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Be advised if the patient is taking or has recently used any other medicines. This includes medicines that the patient buys without a prescription. This is because Esomeprazole NORMON can affect the way some medicines work and some medicines have an effect on Esomeprazole NORMON.
Esomeprazole NORMON must not be given if patient is taking a medicine containing nelfinavir (used to treat HIV).
Be advised if patient is using any of the following medicines: Atazanavir (used to treat HIV).
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 patient is taking phenytoin, when to start or stop Esomeprazole NORMON may need to be monitored.
Medicines that are used to thin the blood such as warfarin. When to start or stop Esomeprazole NORMON may need to be monitored.
Cilostazol (used to treat intermittent claudication - a pain in the legs when walking 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 patient is taking a high dose of methotrexate, Esomeprazole NORMON treatment may be temporarily stopped.
Tacrolimus (organ transplantation).
Rifampicin (used for treatment of tuberculosis).
St. John's wort (Hypericum perforatum) (used to treat depression).
Concomitant use with clopidogrel: Esomeprazole is a CYP2C19 inhibitor. When starting or ending treatment with esomeprazole, the potential for interactions with drugs metabolized through CYP2C19 should be considered. An interaction is observed between clopidogrel and omeprazole. The clinical relevance of this interaction is uncertain. As a precaution, concomitant use of esomeprazole and clopidogrel should be discouraged.
Concomitant use of Proton Pump Inhibitor (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 the PPI may be considered in some patients receiving treatments with high dose 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.
