Esomeprazole and Posaconazole Interaction
Drug interaction information between Esomeprazole and Posaconazole.
Esomeprazole and Posaconazole have a documented major interaction in FDA labeling.
FDA drug labeling documents a major-severity interaction between Esomeprazole and Posaconazole. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
How They Interact
Esomeprazole changes the acid levels in the stomach, which can prevent certain forms of posaconazole from being absorbed into the body. This may make the antifungal treatment less effective.
What To Do
Avoid taking these together unless your doctor determines the benefits are greater than the risks. Note that this warning may not apply if you are taking the tablet form of posaconazole.
FDA Label Information
Interaction Drug Interaction Rifabutin, phenytoin, efavirenz, cimetidine, esomeprazole* Avoid coadministration unless the benefit outweighs the risks ( 7.6 , 7.7 , 7.8 , 7.9 ) Other drugs metabolized by CYP3A4 Consider dosage adjustment and monitor for adverse effects and toxicity ( 7.1 , 7.10 , 7.11 ) Digoxin Monitor digoxin plasma concentrations ( 7.12 ) Fosamprenavir, metoclopramide* Monitor for breakthrough fungal infections ( 7.6 , 7.13 ) *The drug interactions with esomeprazole and metoclopramide do not apply to posaconazole tablets.
Esomeprazole Also Interacts With
- Clopidogrel moderate
- Digoxin minor
- Risedronate minor
Posaconazole Also Interacts With
- Digoxin major
- Cimetidine major
- Metoclopramide major
- Phenytoin major
- Efavirenz/Emtricitabine/Tenofovir moderate
Frequently Asked Questions
Can I take Esomeprazole and Posaconazole together?
This is a major interaction. Avoid taking these together unless your doctor determines the benefits are greater than the risks. Note that this warning may not apply if you are taking the tablet form of posaconazole.
How serious is the interaction between Esomeprazole and Posaconazole?
This interaction is classified as "major" severity by the FDA. Major interactions may be life-threatening or cause serious side effects.
Why do Esomeprazole and Posaconazole interact?
Esomeprazole changes the acid levels in the stomach, which can prevent certain forms of posaconazole from being absorbed into the body. This may make the antifungal treatment less effective.
Understanding the Esomeprazole and Posaconazole Interaction
FDA-approved prescribing information for these two drugs flags their combination as a major-severity interaction. Esomeprazole belongs to the Proton Pump Inhibitor (PPI) class and Posaconazole belongs to the Azole Antifungal class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Esomeprazole changes the acid levels in the stomach, which can prevent certain forms of posaconazole from being absorbed into the body. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Esomeprazole has 4 total documented interactions on file in this dataset, and Posaconazole has 27. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: Avoid taking these together unless your doctor determines the benefits are greater than the risks. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Esomeprazole or Posaconazole based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.