Drug interactions
Esomeprazole + Letermovir
Severity: Moderate
Esomeprazole and Letermovir: 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
Letermovir inhibits CYP3A4 and can raise levels of substrates, but it also induces CYP2C19 and CYP2C9. For PPIs metabolized by CYP2C19, such as esomeprazole, the net effect is more likely a reduction in exposure.
What this interaction means in plain words
Esomeprazole and Letermovir 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 belongs to Gastrointestinal Tract; Letermovir belongs to Anti Virals.
Why it happens
Letermovir induces CYP2C19, which may lower esomeprazole concentrations, while its CYP3A4 inhibition has a smaller opposing effect.
What to do
Monitor for reduced acid suppression and consider a higher PPI dose if symptoms are not controlled during letermovir therapy.
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 Letermovir
- Ergotamine + Letermovir Contraindicated
- Letermovir + Pimozide Contraindicated
- Apalutamide + Letermovir Major
- Atorvastatin + Letermovir Major
- Carbamazepine + Letermovir Major
- Colchicine + Letermovir Major
Frequently asked questions
Can I take Esomeprazole with Letermovir?
MediHelp rates the interaction as moderate. Esomeprazole and Letermovir 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. Letermovir inhibits CYP3A4 and can raise levels of substrates, but it also induces CYP2C19 and CYP2C9. For PPIs metabolized by CYP2C19, such as esomeprazole, the net effect is more likely a reduction in exposure.
How serious is the interaction between Esomeprazole and Letermovir?
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 reduced acid suppression and consider a higher PPI dose if symptoms are not controlled during letermovir therapy.
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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