Esomeprazole and Rifampin interaction
Esomeprazole and Rifampin: the Esomeprazole prescribing label flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Esomeprazole (NEXIUM) label · effective 2025-12-19
John’s Wort or Rifampin: Avoid concomitant use of NEXIUM.
John’s Wort, rifampin : Avoid concomitant use with [see Warnings and Precautions (5.10) ].
John’s Wort or rifampin) can substantially decrease esomeprazole concentrations [see Drug Interactions (7) ] .
Table 4: Clinically Relevant Interactions Affecting Esomeprazole When Co-Administered with Other Drugs CYP2C19 or CYP3A4 Inducers Clinical Impact: Decreased exposure of esomeprazole when used concomitantly with strong inducers [see Clinical Pharmacology (12.3) ].
John’s Wort or rifampin.
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot 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.