Esomeprazole Actavis Drug Interactions

Other Medicines and Esomeprazole Actavis: Tell the physician or pharmacist if the patient is taking, have recently taken or might take any other medicines. This is because Esomeprazole Actavis can affect the way some medicines work and some medicines can have an effect on Esomeprazole Actavis.
Do not take Esomeprazole Actavis if the patient is taking a medicine containing nelfinavir (used to treat HIV infection).
Tell the physician or pharmacist if the patient is taking any of the following medicines:
Atazanavir (used to treat HIV infection).
Clopidogrel (used to prevent blood clots).
Ketoconazole, itraconazole or voriconazole (used to treat infections caused by a fungus).
Erlotinib (used to treat cancer).
Citalopram, imipramine, clomipramine (used to treat depression).
Diazepam (used to treat anxiety, relax muscles or in epilepsy).
Phenytoin (used in epilepsy). If the patient is taking phenytoin, the physician will need to monitor the patient when starting or stopping Esomeprazole Actavis.
Cilostazol (used to treat intermittent claudication- a pain in the legs when the patient walks which is caused by an insufficient blood supply).
Cisapride (used for indigestion and heartburn).
Digoxin (used for heart problems).
Methotrexate (a chemotherapy medicine used in high doses to treat cancer)- if the patient is taking a high dose of methotrexate, the physician may temporarily stop Esomeprazole Actavis treatment.
Concomitant Use of Proton Pump Inhibitors (PPIs) with Methotrexate: Literature suggests that concomitant use of PPIs with methotrexate (primarily at high dose) may elevate and prolong serum levels of methotrexate and/or its metabolite, possibly leading to methotrexate toxicities. A temporary withdrawal of PPI may be considered in some patients receiving treatments with high dose of methotrexate.
Case reports, published population pharmacokinetic studies, and retrospective analyses suggest that concomitant administration of PPIs and methotrexate (primarily at high dose) may elevate and prolong serum levels of methotrexate and/or its metabolite hydroxymethotrexate. However, no formal drug interaction studies of methotrexate with PPIs have been conducted.
Tacrolimus (organ transplantation).
Rifampicin (used for treatment of tuberculosis).
St. John's wort (Hypericum perforatum) (used to treat depression).
If the physician prescribed the antibiotics amoxicillin and clarithromycin as well as Esomeprazole Actavis to treat ulcers caused by Helicobacter pylori infection, it is very important that the patient tells the physician about any other medicines he/she is taking.
Other Effects Related to Acid Inhibition: Decreased gastric acidity due to any means, including proton pump inhibitors, increases gastric counts of bacteria normally present in the gastrointestinal tract. Treatment with proton pump inhibitors may lead to slightly increased risk of gastrointestinal infections such as Salmonella and Campylobacter and possibly Clostridium difficile.
Esomperazole Actavis with Food and Drink: The patient can take tablets with food or an empty stomach.