What the FDA labels say about taking them together
Esomeprazole and rilpivirine
Esomeprazole's FDA label of March 19, 2024 names rilpivirine in its drug interactions (prescription label) section, and rilpivirine's label names esomeprazole too. The rilpivirine label: “Coadministration is contraindicated with EDURANT or EDURANT PED.”
Check it at the source: the esomeprazole FDA label on DailyMed (effective March 19, 2024, Haleon US Holdings LLC); the rilpivirine FDA label on DailyMed (effective August 28, 2025, Janssen Products, LP).
What does the esomeprazole label say about rilpivirine?
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. …
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 rilpivirine label say about esomeprazole?
Rilpivirine label, contraindicationsDrug Class: Proton Pump Inhibitors; Contraindicated Drugs in Class: e.g., Esomeprazole Lansoprazole Omeprazole Pantoprazole Rabeprazole; Clinical Comment: Potential for significant decreases in rilpivirine plasma concentrations due to gastric pH increase, which may result in loss of virologic response.
Rilpivirine label, drug interactionsConcomitant Drug Class/Drug Name: Proton Pump Inhibitors: e.g., esomeprazole lansoprazole omeprazole pantoprazole rabeprazole; Effect on Concentration of Rilpivirine or Concomitant Drug: ↓ rilpivirine; Clinical Comment: Coadministration is contraindicated with EDURANT or EDURANT PED [see ].
Source: FDA drug label (EDURANT), Janssen Products, LP, effective August 28, 2025 (SPL set 03880372-2c68-45c6-a53a-f420c49541d6), 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 | Rilpivirine | |
|---|---|---|
| Labeled for | Acid reflux and ulcers | HIV |
| Boxed warning | No | No |
| Pharmacy cost (NADAC) | $0.145 per capsule 20 mg capsule | $48.04 per tablet 25 mg tablet |
| 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