Drug interactions
Esomeprazole + Itraconazole
Severity: Major
Esomeprazole and Itraconazole: major interaction.
Last updated Sources: US FDA label
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
Reduced gastric acidity impairs dissolution and absorption of itraconazole capsules, which can cause subtherapeutic antifungal levels and treatment failure. The oral solution and SUBA formulations are less affected.
What this interaction means in plain words
Esomeprazole and Itraconazole 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; Itraconazole belongs to Anti Fungals.
Why it happens
Raised gastric pH decreases dissolution and absorption of acid-dependent itraconazole capsules.
What to do
Avoid PPIs with itraconazole capsules or use the oral solution, which is not acid-dependent. Monitor itraconazole levels and clinical response if co-therapy is unavoidable.
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?
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References
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Frequently asked questions
Can I take Esomeprazole with Itraconazole?
MediHelp rates the interaction as major. Esomeprazole and Itraconazole 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. Reduced gastric acidity impairs dissolution and absorption of itraconazole capsules, which can cause subtherapeutic antifungal levels and treatment failure. The oral solution and SUBA formulations are less affected.
How serious is the interaction between Esomeprazole and Itraconazole?
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 PPIs with itraconazole capsules or use the oral solution, which is not acid-dependent. Monitor itraconazole levels and clinical response if co-therapy is unavoidable.
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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