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Esomeprazole Drug Interactions

Digoxin
Esomeprazole may slightly increase the level of digoxin in the blood. Your healthcare provider may choose to monitor you more closely. Esomeprazole may cause low blood magnesium levels, which can lead to serious arrhythmias (irregular heart rhythms), especially in people taking digoxin. Your healthcare provider may decide to monitor your magnesium levels periodically if you are taking digoxin and esomeprazole.
 
Certain Diuretics 
Esomeprazole can cause low blood magnesium (hypomagnesemia). Because certain diuretics can also cause this problem, combining esomeprazole with one of these diuretics could cause severely low blood magnesium levels, which may lead to serious side effects such as muscle spasms, irregular heart rhythms, or seizures. Your healthcare provider may decide to monitor your magnesium levels periodically if you are taking esomeprazole with one of these diuretics.
  
Erlotinib
Esomeprazole may decrease the absorption of erlotinib, perhaps making it less effective. Your healthcare provider may recommend an alternative to esomeprazole while you are taking erlotinib.
 
Iron
Esomeprazole may decrease the absorption of iron supplements and medications, since stomach acid is necessary for iron absorption. If you need to take iron for a medical reason (such as for anemia), your healthcare provider may recommend an alternative to esomeprazole.
 
Mesalamine
Esomeprazole may interfere with the delayed-release mechanism of Apriso capsules, perhaps making Apriso less effective. This is not thought to be a problem with other mesalamine products. In general, these medications should not be taken together.
 
Methotrexate
Esomeprazole might increase the level of methotrexate in the blood, increasing the risk for methotrexate side effects. Check with your healthcare provider before combining these two medications.
  
Rifampin
Rifampin may significantly decrease the level of esomeprazole in the blood, making it less effective. These medications should not be combined.
  
Some Protease Inhibitors
Esomeprazole may decrease the level of atazanavir or nelfinavir in the blood. It may increase the level of saquinavir in the blood. If you take a protease inhibitor, check with your healthcare provider before taking esomeprazole. In many situations, esomeprazole will not be recommended.
 
St. John's Wort
St. Johns wort may significantly decrease the level of esomeprazole in the blood, making it less effective. These medications should not be combined.

Esomeprazole Magnesium

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