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Does Nelfinavir Interact with Esomeprazole?

Nelfinavir and Esomeprazole have a contraindicated drug interaction according to U.S. FDA drug labeling data. Concomitant use is not recommended. Co-administration decreases nelfinavir serum levels (AUC decreased by 92%, Cmax by 89%, Cmin by 75%) and active metabolite M8 levels. The mechanism involves increased gastric ph reducing absorption and possible cyp2c19 interaction. 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
Contraindicated
Esomeprazole Class
Proton Pump Inhibitor
Management
Do not take together
Data Source
U.S. FDA via OpenFDA

How This Interaction Works

The interaction between Nelfinavir and Esomeprazole occurs because increased gastric ph reducing absorption and possible cyp2c19 interaction. Clinically, this means concomitant use is not recommended. co-administration decreases nelfinavir serum levels (auc decreased by 92%, cmax by 89%, cmin by 75%) and active metabolite m8 levels. Because of the severity of this interaction, these medications are contraindicated — meaning they should not be taken together under any circumstances. If you are currently taking both, contact your healthcare provider immediately to discuss alternatives.

What To Tell Your Doctor or Pharmacist

If you are taking Nelfinavir and your doctor is considering prescribing Esomeprazole (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 about alternative medications that do not interact with your current regimen
  • Ask how frequently you should be monitored while these are co-prescribed
  • Never stop or change either medication without first consulting your healthcare provider
💊 Nelfinavir+💊 Esomeprazole

Severity & Interaction Details

⛔
contraindicated
Avoid this combination
FDA labeling lists this pair as contraindicated. The risk outweighs the benefit in nearly all cases.
Severity scale
MinorContra
On record
Yes
Drug A class
—
Drug B class
Proton Pump Inhibitor
Source
NLP:esomeprazole dr

What this means in plain English

Concomitant use is not recommended. Co-administration decreases nelfinavir serum levels (AUC decreased by 92%, Cmax by 89%, Cmin by 75%) and active metabolite M8 levels.

What the FDA label says

"Increased gastric pH reducing absorption and possible CYP2C19 interaction"

📖 Source: NLP:esomeprazole dr

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Data sourced from U.S. FDA drug labeling via openFDA and the NIH National Library of Medicine. For informational purposes only. Always consult your pharmacist or physician.