Drug & supplement interaction

Lorenzo's Oil + Esomeprazole

Esomeprazole brand name: Nexium.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Lorenzo's Oil 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

Lorenzo's Oil 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 Lorenzo's Oil 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.

Worth understanding: our licensed dataset holds no drug-interaction record for Lorenzo's Oil at all — not against Esomeprazole, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

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.

Lorenzo's Oil safety at a glance

Lorenzo's Oil overall Use caution It is a medical treatment for a rare disease and should only be used under specialist supervision, not as a general supplement.
Pregnancy Avoid Safety in pregnancy is not established; use only if a specialist directs it.
Breastfeeding Avoid Safety while breastfeeding is not established; talk to your doctor first.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Esomeprazole and Lorenzo's Oil? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Lorenzo's Oil 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. 4 of them are worth acting on rather than waiting out — marked below.

  • A low platelet count / A low white blood cell count / Bleeding or bruising Worth acting on Additional detail

    Lorenzo's Oil

    “Orally, Lorenzo's oil can cause thrombocytopenia, neutropenia, purpura, petechiae, and bleeding (6,924,926,927).”

    Lorenzo's Oil · Natural Medicines adverse-effect record, reported in thrombocytopenia.

    4 sources cited
    1. 6. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
    2. 924. Aubourg P, Adamsbaum C, Lavallard-Rousseau MC, et al. A two-year trial of oleic and erucic acids (Lorenzo's oil) as treatment for adrenomyeloneuropathy. N Engl J Med 1993;329:745-52. PubMed
    3. 926. Chai BC, Etches WS, Stewart MW, Siminoski K. Bleeding in a patient taking Lorenzo's oil: evidence for a vascular defect. Postgrad Med J 1996;72:113-4.
    4. 927. Revell P, Green A, Green S. Platelets in treated adrenoleukodystrophy: a brief report. J Inherit Metab Dis 1995;18:635-7. PubMed

    “Orally, Lorenzo's oil can cause thrombocytopenia, purpura, petechiae, bleeding, and neutropenia (6,924,926,927).”

    Lorenzo's Oil · Natural Medicines adverse-effect record, reported in thrombocytopenia.

    4 sources cited
    1. 6. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
    2. 924. Aubourg P, Adamsbaum C, Lavallard-Rousseau MC, et al. A two-year trial of oleic and erucic acids (Lorenzo's oil) as treatment for adrenomyeloneuropathy. N Engl J Med 1993;329:745-52. PubMed
    3. 926. Chai BC, Etches WS, Stewart MW, Siminoski K. Bleeding in a patient taking Lorenzo's oil: evidence for a vascular defect. Postgrad Med J 1996;72:113-4.
    4. 927. Revell P, Green A, Green S. Platelets in treated adrenoleukodystrophy: a brief report. J Inherit Metab Dis 1995;18:635-7. PubMed

    Esomeprazole

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

  • A higher chance of infection Worth acting on Additional detail

    Lorenzo's Oil

    “In one case report, a 39-year-old man with adrenoleukodystrophy developed lipoid pneumonia while taking Lorenzo's oil. He presented with respiratory failure; bronchoalveolar lavage produced fluid with an oily appearance.”

    Lorenzo's Oil · Natural Medicines adverse-effect record, reported in adrenoleukodystrophy (ald).

    1 source cited
    1. 99422. Majori M, Scarascia A, Anghinolfi M, et al. Lipoid pneumonia as a complication of Lorenzo's oil therapy in a patient with adrenoleukodystrophy. J Bronchology Interv Pulmonol 2014;21(3):271-3. doi: 10.1097/LBR.0000000000000084. PubMed

    Esomeprazole

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

Effects for Esomeprazole come from the ADVERSE REACTIONS section of its FDA label; effects for Lorenzo's Oil 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.

How to take them

Some Esomeprazole Products Have a Food Rule — Lorenzo's Oil Should Not Break It

At least one FDA label for a product containing Esomeprazole says to take it on an empty stomach. Most supplements — Lorenzo's Oil 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 Lorenzo's Oil 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 Lorenzo's Oil 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 Lorenzo's Oil 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 Lorenzo's Oil 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

How much people look this up

Where Lorenzo's Oil 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 Lorenzo's Oil
Steady interest

#1,005 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Esomeprazole
Top 25%

#452 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 Lorenzo's Oil reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Lorenzo's Oil and Esomeprazole records this page draws on were last updated July 10, 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 Lorenzo's Oil

What is Lorenzo's Oil?

  • Adrenoleukodystrophy (ALD)
  • Adrenomyeloneuropathy (AMN)
  • Lowering very long-chain fatty acids in blood
  • Slowing progression of certain inherited disorders

Lorenzo's Oil is not a typical herbal supplement—it is a specially formulated mixture of two fatty acids (glyceryl trioleate and glyceryl trierucate, in a 4:1 ratio) developed to lower very long-chain fatty acids in people with adrenoleukodystrophy (ALD). It can normalize blood fatty acid levels and may help delay disease in some boys who are not yet showing symptoms, but it is not a cure and should only be used under specialist medical supervision.

Refined plant-derived oils (rapeseed/olive oil sources) · Oral liquid oil (prescription-style medical formulation)

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

Lorenzo's Oil: dosing

There is no standard over-the-counter dose for Lorenzo's Oil. When used medically, the amount is calculated by a specialist based on the person's body and is adjusted using blood tests and a carefully controlled low-fat diet.Because dosing must be individualized and monitored, you should not try to dose this product yourself. Do not use it as a casual supplement.

From our Lorenzo's Oil monograph — the full record covers uses, side effects and every documented interaction.

Read the full Lorenzo's Oil 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 & Lorenzo's Oil

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

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

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

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Lorenzo's Oil list.

See the full Lorenzo's Oil interactions page
See every supplement checked against Esomeprazole, ranked by severity
Evidence & sources

Lorenzo's Oil References

The 12 references that drive our Lorenzo's Oil 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. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. Kaplan PW, Tusa RJ, Shankroff J, et al. Visual evoked potentials in adrenoleukodystrophy: a trial with glycerol trioleate and Lorenzo oil. Ann Neurol 1993;34:169-74.
  3. Poulos A, Gibson R, Sharp P, et al. Very long chain fatty acids in X-linked adrenoleukodystrophy brain after treatment with Lorenzo's oil. Ann Neurol 1994;36:741-6. PubMed
  4. Duchesne N, Dufour M, Bouchard G, et al. Adrenoleukodystrophy: magnetic resonance follow-up after Lorenzo's oil therapy. Can Assoc Radiol J 1995;46:386-91.
  5. Moser HW. Clinical and therapeutic aspects of adrenoleukodystrophy and adrenomyeloneuropathy. J Neuropathol Exp Neurol 1995;54:740-5. PubMed
  6. Aubourg P, Adamsbaum C, Lavallard-Rousseau MC, et al. A two-year trial of oleic and erucic acids (Lorenzo's oil) as treatment for adrenomyeloneuropathy. N Engl J Med 1993;329:745-52. PubMed
  7. Chai BC, Etches WS, Stewart MW, Siminoski K. Bleeding in a patient taking Lorenzo's oil: evidence for a vascular defect. Postgrad Med J 1996;72:113-4.
  8. Revell P, Green A, Green S. Platelets in treated adrenoleukodystrophy: a brief report. J Inherit Metab Dis 1995;18:635-7. PubMed
  9. Maeda K, Suzuki Y, Yajima S, et al. Improvement of clinical and MRI findings in a boy with adrenoleukodystrophy by dietary erucic acid therapy. Brain Dev 1992;14:409-12.
  10. Wong V. Adrenoleukodystrophy in a Chinese boy. Brain Dev 1992;14:276-7. PubMed
  11. Moser HW, Raymond GV, Lu SE, et al. Follow-up of 89 asymptomatic patients with adrenoleukodystrophy treated with Lorenzo's Oil. Arch Neurol 2005;62:1073-80. PubMed
  12. Majori M, Scarascia A, Anghinolfi M, et al. Lipoid pneumonia as a complication of Lorenzo's oil therapy in a patient with adrenoleukodystrophy. J Bronchology Interv Pulmonol 2014;21(3):271-3. doi: 10.1097/LBR.0000000000000084. 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 Lorenzo's Oil and Esomeprazole Together: Common Questions

Is it safe to take Lorenzo's Oil with Esomeprazole?
We do not list a known interaction between Lorenzo's Oil 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 Lorenzo's Oil and Esomeprazole have any of the same side effects?
Yes — our sources link each of them separately to 4 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 Lorenzo's Oil 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 Lorenzo's Oil 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.
Does Esomeprazole interact with any supplements?
Yes. Esomeprazole has documented interactions with 154 supplements in our database — Lorenzo's Oil 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

Where next

Keep Exploring

Lorenzo's Oil monograph Uses, safety profile, and every drug interaction in one place Esomeprazole drug information The full plain-English guide to this medication Esomeprazole supplement interactions Every supplement checked against Esomeprazole, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 12 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Esomeprazole and Lorenzo's Oil?

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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.