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Drug Interactions between esomeprazole and nelfinavir

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

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Interactions between your drugs

Major

nelfinavir esomeprazole

Applies to: nelfinavir and esomeprazole

GENERALLY AVOID: Concurrent use of inhibitors of the proton pump (PPIs or potassium-competitive acid blockers [PCABs]) may decrease the oral bioavailability of nelfinavir and reduce its concentrations in plasma. Nelfinavir solubility may decrease with increasing pH, thus inhibition of gastric acid secretion may interfere with dissolution of the drug. In one study, administration of omeprazole (40 mg once daily) 30 minutes before nelfinavir (1250 mg twice a day) for 4 days reduced the peak plasma concentration, trough plasma concentration, and systemic exposure (AUC) of nelfinavir by a little over one-third.

MANAGEMENT: Given the risk of reduced viral susceptibility and resistance development associated with subtherapeutic antiretroviral drug levels, use of inhibitors of the proton pump is not recommended in patients treated with nelfinavir.

References

  1. (2001) "Product Information. Viracept (nelfinavir)." Agouron Pharma Inc
  2. Durant J, Clevenbergh P, Garraffo R, Halfon P, Icard S, DelGiudice P, Montagne N, Schapiro JM, Dellamonica P (2000) "Importance of protease inhibitor plasma levels in HIV-infected patients treated with genotypic-guided therapy: pharmacological data from the Viradapt Study." Aids, 14, p. 1333-9
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  4. Fang AF, Damle BD, Labadie RR, Crownover PH, Hewlett D, Glue PW (2008) "Significant decrease in nelfinavir systemic exposure after omeprazole coadministration in healthy subjects." Pharmacotherapy, 28, p. 42-50
  5. (2022) "Product Information. Voquezna Dual Pak (amoxicillin-vonoprazan)." Phathom Pharmaceuticals, Inc
  6. (2022) "Product Information. Voquezna Triple Pak (amoxicillin/clarithromycin/vonoprazan)." Phathom Pharmaceuticals, Inc
View all 6 references

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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

  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

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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.

See also

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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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