Drug & supplement interaction

Eurycoma Longifolia + Esomeprazole

Esomeprazole brand name: Nexium.

Minor Interaction
Medically reviewed by · Updated September 2026
The bottom line Minor

Eurycoma Longifolia has a minor interaction with Esomeprazole. Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Eurycoma Longifolia and Esomeprazole

Here is the interaction we found between these two, with the evidence behind it.

Minor

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

Why this applies to Esomeprazole

Esomeprazole falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES — the group Eurycoma Longifolia interacts with.

Theoretically, Eurycoma longifolia might increase levels of CYP2C19 substrates.
In vitro research suggests that methanolic Eurycoma longifolia root extract weakly inhibits CYP2C19 enzymes. This effect has not been reported in humans.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: your body uses a liver enzyme called CYP2C19 to clear esomeprazole (Nexium) from your system. In a lab dish, tongkat ali (Eurycoma longifolia) seemed to mildly slow that same enzyme down. If that happened in real life, esomeprazole could hang around a bit longer and its effect could be slightly stronger. With this drug that's not scary, since it's a well-tolerated medicine. At most you might notice things like headache, a little nausea, or some gas.

The big caveat: this is purely theoretical, based only on test-tube research, and it has never actually been seen in people. I wouldn't lose sleep over it. Still, it's worth mentioning to your pharmacist or doctor before you add the supplement, just so it's on their radar.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Han YM, Kim IS, Rehman SU, Choe K, Yoo HH. In vitro evaluation of the effects of Eurycoma longifolia extract on CYP-mediated drug metabolism. Evid Based Complement Alternat Med 2015;2015:631329.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Eurycoma Longifolia Also Interacts With Other Medications

Eurycoma Longifolia has 3 moderate, 244 minor known drug interactions in our database — the Esomeprazole one above is one of them. If you take anything else, check it against the full list below.

Moderate 3 Minor 244 No known interaction 2,583 (incl. Esomeprazole)
Taking anything else?

Check Another of Your Medications Against Eurycoma Longifolia

Covers the 2,830 medications we’ve checked against Eurycoma Longifolia. Pick one to open its full report.

From our Q&A

Questions About Eurycoma Longifolia or Esomeprazole

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Eurycoma Longifolia or Esomeprazole, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Esomeprazole

This page covers Eurycoma Longifolia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Esomeprazole page lists 154 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 102 moderate · 49 minor.

From our pharmacist’s overview on the Esomeprazole page

“St. John's wort can lower the amount of esomeprazole (Nexium) in your blood by speeding up how the liver clears it, which can leave heartburn or ulcer treatment falling short.”

Reviewed by 2 · Jul 18, 2026

Open the Esomeprazole interaction page

One more smart check

Taking Eurycoma Longifolia as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,122 real supplement products containing Eurycoma Longifolia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Eurycoma Longifolia. Your product may carry other ingredients that interact with Esomeprazole too, on top of Eurycoma Longifolia — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Eurycoma Longifolia and Esomeprazole Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Eurycoma Longifolia
Top 10%

#128 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Esomeprazole
Steady interest

#1,525 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Eurycoma Longifolia

What is Eurycoma Longifolia?

Eurycoma Longifolia
  • Low testosterone or low libido in men
  • Male fertility support
  • Athletic performance and muscle strength
  • Energy and fatigue
  • Stress and mood
  • General male enhancement

Eurycoma longifolia (tongkat ali) is a Southeast Asian herb most popular for supporting testosterone, libido, and male fertility, with some small human studies suggesting possible benefits. However, the overall evidence is still limited and product quality varies widely, so talk with your pharmacist or doctor before using it, and avoid it if you are pregnant or breastfeeding.

Read the full Eurycoma Longifolia monograph & all interactions
Medication

About Esomeprazole

What Is Esomeprazole Used For?

Brand name: Nexium

Esomeprazole treats problems caused by excess stomach acid. It's used to heal erosive esophagitis (damage to the esophagus from acid), control GERD (gastroesophageal reflux disease) symptoms like heartburn, and protect the stomach lining in people at risk for ulcers caused by NSAIDs (anti-inflammatory pain relievers like ibuprofen).

It's also used as part of a three-drug combination to wipe out H. pylori — a stomach bacteria linked to ulcers — and for people with rare conditions that cause the stomach to overproduce acid, such as Zollinger-Ellison syndrome.

See full Esomeprazole drug information
Keep checking

Other Drugs & Eurycoma Longifolia

Browse every other medication we’ve checked against Eurycoma Longifolia — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
3Moderate
244Minor
2,582No known interaction
3 Moderate 244 Minor 2,582 No interaction
Moderate

3 interactions

Minor

244 interactions

Showing 60 of 244 minor interactions — see all 244 on the Eurycoma Longifolia page.

No interaction 2,582 drugs checked — show the list

We also checked Eurycoma Longifolia against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,582 medications checked with no known interaction — see the full Eurycoma Longifolia list.

See the full Eurycoma Longifolia interactions page
See every supplement checked against Esomeprazole, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Eurycoma Longifolia monograph › Uses, safety, and every drug interaction in one place Esomeprazole supplement interactions › Every supplement checked against Esomeprazole, ranked by severity Esomeprazole drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Eurycoma Longifolia and Esomeprazole Together: Common Questions

Can you take Eurycoma Longifolia with Esomeprazole?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Eurycoma Longifolia and Esomeprazole interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Esomeprazole and Eurycoma Longifolia?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.