Digoxin and Esomeprazole interaction

Digoxin and Esomeprazole: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Digoxin label · effective 2025-04-10

Moderate

…to 49% NA Ticagrelor 31% 28% Tolvaptan 30% 20% Trimethoprim 22 to 28% NA Digoxin Concentrations Increased, but Magnitude is Unclear Alprazolam, Azithromycin, Cyclosporine, Diclofenac, Diphenoxylate, Epoprostenol, Esomeprazole, Ibuprofen, Ketoconazole, Lansoprazole, Metformin, Omeprazole Measure serum digoxin concentrations before initiating concomitant drugs.

Drug interactionsnames EsomeprazoleView label on DailyMed

From the Esomeprazole (NEXIUM) label · effective 2025-12-19

Moderate

For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ] .

Warnings and precautionsnames DigoxinView label on DailyMed
Moderate

Digoxin Clinical Impact: Potential for increased exposure of digoxin [see Clinical Pharmacology (12.3) ].

Drug interactionsnames DigoxinView label on DailyMed
Moderate

Intervention: Monitor digoxin concentrations and adjust the dose, if needed, to maintain therapeutic drug concentrations.

Drug interactionsnames DigoxinView label on DailyMed
Minor

See prescribing information for digoxin.

Drug interactionsnames DigoxinView label on DailyMed

Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.