What the FDA labels say about taking them together
Esomeprazole and omeprazole
Esomeprazole's FDA label of March 19, 2024 names omeprazole in its drug interactions (prescription label) section; omeprazole's label does not name esomeprazole itself but warns about its class (Proton pump inhibitors (PPIs)). The esomeprazole label: “Esomeprazole can reduce the absorption of other drugs due to its effect on reducing intragastric acidity”
Check it at the source: the esomeprazole FDA label on DailyMed (effective March 19, 2024, Haleon US Holdings LLC); the omeprazole FDA label on DailyMed (effective April 22, 2024, Apotex Corp).
What does the esomeprazole label say about omeprazole?
Esomeprazole label, drug interactions (prescription label)Clinical Impact: Esomeprazole can reduce the absorption of other drugs due to its effect on reducing intragastric acidity Intervention: Mycophenolate mofetil (MMF): Co-administration of omeprazole, of which esomeprazole is an enantiomer, in healthy subjects and in transplant patients receiving MMF has been reported to reduce the exposure to the active metabolite, mycophenolic acid (MPA), possibly due to a decrease in MMF …
Esomeprazole Strontium label (R2 Pharma, LLC, September 22, 2016), drug interactionsIncreased gastric pH during omeprazole treatment may change the absorption of the antiretroviral drug.
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 omeprazole label say about esomeprazole?
Omeprazole's label does not name esomeprazole itself; it warns about its class (Proton pump inhibitors (PPIs)):
Omeprazole label, contraindicationsProton pump inhibitors (PPIs), including omeprazole, are contraindicated in patients receiving rilpivirine-containing products [see Drug Interactions ( 7 )].
Omeprazole label, drug interactionsIncreased INR and prothrombin time in patients receiving PPIs, including omeprazole, and warfarin concomitantly.
Source: FDA drug label (Omeprazole), Apotex Corp, effective April 22, 2024 (SPL set b83329ac-a65e-b3af-a3fb-c5a6c740e5e7), 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 | Omeprazole | |
|---|---|---|
| Labeled for | Acid reflux and ulcers | Acid reflux and ulcers |
| Boxed warning | No | No |
| Pharmacy cost (NADAC) | $0.145 per capsule 20 mg capsule | $0.0295 per capsule 20 mg capsule |
| Shortage now | No current entry | A presentation being discontinued |
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