Drug & supplement interaction

Horseradish + Esomeprazole

Esomeprazole brand name: Nexium.

No Known Interaction
The bottom line No known interaction

We found no known interaction between Horseradish and Esomeprazole in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Esomeprazole states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Horseradish and Esomeprazole

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Esomeprazole and Horseradish in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Horseradish safety at a glance

Horseradish overall Use caution Food amounts are generally safe, but concentrated supplements may irritate the digestive tract and mucous membranes.
Pregnancy Avoid Avoid medicinal amounts during pregnancy because safety has not been established.
Breastfeeding Likely Safe When the root is used orally in amounts commonly found in foods. Horseradish has Generally Recognized as Safe (GRAS) status in the US. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Esomeprazole and Horseradish? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Esomeprazole

Interactions in our licensed database are recorded against drug classes, not just single drug names. Esomeprazole is filed under 6 classifications — including proton pump inhibitors (ppis), cytochrome p450 2c19 (cyp2c19) inhibitors, cytochrome p450 1a2 (cyp1a2) inducers. Horseradish has documented interactions with 1 drug class — the most serious being thyroid hormone (moderate) — and none of Esomeprazole’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Horseradish Does Interact With Other Medications

Horseradish has 16 moderate known drug interactions in our database — Esomeprazole isn’t one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Horseradish

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

What to actually watch for

No Interaction Found — But Data Suggests Horseradish and Esomeprazole May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • An allergic reaction Worth acting on Additional detail

    Horseradish

    “Orally, horseradish is generally well tolerated when consumed in amounts commonly used with foods. But consuming large amounts of horseradish can cause various adverse effects.

    Most Common Adverse Effects:

    Orally: When consumed in large amounts, bloody vomiting, diarrhea, gastrointestinal upset.

    Topically: Fresh horseradish can cause irritation or allergic reaction.

    Serious Adverse Effects (Rare):

    Orally: Transient v…”

    Horseradish · Natural Medicines adverse-effect record, reported in diarrhea.

    Esomeprazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Esomeprazole. Read the label on DailyMed ›

  • Sweating / A fast or pounding heartbeat Additional detail

    Horseradish

    “Orally, consuming large amounts of horseradish can cause vasovagal syncope in rare cases. At least two cases of vasovagal syncope associated with horseradish consumption have been reported. In one case, a 56-year-old male experienced a sharp burning sensation in his stomach followed by tachycardia, weakness, and excessive perspiration after consuming an oyster topped with an olive-sized dollop of fresh horseradish.”

    Horseradish · Natural Medicines adverse-effect record, reported in irregular heartbeat.

    1 source cited
    1. 111724. Lehmann CU, Puckett AL, Betz BO. 56-year-old man - increased heart rate - weakness - intense sweating - horseradish consumption - Dx?. J Fam Pract 2022;71(7):317-321. PubMed

    Esomeprazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Esomeprazole. Read the label on DailyMed ›

  • Stomach upset / Diarrhea / Vomiting reported in 4.8% of FDA reports for Esomeprazole Additional detail

    Horseradish

    “Orally, consuming large amounts of horseradish can cause gastrointestinal upset, bloody vomiting and diarrhea (2,6), and irritation of mucous membranes (2,4).”

    Horseradish · Natural Medicines adverse-effect record, reported in diarrhea.

    3 sources cited
    1. 2. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
    2. 6. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
    3. 4. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.

    Esomeprazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Esomeprazole, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Reported for Horseradish but not commonly for Esomeprazole: fainting.

Effects for Esomeprazole come from the ADVERSE REACTIONS section of its FDA label; effects for Horseradish come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 235,235 voluntary FDA FAERS reports for Esomeprazole that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Horseradish in Pregnancy & Breastfeeding

Lactation Likely Safe

When the root is used orally in amounts commonly found in foods. Horseradish has Generally Recognized as Safe (GRAS) status in the US.

Lactation Likely Unsafe

When used orally in large amounts. The mustard oils produced by glucosinolates from horseradish are considered toxins that can be excreted through breast milk.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Esomeprazole Products Have a Food Rule — Horseradish Should Not Break It

At least one FDA label for a product containing Esomeprazole says to take it on an empty stomach. Most supplements — Horseradish included — are taken with a meal, so the easy mistake is swallowing both together at breakfast. Where that rule applies, keep Esomeprazole on its own and move Horseradish to a meal later in the day.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Esomeprazole products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

Table 2: Recommended Dosage of Esomeprazole Magnesium Delayed-Release Capsules in Pediatric Patients by Indication Indication Patient Age Recommended Dosage Duration Healing of EE 12 years to 17 years Esomeprazole magnesium delayed-release capsules: 20 mg or 40 mg once daily 4 to 8 Weeks Treatment of Symptomatic GERD 12 years to 17 years Esomeprazole magnesium delayed-release capsules: 20 mg once

From the Dosage and Administration section of the FDA label we read for Esomeprazole — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

From our Q&A

Questions About Horseradish 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 Horseradish 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 Horseradish 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 Horseradish as Part of a Dietary Supplement Product? Check It for Interactions

We hold 245 real supplement products containing Horseradish, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Horseradish. Even though Horseradish itself has no known interaction with Esomeprazole, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Horseradish 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 Horseradish
Top half

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

29 days ago today
Medication Esomeprazole
Top 25%

#496 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Horseradish reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Horseradish and Esomeprazole records this page draws on were last updated July 11, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Horseradish

What is Horseradish?

  • Sinus and respiratory congestion
  • Urinary tract infections
  • Digestive support
  • Antimicrobial
  • Culinary flavoring

Horseradish is a pungent root used as a food and folk remedy, most often for sinus congestion and urinary tract complaints. Human evidence is limited, and while culinary amounts are generally well tolerated, concentrated supplements can irritate the stomach and should be used cautiously. Talk with your pharmacist or doctor before using horseradish as a medicine.

Armoracia rusticana · Brassicaceae · Root (fresh or dried) · Fresh grated root, dried root powder, prepared condiment (sauce), capsules, tinctures

An interaction check asks whether these two react with each other — it does not ask whether Horseradish is a good idea for someone in your situation. Here is what our Horseradish record says about it on its own.

Horseradish: dosing

There is no well-established standardized medicinal dose for horseradish. Amounts used in research and traditional practice vary widely depending on the form (fresh root, dried powder, or extract).If you use a commercial supplement, follow the directions on the product label and do not exceed the recommended amount. Avoid taking large or concentrated amounts in hopes of stronger effects, since this mainly increases the risk of irritation and side effects.

From our Horseradish monograph — the full record covers uses, side effects and every documented interaction.

Read the full Horseradish 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.

Most-Reported Side Effects for Esomeprazole

From FAERS, the FDA’s public side-effect reporting system (235,235 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Chronic kidney disease 35,589 reports
Acute kidney injury 20,510 reports
Renal failure 16,295 reports
Nausea 13,667 reports
Gastrooesophageal reflux disease 12,006 reports
See full Esomeprazole drug information
Keep checking

Other Drugs & Horseradish

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

0Major
16Moderate
0Minor
2,813No known interaction
Moderate

16 interactions

No interaction 2,813 drugs checked — show the list
Evidence & sources

Horseradish References

The 6 references that drive our Horseradish monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
  2. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
  3. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  4. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
  5. Panter, K. E. and James, L. F. Natural plant toxicants in milk: a review. J Anim Sci 1990;68(3):892-904. PubMed
  6. Lehmann CU, Puckett AL, Betz BO. 56-year-old man - increased heart rate - weakness - intense sweating - horseradish consumption - Dx?. J Fam Pract 2022;71(7):317-321. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Horseradish and Esomeprazole Together: Common Questions

Is it safe to take Horseradish with Esomeprazole?
We do not list a known interaction between Horseradish and Esomeprazole. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Horseradish and Esomeprazole have any of the same side effects?
Yes — our sources link each of them separately to 6 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Horseradish and Esomeprazole at the same time of day?
At least one FDA label for a product containing Esomeprazole says to take it on an empty stomach, and supplements are usually taken with a meal — so taking them together at breakfast is the easy mistake. Where that applies, keep Esomeprazole on its own and move Horseradish to a meal later in the day. Food instructions belong to the product rather than the ingredient, so check the directions on your own box. This is about absorption, not an interaction.
How was the Horseradish and Esomeprazole combination checked?
Interactions in our licensed database are recorded against drug classes. Esomeprazole is filed under 6 classifications, and Horseradish has documented interactions with 1 drug class — none of Esomeprazole's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Horseradish interact with any other medications?
Yes. Horseradish has 16 documented drug interactions in our database — Esomeprazole is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Esomeprazole interact with any supplements?
Yes. Esomeprazole has documented interactions with 154 supplements in our database — Horseradish is not one of them. The Esomeprazole interaction page linked on this page lists every one, ranked by severity.

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

Still Have a Question About Esomeprazole and Horseradish?

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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.