Drug interactions
Esomeprazole + Rifampin
Severity: Moderate
Esomeprazole and Rifampin: 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
Rifampin is a potent inducer of CYP2C19 and CYP3A4, the enzymes that clear esomeprazole. Exposure to esomeprazole can drop substantially, risking inadequate acid suppression.
What this interaction means in plain words
Esomeprazole and Rifampin 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.
Why it happens
Rifampin induces CYP2C19 and CYP3A4, increasing esomeprazole clearance.
What to do
Monitor for loss of symptom control and consider increasing the esomeprazole dose or using an alternative acid suppressant while on rifampin.
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
Frequently asked questions
Can I take Esomeprazole with Rifampin?
MediHelp rates the interaction as moderate. Esomeprazole and Rifampin 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. Rifampin is a potent inducer of CYP2C19 and CYP3A4, the enzymes that clear esomeprazole. Exposure to esomeprazole can drop substantially, risking inadequate acid suppression.
How serious is the interaction between Esomeprazole and Rifampin?
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 loss of symptom control and consider increasing the esomeprazole dose or using an alternative acid suppressant while on rifampin.
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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