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Drug Interactions between esomeprazole and Mavyret

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

esomeprazole glecaprevir

Applies to: esomeprazole and Mavyret (glecaprevir / pibrentasvir)

MONITOR: Coadministration with omeprazole may decrease the plasma concentrations of glecaprevir. The mechanism of interaction has not been established. When a single 300 mg-120 mg dose of glecaprevir-pibrentasvir was administered with omeprazole 20 mg once daily to 9 study subjects, glecaprevir peak plasma concentration (Cmax) and systemic exposure (AUC) decreased by 22% and 29%, respectively. When the dose of glecaprevir-pibrentasvir was administered with omeprazole 40 mg once daily (one hour before glecaprevir-pibrentasvir) to 12 study subjects, glecaprevir Cmax decreased by 64% and AUC decreased by 51%. The pharmacokinetics of pibrentasvir were not affected.

MANAGEMENT: According to the manufacturer, no dosage adjustment is necessary for glecaprevir-pibrentasvir during coadministration with omeprazole. However, the potential for diminished pharmacologic effects of glecaprevir-pibrentasvir should be considered during coadministration with higher dosages of omeprazole. Alternative treatments may be required if an interaction is suspected.

References (1)
  1. (2017) "Product Information. Mavyret (glecaprevir-pibrentasvir)." Abbott Pharmaceutical

Drug and food interactions

Moderate

esomeprazole food

Applies to: esomeprazole

ADJUST DOSING INTERVAL: Food may interfere with the absorption of esomeprazole. The manufacturer reports that the area under the concentration-time curve for esomeprazole following a single 40 mg dose was 33% to 53% lower when administered after food intake as opposed to during fasting conditions.

MANAGEMENT: Esomeprazole should be taken at least one hour before meals. When administered to patients receiving continuous enteral nutrition, some experts recommend that the tube feeding should be interrupted for at least 1 hour before and 1 hour after the dose of esomeprazole is given.

References (2)
  1. (2001) "Product Information. Nexium (esomeprazole)." Astra-Zeneca Pharmaceuticals
  2. Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT (2009) "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm, 66, p. 1438-67
Moderate

glecaprevir food

Applies to: Mavyret (glecaprevir / pibrentasvir)

ADJUST DOSING INTERVAL: Food enhances the oral bioavailability of glecaprevir and pibrentasvir. Relative to fasting conditions, mean glecaprevir systemic exposure (AUC) increased by 83% to 163% and mean pibrentasvir AUC increased by 40% to 53% when administered with moderate to high fat meals.

MANAGEMENT: Glecaprevir-pibrentasvir should be administered with food.

References (1)
  1. (2017) "Product Information. Mavyret (glecaprevir-pibrentasvir)." Abbott Pharmaceutical

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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