Can You Take Xarelto And Nexium Together?
In our latest question and answer, the pharmacist discusses the safety of combining Nexium and Xarelto.
Can I take Xarelto at the same time as esomeprazole? Are there any issues with interactions, or would esomeprazole hinder the proper absorption of Xarelto? When should I take these medications?
Jul 03, 2023- There are no known interactions between Xarelto and Nexium, so taking them together is generally safe.
- Nexium does not interfere with how Xarelto is absorbed, broken down, or works in your body.
Quick Answer
There are no known interactions between Xarelto (rivaroxaban) and Nexium (esomeprazole). Taking them together is generally safe as esomeprazole does not interfere with the absorption of Xarelto, its metabolism or how it works.
Detailed Answer
This is a great question as there are several well-known and potentially dangerous drug interactions between proton pump inhibitors (PPIs), like Nexium, and blood-thinning medications.
One such well-known interaction is between the antiplatelet Plavix (clopidogrel) and Prilosec (omeprazole). Prilosec is an inhibitor of the metabolizing enzyme CYP2C19, which is the same enzyme responsible for metabolizing Plavix into its active form.
The good news regarding Xarelto and Nexium is that there is no evidence to suggest a similar interaction. These two drugs are generally considered safe to take together.
Xarelto is primarily metabolized by several enzymes and transporters, including CYP3A4/5, CYP2J2, P-glycoprotein (P-gp), and ATP-binding cassette G2 (ABCG2).
Nexium does not significantly affect these metabolic pathways or transporters. While it is an inhibitor of CYP2C19, which can increase the exposure of drugs metabolized by CYP2C19, this pathway is not majorly involved in the metabolism of Xarelto.
Additionally, studies have shown that Xarelto does not inhibit or induce major cytochrome P450 enzymes, nor does it affect P-gp transporters. There is no evidence of any interaction with Nexium in relation to Xarelto.
Final Words
I hope this information has been helpful to you! If you have any further questions, feel free to ask. Thank you for reaching out!
References & sources
Glossary — Terms in This Answer
- Proton pump inhibitors (PPIs)
- A class of medications that reduce stomach acid by blocking a specific mechanism in acid-producing cells.
- Antiplatelet
- A type of medication that prevents blood cells from sticking together to form clots.
- Metabolizing enzyme
- A protein in your body that breaks down drugs so they can be processed and eliminated.
- CYP2C19
- A specific enzyme in your body responsible for breaking down certain medications.
- CYP3A4/5
- Enzymes in your body that metabolize a wide range of medications.
- P-glycoprotein (P-gp)
- A transport protein that helps move drugs out of cells and reduce their absorption.
- Cytochrome P450 enzymes
- A family of proteins in your body that break down many different medications.
- Absorption
- The process by which a drug enters the bloodstream and becomes available to work in the body.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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