Drug interactions
Esomeprazole + Istradefylline
Severity: Minor
Esomeprazole and Istradefylline: minor 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
Istradefylline at 40 mg daily can raise exposure to sensitive CYP3A4 substrates, but this was not seen at 20 mg daily. Esomeprazole is metabolized mainly by CYP2C19 with a smaller CYP3A4 contribution, and has a wide therapeutic margin, so a meaningful effect is unlikely.
What this interaction means in plain words
Esomeprazole and Istradefylline have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Esomeprazole belongs to Gastrointestinal Tract; Istradefylline belongs to Central Nervous System.
Why it happens
Weak CYP3A4 inhibition by istradefylline at higher doses may modestly reduce the minor CYP3A4 metabolic pathway of esomeprazole.
What to do
No routine dose change is needed; be alert for increased PPI adverse effects if istradefylline 40 mg/day is used.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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 Istradefylline
Frequently asked questions
Can I take Esomeprazole with Istradefylline?
MediHelp rates the interaction as minor. Esomeprazole and Istradefylline have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Istradefylline at 40 mg daily can raise exposure to sensitive CYP3A4 substrates, but this was not seen at 20 mg daily. Esomeprazole is metabolized mainly by CYP2C19 with a smaller CYP3A4 contribution, and has a wide therapeutic margin, so a meaningful effect is unlikely.
How serious is the interaction between Esomeprazole and Istradefylline?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine dose change is needed; be alert for increased PPI adverse effects if istradefylline 40 mg/day is used.
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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