Esomeprazole and Thiopental: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Thiopental
No brand names on recordEsomeprazole
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
Increased volume of distribution and prolonged half life of thiopental
Interaction Deep Dive
Concomitant use of thiopental and esomeprazole increased the volume of distribution and prolong the half life of thiopental in a study of 52 critically ill patients with intracranial hypertension. Therapeutic drug monitoring of thiopental may be useful to reduce the risk of toxicity. Adjustment of the dose of thiopental may be necessary to reach a target concentration and depth of sedation1.
Why it happens (mechanism)
Unknown
Literature reports
1 report — tap to read
a) In a study of 52 critically ill patients with intracranial hypertension due to traumatic brain injury or hemorrhagic stroke, patients receiving high-dose thiopental 2.95 mg/hr/kg IV infusion (mean), when given concomitantly with esomeprazole, significantly increased the volume of distribution of thiopental from 153.2 to 256.1 L and prolonged the half life from 20 to 33.5 hours. Notably estimated clearance in this population was comparable to values for high-dose thiopental infusion 1.
Common questions
Can I take Esomeprazole and Thiopental together?
Increased volume of distribution and prolonged half life of thiopental Always confirm with your pharmacist or prescriber before making any change.
How serious is the Esomeprazole and Thiopental 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 "established". Well documented — supported by controlled studies or strong clinical data.
Questions for your pharmacist
- Does my dose of Esomeprazole or Thiopental 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)
- Marsot A, Goirand F, Milesi N, et al: Interaction of thiopental with esomeprazole in critically ill patients. Eur J Clin Pharmacol 2013; 69(9):1667-1672. DOI
Keep reading about Thiopental
Keep reading about Esomeprazole
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