Drug Interaction Report

Defactinib and Esomeprazole Injection: Interaction Details

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Esomeprazole Injection

Nexium Nexium I.V.®
+

Defactinib

No brand names on record
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Aug 8, 2026
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 16 documented Defactinib interactions, 16 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
probable
Severity
Major

What happens

Reduced defactinib exposure and an reduced efficacy of defactinib

Interaction Deep Dive

Avoid concomitant use of defactinib with proton pump inhibitors (PPIs) as it may reduce defactinib exposure which may reduce efficacy of defactinib. If concomitant use of an acid-reducing agent cannot be avoided, administer defactinib 2 hours before or 2 hours after the administration of a locally acting antacid. Defactinib displayed pH-dependent aqueous solubility. Defactinib AUC decreased by 79% and Cmax decreased by 85% following concomitant use of multiple doses of omeprazole (PPI) 40 mg daily. M4 AUC decreased by 83% and Cmax decreased by 88%1.

Why it happens (mechanism)

Changes in gastric pH

Literature reports

1 report — tap to read

a) Defactinib displayed pH-dependent aqueous solubility. Defactinib AUC decreased by 79% and Cmax decreased by 85% following concomitant use of multiple doses of omeprazole (PPI) 40 mg daily. Major metabolite of defactinib, N-desmethyl amide (M4) AUC decreased by 83% and Cmax decreased by 88% 1.

Common questions

Can I take Defactinib and Esomeprazole Injection together?

Reduced defactinib exposure and an reduced efficacy of defactinib Always confirm with your pharmacist or prescriber before making any change.

How serious is the Defactinib and Esomeprazole Injection interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

  • Does my dose of Defactinib or Esomeprazole Injection need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (1)

  1. Product Information: AVMAPKI(TM) FAKZYNJA(TM) CO-PACK oral capsules, tablets, avutometinib oral capsules, defactinib oral tablets. Verastem, Inc (per manufacturer), Needham, MA, 2025. DailyMed
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