Esomeprazole and Nirogacestat: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Esomeprazole
Nirogacestat
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.
What happens
Reduced nirogacestat exposure and reduced efficacy of nirogacestat
Interaction Deep Dive
Avoid concomitant use of nirogacestat with proton pump inhibitors such as esomeprazole. If concomitant use cannot be avoided, nirogacestat can be staggered with antacids (eg, administer nirogacestat 2 hours before or 2 hours after antacid use). Nirogacestat is poorly soluble at pH 6 or greater. Gastric acid reducing agents may decrease serum nirogacestat exposure, which may reduce the effectiveness of nirogacestat1.
Why it happens (mechanism)
Reduced gastric acidity
Literature reports
1 report — tap to read
a) Concomitant administration of nirogacestat with proton pump inhibitors (eg, omeprazole) is expected to reduce concentrations of nirogacestat 1.
Common questions
Can I take Esomeprazole and Nirogacestat together?
Reduced nirogacestat exposure and reduced efficacy of nirogacestat Always confirm with your pharmacist or prescriber before making any change.
How serious is the Esomeprazole and Nirogacestat 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 "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Esomeprazole or Nirogacestat 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)
- Product Information: OGSIVEO(TM) oral tablets, nirogacestat oral tablets. SpringWorks Therapeutics, Inc. (per FDA), Stamford, CT, 2023. DailyMed
Keep reading about Esomeprazole
Keep reading about Nirogacestat
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