What the FDA labels say about taking them together
Esomeprazole and nelfinavir
Esomeprazole's FDA label of March 19, 2024 names nelfinavir in its drug interactions (prescription label) section; nelfinavir's label does not name esomeprazole itself but warns about its class (Proton pump inhibitors (PPIs)). The esomeprazole label: “The effect of PPIs on antiretroviral drugs is variable. The clinical importance and the mechanisms behind these interactions are not always known. …”
Check it at the source: the esomeprazole FDA label on DailyMed (effective March 19, 2024, Haleon US Holdings LLC); the nelfinavir FDA label on DailyMed (effective December 11, 2025, AGOURON).
What does the esomeprazole label say about nelfinavir?
Esomeprazole label, drug interactions (prescription label)Antiretrovirals Clinical Impact: The effect of PPIs on antiretroviral drugs is variable. The clinical importance and the mechanisms behind these interactions are not always known. • Decreased exposure of some antiretroviral drugs (…) when used concomitantly with esomeprazole may reduce antiviral effect and promote the development of drug resistance. … Intervention: Rilpivirine-containing products: Concomitant use with NEXIUM is contraindicated [see ]. Atazanavir: See prescribing information for atazanavir for dosing information. Nelfinavir: Avoid concomitant use with NEXIUM. See prescribing information for nelfinavir. …
Esomeprazole Strontium label (R2 Pharma, LLC, September 22, 2016), drug interactionsDRUG INTERACTIONS 7.1 Interference with Antiretroviral Therapy Concomitant use of atazanavir and nelfinavir with proton pump inhibitors is not recommended.
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
What does the nelfinavir label say about esomeprazole?
Nelfinavir's label does not name esomeprazole itself; it warns about its class (Proton pump inhibitors (PPIs)):
Nelfinavir label, drug interactionsPROTON PUMP INHIBITORS Omeprazole ↓ nelfinavir Omeprazole decreases the plasma concentrations of nelfinavir.
Nelfinavir label, drug interactionsPROTON PUMP INHIBITORS Omeprazole ↓ nelfinavir Omeprazole decreases the plasma concentrations of nelfinavir. Concomitant use of proton pump inhibitors and VIRACEPT may lead to a loss of virologic response and development of resistance.
Source: FDA drug label (VIRACEPT), AGOURON, effective December 11, 2025 (SPL set e72c2bc6-9462-4a2e-8e1d-b97592376cbd), 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
| Esomeprazole | Nelfinavir | |
|---|---|---|
| Labeled for | Acid reflux and ulcers | HIV |
| Boxed warning | No | No |
| Pharmacy cost (NADAC) | $0.145 per capsule 20 mg capsule | n/a |
| 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