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Drug interactions

Esomeprazole + Gefitinib

Severity: Major

Esomeprazole and Gefitinib: major 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

Gefitinib solubility falls as gastric pH rises, and PPIs can markedly lower gefitinib exposure. This may reduce anticancer efficacy.

What this interaction means in plain words

Esomeprazole and Gefitinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.

Esomeprazole belongs to Gastrointestinal Tract; Gefitinib belongs to Oncology.

Evidence level: High

Why it happens

Sustained increases in gastric pH reduce gefitinib dissolution and absorption.

What to do

Avoid concomitant PPI use if possible; if a PPI is essential, give gefitinib 12 hours after the PPI dose and consider an alternative acid reducer.

What to ask your pharmacist

  • Does the benefit of taking both outweigh the risk in my case?
  • Do I need any blood test, ECG or other check while on both?
  • What early warning signs should I watch for, and what should I do if they appear?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Esomeprazole with Gefitinib?

MediHelp rates the interaction as major. Esomeprazole and Gefitinib can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Gefitinib solubility falls as gastric pH rises, and PPIs can markedly lower gefitinib exposure. This may reduce anticancer efficacy.

How serious is the interaction between Esomeprazole and Gefitinib?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concomitant PPI use if possible; if a PPI is essential, give gefitinib 12 hours after the PPI dose and consider an alternative acid reducer.

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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