Drug interactions
Escitalopram + Esomeprazole
Severity: Moderate
Escitalopram and Esomeprazole: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Esomeprazole inhibits CYP2C19, which helps clear escitalopram, so escitalopram levels may increase. Higher exposure can increase serotonergic adverse effects and QT prolongation.
What this interaction means in plain words
Escitalopram and Esomeprazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Escitalopram belongs to Central Nervous System; Esomeprazole belongs to Gastrointestinal Tract.
Why it happens
Esomeprazole inhibits CYP2C19, reducing escitalopram metabolism.
What to do
Monitor for adverse effects and consider a lower escitalopram dose, as labeling advises a maximum of 10 mg daily with CYP2C19 inhibitors in some regions. Consider an ECG in patients with QT risk factors.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Esomeprazole
- Esomeprazole + Mavacamten Contraindicated
- Esomeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Esomeprazole Major
- Atazanavir + Esomeprazole Major
- Citalopram + Esomeprazole Major
- Clopidogrel + Esomeprazole Major
Other interactions of Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Frequently asked questions
Can I take Escitalopram with Esomeprazole?
MediHelp rates the interaction as moderate. Escitalopram and Esomeprazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Esomeprazole inhibits CYP2C19, which helps clear escitalopram, so escitalopram levels may increase. Higher exposure can increase serotonergic adverse effects and QT prolongation.
How serious is the interaction between Escitalopram and Esomeprazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for adverse effects and consider a lower escitalopram dose, as labeling advises a maximum of 10 mg daily with CYP2C19 inhibitors in some regions. Consider an ECG in patients with QT risk factors.
What other medicines interact with Esomeprazole?
MediHelp also lists interactions of Esomeprazole with, for example, Mavacamten, Rilpivirine, Acalabrutinib. The full list is on the Esomeprazole page.
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