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Drug interactions

Lansoprazole + Nelfinavir

Severity: Major

Lansoprazole and Nelfinavir: 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

Lansoprazole may lower nelfinavir exposure and its active metabolite, risking loss of virologic suppression and resistance. Nelfinavir labeling advises against coadministration with proton pump inhibitors.

What this interaction means in plain words

Lansoprazole and Nelfinavir 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.

Lansoprazole belongs to Gastrointestinal Tract; Nelfinavir belongs to Anti Virals.

Evidence level: Moderate

Why it happens

Reduced gastric acidity may impair nelfinavir absorption and CYP2C19 inhibition may reduce formation of its active M8 metabolite.

What to do

Avoid the combination; use an H2 antagonist or antacid with appropriate spacing instead. If unavoidable, monitor HIV RNA closely.

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 Lansoprazole with Nelfinavir?

MediHelp rates the interaction as major. Lansoprazole and Nelfinavir 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. Lansoprazole may lower nelfinavir exposure and its active metabolite, risking loss of virologic suppression and resistance. Nelfinavir labeling advises against coadministration with proton pump inhibitors.

How serious is the interaction between Lansoprazole and Nelfinavir?

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 the combination; use an H2 antagonist or antacid with appropriate spacing instead. If unavoidable, monitor HIV RNA closely.

What other medicines interact with Lansoprazole?

MediHelp also lists interactions of Lansoprazole with, for example, Mavacamten, Rilpivirine, Acalabrutinib. The full list is on the Lansoprazole page.

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