Naproxen and esomeprazole and Tenofovir interaction
Naproxen and esomeprazole and Tenofovir: both prescribing labels 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 Tenofovir (Viread) label · effective 2025-02-18
VIREAD should be avoided with concurrent or recent use of a nephrotoxic agent (e.g., high-dose or multiple non-steroidal anti-inflammatory drugs [NSAIDs]) [see Drug Interactions (7.1) ] .
Cases of acute renal failure after initiation of high-dose or multiple NSAIDs have been reported in HIV-infected patients with risk factors for renal dysfunction who appeared stable on TDF.
Alternatives to NSAIDs should be considered, if needed, in patients at risk for renal dysfunction.
Some examples include, but are not limited to, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple NSAIDs [see Warnings and Precautions (5.2) ].
From the Naproxen and esomeprazole (Naproxen and esomeprazole magnesium) label · effective 2026-05-27
• Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with esomeprazole magnesium may reduce antiviral effect and promote the development of drug resistance [see Clinical Pharmacology (12.3) ].
• Increased exposure of other antiretroviral drugs (e.g., saquinavir) when used concomitantly with esomeprazole magnesium may increase toxicity [see Clinical Pharmacology (12.3) ].
Antiretrovirals Clinical Impact : The effect of esomeprazole magnesium on antiretroviral drugs is variable.
• There are other antiretroviral drugs which do not result in clinically relevant interactions with esomeprazole magnesium.
Other antiretrovirals : See prescribing information of specific drugs.
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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.