Does Esomeprazole Interact with Ketoconazole?
Esomeprazole and Ketoconazole have a moderate drug interaction according to U.S. FDA drug labeling data. Esomeprazole can reduce ketoconazole absorption due to effects on gastric acid secretion. The mechanism involves decreased intragastric acidity reducing drug bioavailability. Patients taking both medications should consult their healthcare provider before starting, stopping, or changing the dosage of either drug. This information is based on official FDA drug labeling sourced from OpenFDA and the NIH National Library of Medicine.
- Severity
- Moderate
- Esomeprazole Class
- Proton Pump Inhibitor
- Ketoconazole Class
- Azole Antifungal
- Management
- Monitor for effects
- Data Source
- U.S. FDA via OpenFDA
How This Interaction Works
The interaction between Esomeprazole and Ketoconazole occurs because decreased intragastric acidity reducing drug bioavailability. Clinically, this means esomeprazole can reduce ketoconazole absorption due to effects on gastric acid secretion. This is classified as a moderate interaction. While it may not require stopping either medication, your healthcare provider should be aware you are taking both so they can monitor for potential effects and adjust treatment if necessary.
What To Tell Your Doctor or Pharmacist
If you are taking Esomeprazole and your doctor is considering prescribing Ketoconazole (or vice versa), make sure to:
- Inform your doctor and pharmacist of all current medications, including over-the-counter drugs and supplements
- Ask whether the benefits of combining these medications outweigh the risks for your specific situation
- Ask what symptoms to watch for that would indicate the interaction is causing problems
- Ask whether any dosage adjustments are needed
- Never stop or change either medication without first consulting your healthcare provider