What the FDA labels say about taking them together
Esomeprazole and warfarin
Esomeprazole's FDA label of March 19, 2024 names warfarin in its drug interactions (prescription label) section; the warfarin label PlainMeds reads does not name esomeprazole. The esomeprazole label: “Increased INR and prothrombin time in patients receiving PPIs, including esomeprazole, and warfarin concomitantly. Increases in INR and prothrombin time may lead to abnormal bleeding and even death.”
Check it at the source: the esomeprazole FDA label on DailyMed (effective March 19, 2024, Haleon US Holdings LLC); the warfarin FDA label on DailyMed (effective May 29, 2026, Amneal Pharmaceuticals LLC).
What does the esomeprazole label say about warfarin?
Esomeprazole label, drug interactions (prescription label)Warfarin Clinical Impact: Increased INR and prothrombin time in patients receiving PPIs, including esomeprazole, and warfarin concomitantly. Increases in INR and prothrombin time may lead to abnormal bleeding and even death. Intervention: Monitor INR and prothrombin time and adjust the dose of warfarin, if needed, to maintain the target INR range.
Esomeprazole Strontium label (R2 Pharma, LLC, September 22, 2016), drug interactionsAlthough drug interaction studies have not shown that esomeprazole has a clinically significant interaction with warfarin, post-marketing reports of changes in prothrombin measures have been received among patients on concomitant warfarin and esomeprazole therapy.
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 warfarin label say about esomeprazole?
Warfarin's label (effective May 29, 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 (Warfarin Sodium), Amneal Pharmaceuticals LLC, effective May 29, 2026 (SPL set 558b7a0d-5490-4c1b-802e-3ab3f1efe760), 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 | Warfarin | |
|---|---|---|
| Labeled for | Acid reflux and ulcers | Blood clots (DVT and PE), Atrial fibrillation |
| Boxed warning | No | Yes |
| Pharmacy cost (NADAC) | $0.145 per capsule 20 mg capsule | $0.093 per tablet 2 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