Drug & supplement interaction

Thiamine + 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 Thiamine 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

Thiamine 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 Thiamine 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.

Thiamine safety at a glance

Thiamine overall Generally safe Thiamine is generally very safe when taken by mouth in normal amounts.
Pregnancy Likely Safe When used orally in dietary amounts of 1.4 mg daily. A tolerable upper intake level (UL) has not been established for healthy individuals. Read the full pregnancy detail
Breastfeeding Likely Safe When used orally in dietary amounts of 1.4 mg daily. A tolerable upper intake level (UL) has not been established for healthy individuals. 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 Thiamine? 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. Thiamine has documented interactions with 1 drug class — the most serious being trimethoprim (proloprim) (minor) — 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

Thiamine Does Interact With Other Medications

Thiamine has 3 minor known drug interactions in our database — Esomeprazole isn’t one of them. If you take anything else, check it against the full list below.

Minor 3 No known interaction 2,827 (incl. Esomeprazole)
Taking anything else?

Check Another of Your Medications Against Thiamine

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

What to actually watch for

No Interaction Found — But Data Suggests Thiamine 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. 6 of them are worth acting on rather than waiting out — marked below.

  • Bleeding in the gut / Shortness of breath / A severe allergic reaction / Hives / Bleeding or bruising / An allergic reaction Worth acting on Additional detail

    Thiamine

    “Orally, thiamine might rarely cause dermatitis and other allergic reactions. Parenterally, thiamine can cause anaphylactoid and hypersensitivity reactions, but this is also rare (”

    Thiamine · Natural Medicines adverse-effect record, reported in acute respiratory distress syndrome (ards).

    4 sources cited
    1. 15. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
    2. 35585. Rogovik, A. L., Vohra, S., and Goldman, R. D. Safety considerations and potential interactions of vitamins: should vitamins be considered drugs? Ann.Pharmacother. 2010;44(2):311-324. PubMed
    3. 105445. Thiamine hydrochloride injection package insert. Lake Zurich, IL: Fresenius Kabi, LLC; September 2019.
    4. 91170. Arruti N, Bernedo N, Audicana MT, Villarreal O, Uriel O, Muñoz D. Systemic allergic dermatitis caused by thiamine after iontophoresis. Contact Dermatitis. 2013 Dec;69(6):375-6. PubMed

    Esomeprazole

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

  • Numbness or tingling / Itching / Swelling / A skin rash Additional detail

    Thiamine

    Recorded for Thiamine in the same Natural Medicines adverse-effect record shown under Bleeding in the gut / Shortness of breath / A severe allergic reaction / Hives / Bleeding or bruising / An allergic reaction above.

    Esomeprazole

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

Reported for Thiamine but not commonly for Esomeprazole: low blood pressure.

Effects for Esomeprazole come from the ADVERSE REACTIONS section of its FDA label; effects for Thiamine 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

Thiamine in Pregnancy & Breastfeeding

Pregnancy And Lactation Likely Safe

When used orally in dietary amounts of 1.4 mg daily. A tolerable upper intake level (UL) has not been established for healthy individuals.

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 — Thiamine Should Not Break It

At least one FDA label for a product containing Esomeprazole says to take it on an empty stomach. Most supplements — Thiamine 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 Thiamine 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 Thiamine 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 Thiamine 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 Thiamine 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 Thiamine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 3 real supplement products containing Thiamine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Thiamine. Even though Thiamine 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 Thiamine 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 Thiamine
Top 25%

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

29 days ago today
Medication Esomeprazole
Steady interest

#1,509 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 Thiamine reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Thiamine 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 Thiamine

What is Thiamine?

  • Preventing or treating thiamine deficiency
  • Beriberi
  • Wernicke-Korsakoff syndrome (alcohol-related)
  • Supporting energy and nerve function
  • General B-vitamin supplementation

Thiamine (vitamin B1) is an essential nutrient your body needs to turn food into energy and to keep your nerves and heart healthy. Most people get enough from food, but supplements are clearly useful for deficiency, certain medical conditions, and people with heavy alcohol use. Talk with your pharmacist or doctor before starting it, especially if you have a chronic illness.

Tablets, capsules, oral liquids, injectable solutions (prescription), part of B-complex and multivitamins

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

Thiamine: dosing

The right dose of thiamine depends on your age, health, and the reason you are taking it. There is a recommended daily intake for general nutrition, and higher amounts are sometimes used by doctors to treat a deficiency.For supplements, the best approach is to follow the directions on the product label and not exceed them without guidance.

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

Read the full Thiamine 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 & Thiamine

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

0Major
0Moderate
3Minor
2,826No known interaction
3 Minor 2,826 No interaction
Minor

3 interactions

No interaction 2,826 drugs checked — show the list

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

Showing the 60 most looked-up of 2,826 medications checked with no known interaction — see the full Thiamine list.

See the full Thiamine interactions page
See every supplement checked against Esomeprazole, ranked by severity
Evidence & sources

Thiamine References

The 7 references that drive our Thiamine 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. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.
  2. Yates AA, Schlicker SA, Suitor CW. Dietary reference intakes: The new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc 1998;98:699-706. PubMed
  3. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://b
  4. Rogovik, A. L., Vohra, S., and Goldman, R. D. Safety considerations and potential interactions of vitamins: should vitamins be considered drugs? Ann.Pharmacother. 2010;44(2):311-324. PubMed
  5. Arruti N, Bernedo N, Audicana MT, Villarreal O, Uriel O, Muñoz D. Systemic allergic dermatitis caused by thiamine after iontophoresis. Contact Dermatitis. 2013 Dec;69(6):375-6. PubMed
  6. Thiamine hydrochloride injection package insert. Lake Zurich, IL: Fresenius Kabi, LLC; September 2019.
  7. Vora B, Wen A, Yee SW, et al. The Effect of Trimethoprim on Thiamine Absorption: A Transporter-Mediated Drug-Nutrient Interaction. Clin Pharmacol Ther 2023;114(2):381-392.

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 Thiamine and Esomeprazole Together: Common Questions

Is it safe to take Thiamine with Esomeprazole?
We do not list a known interaction between Thiamine 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 Thiamine and Esomeprazole have any of the same side effects?
Yes — our sources link each of them separately to 10 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 Thiamine 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 Thiamine 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 Thiamine and Esomeprazole combination checked?
Interactions in our licensed database are recorded against drug classes. Esomeprazole is filed under 6 classifications, and Thiamine 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 Thiamine interact with any other medications?
Yes. Thiamine has 3 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 — Thiamine 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

Thiamine 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 7 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Esomeprazole and Thiamine?

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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.