What the FDA labels say about taking them together
Esomeprazole and tacrolimus
Esomeprazole's FDA label of March 19, 2024 names tacrolimus in its drug interactions (prescription label) section; the tacrolimus labels PlainMeds reads (4) do not name esomeprazole. The esomeprazole label: “Potentially increased exposure of tacrolimus, especially in transplant patients who are intermediate or poor metabolizers of CYP2C19.”
Check it at the source: the esomeprazole FDA label on DailyMed (effective March 19, 2024, Haleon US Holdings LLC); the tacrolimus FDA label on DailyMed (effective July 17, 2026, Stellon Biotech Inc.).
What does the esomeprazole label say about tacrolimus?
Esomeprazole label, drug interactions (prescription label)Tacrolimus Clinical Impact: Potentially increased exposure of tacrolimus, especially in transplant patients who are intermediate or poor metabolizers of CYP2C19. Intervention: Monitor tacrolimus whole blood concentrations and consider reducing the dose, if needed, to maintain therapeutic drug concentrations. See prescribing information for tacrolimus.
Esomeprazole Strontium label (R2 Pharma, LLC, September 22, 2016), drug interactionsConcomitant administration of esomeprazole and tacrolimus may increase the serum levels of tacrolimus.
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 tacrolimus label say about esomeprazole?
Tacrolimus's label (effective July 17, 2026) and its 3 other brand-application labels do 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 (Tacrolimus), Stellon Biotech Inc., effective July 17, 2026 (SPL set 6b89e8a4-9f11-42e3-8e79-fe617e7c461f), 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 | Tacrolimus | |
|---|---|---|
| Labeled for | Acid reflux and ulcers | Organ transplant rejection, Eczema (atopic dermatitis) |
| Boxed warning | No | Yes |
| Pharmacy cost (NADAC) | $0.145 per capsule 20 mg capsule | $0.970 per gram 0.1% ointment |
| 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