Medication interaction hub

What Supplements Interact with Esomeprazole?

Esomeprazole brand names: Nexium, Nexium 24hr. Every interaction below applies to the brands too.

154 Interactions 3 Major 102 Moderate 49 Minor
Curated & coded by · Clinical Pharmacist · Updated September 22, 2026

Drug–supplement interaction data sourced from Natural Medicines Pro, the licensed clinical database from TRC Healthcare / Therapeutic Research, with additional analysis by the HelloPharmacist Pharmacist Team. Our sources · Editorial policy

What is this page for?

One answer, for one medication: what supplements and herbal products interact with Esomeprazole? Every vitamin, herb, and supplement ingredient we’ve checked against it is on this page, ranked by severity, each linking to the full report for that exact pair.

This page covers supplement interactions only — to check Esomeprazole against your other medications, use the drug–drug interaction checker. Educational information from our licensed clinical databases, not medical advice. Our editorial policy

HelloPharmacist Bottom Line
Our Pharmacist Explains
What is this? The interaction data in the HelloPharmacist supplement database is licensed from Natural Medicines Pro by TRC Healthcare (Therapeutic Research). HelloPharmacist pharmacists often add our own analysis and context on top of that licensed data — such as this Bottom Line summary and the notes on individual interaction pages — and any such commentary is noted as ours.

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. It is one of just three major-rated interactions here, alongside grapefruit, which does the opposite and raises drug levels, and activated charcoal, which can soak up the medicine before your body absorbs it. With 154 supplements and herbs on file against this acid-reducing medicine, I treat this page with genuine caution, starting with those three.

Most of the 102 moderate and 49 minor entries work through the liver enzymes that process esomeprazole, some nudging its blood level up and others pulling it down. A smaller cluster of charcoal and fiber-type products can blunt absorption of any pill swallowed close to them, so space those well apart from your dose. The three at the top are the ones to understand before the rest.

— , Clinical Pharmacist · July 18, 2026

Major 3 Moderate 102 Minor 49 No known interaction 1,298

This box checks one ingredient at a time (like turmeric or magnesium). Taking a supplement product with a whole label of ingredients? Search the product instead — we check every ingredient on it ↓

Most Viewed Ingredient Interactions

Esomeprazole: Top Interactions at a Glance

The Esomeprazole supplement & herbal interactions people checked most in the last 24 hours, colored by severity. Tap any ingredient to open the full report for that pair.

Showing the 12 highest-ranked of 154 interacting ingredients — plus 1,298 more checked with no known interaction. See the complete ranked list.

Start here

The Most-Checked Esomeprazole Combinations Today

The Esomeprazole + supplement pages people viewed most in the last 24 hours (resets at midnight). Open any card for the full report.

Minor Likelihood Possible Betaine Hydrochloride + Esomeprazolei

Betaine hydrochloride increases stomach acidity and could decrease the effects of PPIs.

Read the full interaction Moderate Likelihood Possible Kava + Esomeprazolei

Theoretically, kava might increase levels of CYP2C19 substrates.

Read the full interaction Minor Likelihood Possible Blessed Thistle + Esomeprazolei

Theoretically, blessed thistle might decrease the effectiveness of PPIs.

Read the full interaction Moderate Likelihood Possible Cubebs + Esomeprazolei

Several compounds isolated from cubebs can inhibit cytochrome P450 3A4 (CYP3A4) in vitro.

Read the full interaction Minor Likelihood Possible Cinchona + Esomeprazolei

Theoretically, taking cinchona might decrease the effectiveness of PPIs.

Read the full interaction Major Likelihood Probable St. John's Wort + Esomeprazolei

St.

Read the full interaction
The complete list

Every Supplement Checked Against Esomeprazole

All 1,452 ingredients in our database, ranked by severity — 154 with a Esomeprazole interaction on file and 1,298 with none found. Filter by severity or search any ingredient; hover the for what each ingredient is.

Looking for an interaction with a specific supplement product? Search products instead ↓

Straight answers

Can You Take It With Esomeprazole?

One-line answers, one card per combination — scroll through today’s 20 and tap any card for the full report. A different set rotates in daily until every combination has had its turn.

Can you take Betaine Hydrochloride with Esomeprazole?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Betaine hydrochloride increases stomach acidity and could decrease the effects of PPIs.

Full Betaine Hydrochloride + Esomeprazole answer

Can you take Kava with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, kava might increase levels of CYP2C19 substrates.

Full Kava + Esomeprazole answer

Can you take Blessed Thistle with Esomeprazole?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, blessed thistle might decrease the effectiveness of PPIs.

Full Blessed Thistle + Esomeprazole answer

Can you take Cubebs with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Several compounds isolated from cubebs can inhibit cytochrome P450 3A4 (CYP3A4) in vitro.

Full Cubebs + Esomeprazole answer

Can you take Cinchona with Esomeprazole?

Minor Usually — this is a minor-rated interaction, generally not clinically significant but worth mentioning to your pharmacist. Theoretically, taking cinchona might decrease the effectiveness of PPIs.

Full Cinchona + Esomeprazole answer

Can you take Sage with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2C19.

Full Sage + Esomeprazole answer

Can you take Sassafras with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro research suggests that cytochrome P450 1A2 (CYP1A2) inducers might increase the cytotoxicity of safrole.

Full Sassafras + Esomeprazole answer

Can you take Schizonepeta with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Animal research suggests that schizonepetin, a monoterpene constituent of schizonepeta, induces cytochrome P450 (CYP) 3A4.

Full Schizonepeta + Esomeprazole answer

Can you take Slippery Elm with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, slippery elm may slow the absorption and reduce serum levels of oral drugs.

Full Slippery Elm + Esomeprazole answer

Can you take Sulforaphane with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, sulforaphane might increase the levels and effects of CYP3A4 substrates.

Full Sulforaphane + Esomeprazole answer

Can you take Sweet Annie with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Sweet Annie may alter plasma levels and clinical effects of drugs metabolized by CYP3A4.

Full Sweet Annie + Esomeprazole answer

Can you take Syrian Rue with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, Syrian rue might increase the levels and clinical effects of drugs metabolized by CYP3A4.

Full Syrian Rue + Esomeprazole answer

Can you take Terminalia with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, use of Terminalia arjuna may increase the levels and clinical effects of CYP3A4 substrates.

Full Terminalia + Esomeprazole answer

Can you take Thunder God Vine with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, thunder god vine might increase the levels and clinical effects of CYP3A4 substrates.

Full Thunder God Vine + Esomeprazole answer

Can you take Tinospora Cordifolia with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, Tinospora cordifolia might increase levels of drugs metabolized by CYP2C19.

Full Tinospora Cordifolia + Esomeprazole answer

Can you take Tragacanth with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, tragacanth might alter absorption of oral drugs.

Full Tragacanth + Esomeprazole answer

Can you take Turmeric with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Turmeric might increase or decrease levels of drugs metabolized by CYP3A4.

Full Turmeric + Esomeprazole answer

Can you take Uva Ursi with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, uva ursi may decrease the metabolism of CYP2C19 substrates.

Full Uva Ursi + Esomeprazole answer

Can you take Vitamin E with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. Theoretically, vitamin E might induce metabolism of CYP3A4, possibly reducing the levels CYP3A4 substrates.

Full Vitamin E + Esomeprazole answer

Can you take White Pepper with Esomeprazole?

Moderate Possibly, but carefully — this moderate-rated combination may need monitoring, a dose adjustment, or separated timing. In vitro evidence suggests that piperine, a constituent of white pepper, inhibits cytochrome P450 3A4 (CYP3A4).

Full White Pepper + Esomeprazole answer
Read the list like a pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction 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.
  • Possible. 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each entry links to a full report with the clinical detail, likelihood, evidence level, and citations for that exact combination.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

How Does Our Interaction Checker Work?

Behind every verdict on this page is a category system. Our source database doesn’t document supplement interactions drug-by-drug — it documents them against groups of medications that behave the same way (for example, “drugs processed by the CYP3A4 liver enzyme” or “blood-thinning medications”).

So the check works in three steps: (1) Esomeprazole is classified into the pharmacology categories it belongs to, (2) every supplement interaction documented against any of those categories is inherited by Esomeprazole, and (3) each ingredient keeps its own severity, likelihood, and evidence grades from the underlying record. That’s why one supplement can carry several records for one drug — it may interact through more than one category.

Esomeprazole sits in 6 interaction categories. Open any one to see what the group means:

Cytochrome P450 3A4 (Cyp3A4) Substrates 121 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

121 of the supplement ingredients on this page reach Esomeprazole through this category.

Cytochrome P450 2C19 (Cyp2C19) Substrates 33 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

33 of the supplement ingredients on this page reach Esomeprazole through this category.

Oral Drugs 17 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

17 of the supplement ingredients on this page reach Esomeprazole through this category.

Proton Pump Inhibitors (Ppis) 12 ingredients

A pharmacology grouping from our source database: medications in this group share a property that certain supplements are known to interact with, so an interaction documented for the group applies to every drug in it.

12 of the supplement ingredients on this page reach Esomeprazole through this category.

Cytochrome P450 2C19 (Cyp2C19) Inhibitors 2 ingredients

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

2 of the supplement ingredients on this page reach Esomeprazole through this category.

Cytochrome P450 1A2 (Cyp1A2) Inducers 1 ingredient

A drug-metabolism group: these medications are processed by the named liver enzyme (a cytochrome P450). Supplements that speed this enzyme up or slow it down can lower or raise the medication's levels in your body.

1 of the supplement ingredient on this page reaches Esomeprazole through this category.

About Esomeprazole

Esomeprazole is a proton pump inhibitor used to treat acid reflux, heartburn, and stomach ulcers.

Generic name: Esomeprazole  ·  Brand names: Nexium, Nexium 24hr.

See the full Esomeprazole drug information

Related: does Esomeprazole deplete any nutrients?

Esomeprazole has 9 reported nutrient associations in the research literature — see the Esomeprazole nutrient depletion report.

Check a real product

Take a Supplement Product? Check the Whole Bottle Against Esomeprazole

Most supplements are combination products — and the interaction may come from an ingredient you didn’t buy it for. Search any product below (or scan its label) and we’ll check every ingredient on it against Esomeprazole.

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Pharmacist Counseling Corner

Esomeprazole & Supplements: Common Questions

What supplements interact with Esomeprazole?
In our interaction database, 154 supplement and herbal ingredients have an interaction with Esomeprazole on file — 3 rated major, 102 moderate, and 49 minor. That number sounds scarier than it is: severity matters far more than the count, which is why the list on this page is ranked instead of alphabetical. Start at the top. The highest-ranked right now: Grapefruit, Activated Charcoal, St. John's Wort.
Which Esomeprazole supplement interactions are the most serious?
The 3 major-rated combinations — led by Grapefruit, Activated Charcoal and St. John's Wort — deserve real caution: these are the ones generally best avoided, or used only with your prescriber watching. If you take any of them today, don't panic and don't stop anything abruptly — call your pharmacist first. Jump to the ranked list.
Can I take vitamins or supplements while on Esomeprazole?
That depends entirely on which supplement. The honest answer for Esomeprazole is in the ranked list above — and if what you take is a combination product with a dozen ingredients, don't check them one by one: photograph the label with our scanner and we'll check the whole thing at once. Try the label scanner or the interaction checker.
Do brands like Nexium have the same supplement interactions as Esomeprazole?
Yes — Nexium, Nexium 24hr all contain Esomeprazole, so everything on this page applies to them equally. Interactions belong to the active drug, never to the brand on the box; the same is true of generics.
Where do these interaction ratings come from?
Every rating comes from the Natural Medicines database — the same evidence-graded reference pharmacists and hospitals use — and each interaction carries three separate grades: severity (how bad it can be), likelihood (how well it's documented in studies and case reports), and an evidence level. Our pharmacists review the content; we never let an AI decide an interaction. See how to read the ratings and our editorial policy.
Does Esomeprazole deplete any vitamins or nutrients?
It might — Esomeprazole has 9 reported nutrient-depletion associations in the research literature, which is a different question from interactions: instead of a supplement changing the drug, the drug may lower a nutrient over time. See the Esomeprazole nutrient depletion report for the specifics and what to discuss with your pharmacist.
What about Esomeprazole and my other medications?
This page covers Esomeprazole against supplements and herbal ingredients. Checking Esomeprazole against your other prescription or OTC medications is a different tool — our drug interaction checker covers that side. Head to the drug–drug interaction checker, or read the full Esomeprazole drug information.

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

Where next

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Sourcing

Where This Data Comes From — and Why You Can Trust It

🧪 Licensed clinical database

Every interaction verdict on this page comes from Natural Medicines Pro (TRC Healthcare / Therapeutic Research) — the same evidence-graded reference used by pharmacists and hospitals. We license this data directly; we do not scrape it, and no AI invents an interaction.

🧑‍⚕️ Pharmacist review

This page is curated and coded by , Clinical Pharmacist, with additional analysis by the HelloPharmacist Pharmacist Team. Editorial commentary is ours; the licensed interaction records are shown as sourced.

🔄 Kept current

Our interaction database refreshes on a weekly cycle, and this page re-checks the live database every time it’s rebuilt — what you see reflects the database as of September 22, 2026.

🔍 Full transparency

How every dataset on this site is sourced, licensed, and updated is documented publicly: our data sources · editorial policy · how we use AI.

Educational information, not medical advice. An interaction being on file does not mean it will happen to you — and absence of one is not proof of safety. Never start or stop a medication or supplement without talking to your pharmacist or doctor.