What the FDA labels say about taking them together
Esomeprazole and rifampin
Esomeprazole's FDA label of March 19, 2024 names rifampin in its drug interactions (prescription label) section; the rifampin label PlainMeds reads does not name esomeprazole. The esomeprazole label: “Decreased exposure of esomeprazole when used concomitantly with strong inducers.”
Check it at the source: the esomeprazole FDA label on DailyMed (effective March 19, 2024, Haleon US Holdings LLC); the rifampin FDA label on DailyMed (effective February 11, 2026, Lupin Pharmaceuticals, Inc.).
What does the esomeprazole label say about rifampin?
Esomeprazole label, drug interactions (prescription label)Clinical Impact: Decreased exposure of esomeprazole when used concomitantly with strong inducers. Intervention: St. John’s Wort, rifampin: Avoid concomitant use with [see Warnings and Precautions (5.10) ]. Ritonavir-containing products: see prescribing information for specific drugs Voriconazole
Esomeprazole label, warnings and precautions (prescription label)Interaction with St. John’s Wort or Rifampin: Avoid concomitant use of NEXIUM.
Esomeprazole Strontium label (R2 Pharma, LLC, September 22, 2016), drug interactionsDrugs known to induce CYP2C19 or CYP3A4 or both (such as rifampin) may lead to decreased esomeprazole serum levels.
Esomeprazole Strontium label (R2 Pharma, LLC, September 22, 2016), warnings and precautionsUse of Esomeprazole Strontium with St. John’s Wort or Rifampin Drugs which induce CYP2C19 or CYP3A4 (such as St. John’s Wort or rifampin) can substantially decrease esomeprazole concentrations [see Drug Interactions (7.3)].
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 rifampin label say about esomeprazole?
Rifampin's label (effective February 11, 2026) does not name esomeprazole in these sections. A label lists what its studies and reports found; it is not a complete list.
Source: FDA drug label (rifampin), Lupin Pharmaceuticals, Inc., effective February 11, 2026 (SPL set b56004f0-f23d-47f6-80c7-39884fccbccc), 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 | Rifampin | |
|---|---|---|
| Labeled for | Acid reflux and ulcers | n/a |
| Boxed warning | No | No |
| Pharmacy cost (NADAC) | $0.145 per capsule 20 mg capsule | $0.679 per capsule 300 mg capsule |
| Shortage now | No current entry | In shortage |
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