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The absorption of ketoconazole and itraconazole can decrease during treatment with esomeprazole.
Concomitant administration with esomeprazole and atazanavir is not recommended.
When esomeprazole is combined with drugs metabolized by CYP2C19, such as diazepam, citalopram, imipramine, clomipramine, phenytoin etc, the plasma concentrations of these drugs may be increased and a dose reduction could be needed. It is recommended to monitor the plasma concentration of phenytoin when treatment with esomeprazole is introduced or withdrawn.
Monitoring is recommended when initiating and ending concomitant esomeprazole treatment during treatment with warfarin or other coumarine derivatives.
Esomeprazole has been shown to have no clinically relevant effects on the pharmacokinetics of amoxicillin or quinidine.
Concomitant administration of esomeprazole and a combined inhibitor of CYP2C19 and CYP3A4, such as voriconazole, may result in more than doubling of esomeprazole exposure.
