Proton pump inhibitor
Esomeprazole with antibiotics: interactions and safety
Antibiotic courses are common, short-term and often combined with chronic medications such as Esomeprazole (Esomeprazole). Most antibiotics do not interfere meaningfully with Esomeprazole at 20mg, 40mg, but a few classes do, and a small number of combinations are best avoided.
Common antibiotic interactions
Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Proton pump inhibitor agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Esomeprazole at 20mg, 40mg.
Practical guidance
According to the prescribing information for Esomeprazole, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Esomeprazole is co-administered. Adjusted 20mg, 40mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.
Frequently asked questions
Can I take Esomeprazole during an antibiotic course? ▾
For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Esomeprazole is metabolised and may need a temporary 20mg, 40mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Esomeprazole regimen.
Will antibiotics make Esomeprazole stop working? ▾
Most antibiotics do not affect Esomeprazole efficacy. Rifampicin and a few others can lower Esomeprazole levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.
Products containing Esomeprazole
More on Esomeprazole
- With alcoholEsomeprazole and alcohol — is it safe to drink?
- With foodShould Esomeprazole be taken with food?
- Side effectsEsomeprazole side effects: common, rare and warning signs
- Dosage guideEsomeprazole dosage guide: how much to take and when
- OnsetHow fast does Esomeprazole start working?
- DurationHow long does Esomeprazole last?
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.