What the FDA labels say about taking them together
Digoxin and esomeprazole
Digoxin's FDA label of December 5, 2024 names esomeprazole in its drug interactions section, and esomeprazole's label names digoxin too. The esomeprazole label: “Potential for increased exposure of digoxin.”
Check it at the source: the digoxin FDA label on DailyMed (effective December 5, 2024, Advanz Pharma (US) Corp.); the esomeprazole FDA label on DailyMed (effective March 19, 2024, Haleon US Holdings LLC).
What does the digoxin label say about esomeprazole?
Digoxin label, drug interactionsAlprazolam, azithromycin, cyclosporine, diclofenac, diphenoxylate, epoprostenol, esomeprazole, ibuprofen, ketoconazole, lansoprazole, metformin, omeprazole; Measure serum digoxin concentrations before initiating concomitant drugs. Continue monitoring and reduce digoxin dose as necessary.
Source: FDA drug label (LANOXIN), Advanz Pharma (US) Corp., effective December 5, 2024 (SPL set d91e3646-4c63-4512-ab22-db39c085c4dc), via openFDA; the full label on DailyMed
What does the esomeprazole label say about digoxin?
Esomeprazole label, drug interactions (prescription label)Digoxin Clinical Impact: Potential for increased exposure of digoxin. Intervention: Monitor digoxin concentrations and adjust the dose, if needed, to maintain therapeutic drug concentrations. See prescribing information for digoxin.
Esomeprazole label, warnings and precautions (prescription label)For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ].
Esomeprazole Strontium label (R2 Pharma, LLC, September 22, 2016), drug interactionsLike with other drugs that decrease the intragastric acidity, the absorption of drugs such as ketoconazole, atazanavir, iron salts, erlotinib, and mycophenolate mofetil (MMF) can decrease, while the absorption of drugs such as digoxin can increase during treatment with omeprazole.
Source: FDA drug label (Esomeprazole Strontium, NDA202342), R2 Pharma, LLC, effective September 22, 2016 (SPL set 3c916d32-f9e9-1d15-e054-00144ff88e88), via openFDA
Source: FDA drug label (Nexium 24HR), NDA204655 (Astrazeneca Lp), as published by Haleon US Holdings LLC, effective March 19, 2024 (SPL set 4513934d-0cf0-40fc-a348-b4e75a33b094), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Digoxin | Esomeprazole | |
|---|---|---|
| Labeled for | Heart failure, Atrial fibrillation | Acid reflux and ulcers |
| Boxed warning | No | No |
| Pharmacy cost (NADAC) | $0.133 per tablet 125 mcg tablet | $0.145 per capsule 20 mg capsule |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once