Drug & supplement interaction

Lentinan + Esomeprazole

Esomeprazole brand name: Nexium.

Moderate Interaction
The bottom line Moderate

Esomeprazole falls into 2 drug categories that Lentinan can interact with; the most serious is rated moderate. Laboratory research suggests that lentinan might increase the activity of cytochrome P450 2C19 (CYP2C19).

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Lentinan and Esomeprazole

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Lentinan interacts with whole categories of medication. Esomeprazole falls into 2 of those categories, so it can interact with Lentinan in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

1 of 2

Why this applies to Esomeprazole

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

Laboratory research suggests that lentinan might increase the activity of cytochrome P450 2C19 (CYP2C19). So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP2C19 in patients taking lentinan.
Some drugs metabolized by CYP2C19 include proton pump inhibitors including omeprazole (Prilosec), lansoprazole (Prevacid), and pantoprazole (Protonix); diazepam (Valium); carisoprodol (Soma); nelfinavir (Viracept); and others.
Severity Moderate 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 for esomeprazole (Nexium): your liver uses an enzyme called CYP2C19 to break this medicine down. Lab studies hint that lentinan might rev up that enzyme, which could clear esomeprazole out of your system a little faster. In theory, that means slightly less acid-blocking power, so you might notice heartburn or reflux creeping back if the drug isn't working as well.

I want to be honest, though: this is only seen in test-tube and animal research, and it has never been reported in actual people. So I wouldn't lose sleep over it. If you do decide to use both, just keep an eye on whether your reflux symptoms return, and check in with your pharmacist or doctor before starting or stopping anything.

References
  1. Lin Y, Wei Y, Hu X, et al. Evaluation of lentinan effects on cytochrome P450 activity in rats by a cocktail method. Iran J Basic Med Sci. 2019;22(3):296-301.
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 2

Esomeprazole also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Laboratory research suggests that lentinan might increase the activity of cytochrome P450 3A4 (CYP3A4). So far, this interaction has not been reported in humans. However, watch for a decrease in the levels of drugs metabolized by CYP3A4 in patients taking lentinan.
Some drugs metabolized by CYP3A4 include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and numerous others.
Severity Moderate 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 for Nexium (esomeprazole). Your liver uses several enzymes to clear this medicine, and one of them is called CYP3A4. Lab and animal studies hint that lentinan might speed up CYP3A4. If that happened in people, your body could break down esomeprazole a little faster, which in theory might soften how well it controls your stomach acid. You could notice heartburn or reflux creeping back.

The honest part: this has only been seen in test tubes and animals, never reported in actual patients, so I wouldn't lose sleep over it. Esomeprazole also leans heavily on a different enzyme (CYP2C19), so any real-world effect is likely small. Still, if you start lentinan and your reflux worsens, mention it to your pharmacist or doctor.

References
  1. Lin Y, Wei Y, Hu X, et al. Evaluation of lentinan effects on cytochrome P450 activity in rats by a cocktail method. Iran J Basic Med Sci. 2019;22(3):296-301.

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

Lentinan Also Interacts With Other Medications

Lentinan has 815 moderate known drug interactions in our database — the Esomeprazole one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Lentinan

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

From our Q&A

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

We hold 1 real supplement products containing Lentinan, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Lentinan. Your product may carry other ingredients that interact with Esomeprazole too, on top of Lentinan — 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 Lentinan 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 Lentinan
Steady interest

#1,139 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Esomeprazole
Top 25%

#477 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 Lentinan

What is Lentinan?

Lentinan
  • Immune support
  • Used alongside cancer treatment
  • Anti-inflammatory
  • General wellness/tonic
  • Antimicrobial support

Lentinan is a beta-glucan polysaccharide from shiitake mushrooms that is studied mainly as an immune-modulating add-on to cancer chemotherapy, where it is given by injection in a few countries. Evidence for oral supplements is limited, and quality varies widely between products. Talk with your pharmacist or doctor before using it, especially if you have a health condition or are pregnant or breastfeeding.

Read the full Lentinan monograph & all interactions
Medication

About Esomeprazole

What Is Esomeprazole Used For?

Brand name: Nexium

Esomeprazole lowers stomach acid. Prescription oral products are used for short-term healing of erosive esophagitis (damage to the esophagus lining from acid), keeping it healed, and treating heartburn and other symptoms of GERD (gastroesophageal reflux disease). They are also used to lower the risk of NSAID-associated stomach ulcers in adults at risk, and to treat pathological hypersecretory conditions such as Zollinger-Ellison syndrome in adults (long-term treatment). With amoxicillin and clarithromycin, they treat H. pylori infection to reduce the risk of duodenal ulcer coming back.

Esomeprazole sodium for injection (intravenous) is used for short-term treatment of GERD with erosive esophagitis when oral treatment is not possible or appropriate. It is also used in adults to reduce the risk of rebleeding of stomach or duodenal ulcers after endoscopic treatment of acute bleeding. Over-the-counter esomeprazole products treat frequent heartburn (2 or more days a week) and are not meant for immediate relief.

See full Esomeprazole drug information
Keep checking

Other Drugs & Lentinan

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

0Major
815Moderate
0Minor
2,014No known interaction
Moderate

815 interactions

Showing 60 of 815 moderate interactions — see all 815 on the Lentinan page.

No interaction 2,014 drugs checked — show the list

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

Showing the 60 most looked-up of 2,014 medications checked with no known interaction — see the full Lentinan list.

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
Pharmacist Counseling Corner

Taking Lentinan and Esomeprazole Together: Common Questions

Can you take Lentinan with Esomeprazole?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Lentinan and Esomeprazole?
Esomeprazole belongs to more than one drug category, and Lentinan interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Lentinan and Esomeprazole interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Esomeprazole and Lentinan?

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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.