | |||
|
Back to monograph page |
Drug-drug interactions
Severity level | Drug and description of interaction |
| 4 | atazanavir: Esomeprazole has been shown to decrease the AUC of atazanavir when given with ritonavir.[1] |
| 3 | cilostazol: Bioavailability of these drugs is increased with CYP2C19 inhibition. Cilostazol dosage should be reduced by 50%.[2]
ampicillin, delavirdine, iron salts, itraconazole, ketoconazole: These medications require an acidic environment for absorption. With certain formulations, absorption of these drugs are decreased due to the resultant increase in gastric pH levels with PPI use.[3][4][5] H2 blockers: Decreases the effectiveness of PPIs because PPIs only work on active hydrogen pumps.[6] |
| 2 | alendronate: The risk of having upper GI side effects is increased when alendronate is co-administered with PPIs or H2-receptor blockers by affecting the bioavailability of alendronate.[7]
antimuscarinics, carbamazepine, fluvastatin: Potentially decreases the effectiveness of PPIs because PPIs only work on active hydrogen pumps.[6][8][9] diazepam: Bioavailability of these drugs is increased with CYP2C19 inhibition. Diazepam dosage may not need to be altered; close monitoring is advised when used with esomeprazole.[4] fluvoxamine: Has the potential to inhibit CYP2C19 enzymes thereby theoretically increasing the concentrations of drugs metabolized by this enzyme.[4] gefitinib: This medication requires an acidic environment for absorption. With certain formulations, absorption of this drug is decreased due to the resultant increase in gastric pH levels with PPI use.[10] naproxen: Enteric coating of medications serves as a barrier to prevent exposure of the medication to acidic pH levels. PPIs increase the pH of the gastric cavity and will therefore increase the exposure of enteric coated medications to this area. By doing so, some adverse events such as gastric irritation or drug degradation/stability changes will occur.[11] voriconazole, warfarin: Because esomeprazole is a CYP2C19 inhibitor, there is a potential for the concentrations of drugs metabolized by CYP2C19 to increase. This is only a potential and is not definite. Monitoring with the use of esomeprazole and narrow therapeutic index drugs may be advised.[4] |
| 1 | amoxicillin and clarithromycin in combination: The combination of the three drugs together, when used to eradicate H. pylori infections, has been shown to result in an increase in esomeprazole concentrations.[4]
bortezomib, efavirenz, felbamate, fluconazole, fluoxetine, isoniazid, ticlopidine: Has the potential to inhibit CYP2C19 enzymes thereby theoretically increasing the concentrations of esomeprazole.[12][13] budesonide: Enteric coating of medications serves as a barrier to prevent exposure of the medication to acidic pH levels. PPIs increase the pH of the gastric cavity and will therefore increase the exposure of enteric coated medications to this area. By doing so, some adverse events such as gastric irritation or drug degradation/stability changes will occur.[14] carisoprodol, citalopram, clomipramine, escitalopram, fosphenytoin, imipramine, mephenytoin, phenytoin, proguanil, sertraline: Because esomeprazole is a CYP2C19 inhibitor, there is a potential for the concentrations of drugs metabolized by CYP2C19 to increase. This is only a potential and is not definite. Monitoring with the use of esomeprazole and narrow therapeutic index drugs may be advised.[4] ceftibuten: Based on studies that analyzed the co-administration with ranitidine, there is a potential to have increase in both AUC and Cmax with the use of esomeprazole.[15] cyanocobalamin: Cyanocobalamin requires an acidic environment in order to be released from its dietary source. Effects with esomeprazole are based on those observed with omeprazole.[16] dexmethylphenidate: The dissolution of dexmethylphenidate long acting formulations is altered by various pH levels. The elevated pH levels created by PPIs leads to an increased rate of dissolution for this medication and therefore diminishes its long acting effects, but may increase adverse events or drug concentrations.[17] digoxin: Alterations in gastric pH may effect the AUC of this drug. An increased pH with the use of omeprazole has been shown to cause an increase in digoxin AUC by about 10%. There is a potential for the same to occur with the use of esomeprazole. Monitoring is advised as a precautionary measure.[18] misoprostol, octreotide: Potentially decreases the effectiveness of PPIs because PPIs only work on active hydrogen pumps.[6] sucralfate: Based on an interaction with lansoprazole, there is a potential for sucralfate to decrease the bioavailability of esomeprazole.[19] |
Drug-food/drug-herb interactions
| Severity level | Drug and description of interaction |
| 4 | None known |
| 3 | None known |
| 2 | None known |
| 1 | None known |
References
- ↑ Atazanavir package insert. Princeton, NJ; Bristol-Myers Squibb Company; 2006 August.
- ↑ Pletal (cilostazol) package insert. Tokushima, Japan: Otsuka Pharmaceutical Co., Ltd.; 2004 Feb.
- ↑ Lexi-Comp (2003). Drug Information Handbook. 11th Edition., APhA
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 Nexium (esomeprazole magnesium) package insert for PO use Wilmington, DE; AstraZeneca; 2006 October.
- ↑ Rescriptor (delavirdine) package insert. La Jolla, CA: Agouron Pharmaceuticals; 2006 Feb.
- ↑ 6.0 6.1 6.2 Soll AH, for the Practice Parameters Committee of the American College of Gastroenterology. Medical Treatment of Peptic Ulcer Disease: Practice Guidelines. JAMA 1996;275:622—9.
- ↑ Fosamax® (alendronate sodium) package insert. Whitehouse Station, NJ; Merck & Co.Inc; 2006 Nov.
- ↑ Dixit RK, Chawla AB, Kumar N, et al. Effect of omeprazole on the pharmacokinetics of sustained-release carbamazepine in healthy male volunteers. Methods Find Exp Clin Pharmacol 2001;23:37—9.
- ↑ Lescol® (fluvastatin) package insert. East Hanover, NJ: Novartis Pharmaceuticals Corporation; 2005 Jan.
- ↑ Iressa® (gefitinib) package insert. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2003 May.
- ↑ EC Naprosyn® (naproxen delayed-release) package insert. Nutley, NJ: Roche Laboratories, Inc.; 2003 May.
- ↑ Velcade® (bortezomib) package insert. Cambridge, MA: Millennium Pharmaceuticals, Inc.; 2006 Dec.
- ↑ Sustiva® (efavirenz) package insert. Princeton, NJ: Bristol-Myers Squibb Company; 2007 Jan.
- ↑ Entocort™ EC (budesonide) capsules package insert. Wilmington DE: AstraZeneca Pharmaceuticals LP; 2002 Oct
- ↑ Cedax® (ceftibuten) package insert. Morrisville, NC: Biovail Pharmaceuticals, Inc.; 2002 Mar.
- ↑ Marcuard SP, Albernaz L, Khazanie PG. Omeprazole therapy causes malabsorption of cyanocobalamin (vitamin B12). Ann Intern Med 1994;120:211—5.
- ↑ Focalin™ XR(dexmethylphenidate extended-release) package insert. East Hanover, NJ: Novartis Pharmaceutical Corp.; 2006 August.
- ↑ Oosterhuis B, Jonkman JH, Andersson T, et al. Minor effect of multiple-dose omeprazole on the pharmacokinetics of digoxin after a single oral dose. Br J Clin Pharm 1991;32:569—72.
- ↑ Prevacid® (lansoprazole) package insert. Lake Forest, IL:TAP Pharmaceuticals Inc.; 2004 Jun.
