Meta Information
ID:proton-pump-inhibitors
Name:Proton Pump Inhibitors
Schema Version:2.4_uniform_evidence_2026_06_18
Interactions
Target id:
/class/diuretics
Target name:
diuretics
Severity:
moderate
Interaction type:
synergistic
Nature:
conditional
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Both drugs can lower magnesium levels in the body, and taking them together significantly increases the risk of severe magnesium deficiency.
Actionable advice:
Caution is warranted, and monitoring advised, when combining proton pump inhibitors with diuretics; dose adjustment may be needed.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics)
Label source:
FDA label: DEXILANT (DEXLANSOPRAZOLE) CAPSULE, DELAYED RELEASE [TAKEDA PHARMACEUTICALS AMERICA, INC.]
Source url:
Exact phrase from label:
For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels
Label source:
FDA label: PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) TABLET, DELAYED RELEASE PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) GRANULE, DELAYED RELEASE [WYETH PHARMACEUTICALS LLC, A SUBSIDIARY OF PFIZER INC.]
Action type:
adjust_with_prescriber
Target id:
/class/acid-dependent-absorption-drugs
Target name:
drugs dependent on gastric pH for absorption
Severity:
moderate
Interaction type:
diminishing
Nature:
conditional
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Medications like iron salts or ketoconazole require stomach acid to be absorbed; dexlansoprazole reduces that acidity, making them less effective.
Actionable advice:
Caution is warranted, and monitoring advised, when combining proton pump inhibitors with drugs dependent on gastric pH for absorption; dose adjustment may be needed.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Dexlansoprazole can reduce the absorption of other drugs due to its effect on reducing intragastric acidity.
Label source:
FDA label: DEXILANT (DEXLANSOPRAZOLE) CAPSULE, DELAYED RELEASE [TAKEDA PHARMACEUTICALS AMERICA, INC.]
Source url:
Exact phrase from label:
Lansoprazole can reduce the absorption of other drugs due to its effect on reducing intragastric acidity.
Label source:
FDA label: LANSOPRAZOLE TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE [CARDINAL HEALTH 107, LLC]
Source url:
Exact phrase from label:
Pantoprazole can reduce the absorption of other drugs due to its effect on reducing intragastric acidity.
Label source:
FDA label: PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) TABLET, DELAYED RELEASE PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) GRANULE, DELAYED RELEASE [WYETH PHARMACEUTICALS LLC, A SUBSIDIARY OF PFIZER INC.]
Action type:
adjust_with_prescriber
Target id:
/class/proton-pump-inhibitors
Target name:
substituted benzimidazoles
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Patients with a known allergy to similar drugs in this class risk severe, potentially life-threatening hypersensitivity reactions.
Actionable advice:
Proton pump inhibitors should not be combined with substituted benzimidazoles.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Esomeprazole magnesium delayed-release capsules are contraindicated in patients with known hypersensitivity to substituted benzimidazoles
Label source:
FDA label: ESOMEPRAZOLE MAGNESIUM CAPSULE, DELAYED RELEASE [REMEDYREPACK INC.]
Source url:
Exact phrase from label:
PROTONIX is contraindicated in patients with known hypersensitivity to any component of the formulation or any substituted benzimidazole.
Label source:
FDA label: PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) TABLET, DELAYED RELEASE PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) GRANULE, DELAYED RELEASE [WYETH PHARMACEUTICALS LLC, A SUBSIDIARY OF PFIZER INC.]
Source url:
Exact phrase from label:
ACIPHEX is contraindicated in patients with known hypersensitivity to rabeprazole, substituted benzimidazoles, or to any component of the formulation.
Label source:
FDA label: ACIPHEX (RABEPRAZOLE SODIUM) TABLET, DELAYED RELEASE [WAYLIS THERAPEUTICS LLC]
Action type:
avoid
Target id:
/intervention/atazanavir
Target name:
atazanavir
Severity:
major
Interaction type:
diminishing
Nature:
conditional
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Lowered gastric acidity prevents the body from absorbing this medication effectively, which can decrease its ability to fight viral infection.
Actionable advice:
Caution and close monitoring are important when combining proton pump inhibitors with atazanavir; dose adjustment may be needed.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with dexlansoprazole may reduce antiviral effect
Label source:
FDA label: DEXILANT (DEXLANSOPRAZOLE) CAPSULE, DELAYED RELEASE [TAKEDA PHARMACEUTICALS AMERICA, INC.]
Source url:
Exact phrase from label:
Decreased exposure of some antiretroviral drugs (e.g., rilpivirine atazanavir, and nelfinavir) when used concomitantly with esomeprazole may reduce antiviral effect
Label source:
FDA label: ESOMEPRAZOLE MAGNESIUM CAPSULE, DELAYED RELEASE [REMEDYREPACK INC.]
Source url:
Exact phrase from label:
Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with lansoprazole may reduce antiviral effect
Label source:
FDA label: LANSOPRAZOLE TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE [CARDINAL HEALTH 107, LLC]
Source url:
Exact phrase from label:
Decreased exposure of some antiretroviral drugs (e.g., rilpivirine atazanavir, and nelfinavir) when used concomitantly with pantoprazole may reduce antiviral effect
Label source:
FDA label: PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) TABLET, DELAYED RELEASE PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) GRANULE, DELAYED RELEASE [WYETH PHARMACEUTICALS LLC, A SUBSIDIARY OF PFIZER INC.]
Source url:
Exact phrase from label:
Decreased exposure of some antiretroviral drugs (e.g., rilpivirine, atazanavir, and nelfinavir) when used concomitantly with rabeprazole may reduce antiviral effect
Label source:
FDA label: ACIPHEX (RABEPRAZOLE SODIUM) TABLET, DELAYED RELEASE [WAYLIS THERAPEUTICS LLC]
Action type:
adjust_with_prescriber
Target id:
/intervention/digoxin
Target name:
digoxin
Severity:
moderate
Interaction type:
adverse
Nature:
conditional
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The reduction in stomach acid can increase the absorption of digoxin, potentially leading to toxic levels.
Actionable advice:
Caution is warranted, and monitoring advised, when combining proton pump inhibitors with digoxin; dose adjustment may be needed.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Potential for increased exposure of digoxin
Label source:
FDA label: ESOMEPRAZOLE MAGNESIUM CAPSULE, DELAYED RELEASE [REMEDYREPACK INC.]
Source url:
Exact phrase from label:
For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels
Label source:
FDA label: PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) TABLET, DELAYED RELEASE PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) GRANULE, DELAYED RELEASE [WYETH PHARMACEUTICALS LLC, A SUBSIDIARY OF PFIZER INC.]
Source url:
Exact phrase from label:
Potential for increased exposure of digoxin [see Clinical Pharmacology (12.3)]. Intervention: Monitor digoxin concentrations.
Label source:
FDA label: ACIPHEX (RABEPRAZOLE SODIUM) TABLET, DELAYED RELEASE [WAYLIS THERAPEUTICS LLC]
Action type:
adjust_with_prescriber
Target id:
/intervention/methotrexate
Target name:
methotrexate
Severity:
major
Interaction type:
synergistic
Nature:
conditional
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Using these drugs together can slow down the removal of methotrexate from your system, potentially leading to dangerous toxicity.
Actionable advice:
Caution and close monitoring are important when combining proton pump inhibitors with methotrexate; dose adjustment may be needed.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Concomitant use of PPIs with methotrexate (primarily at high dose) may elevate and/or prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity.
Label source:
FDA label: DEXILANT (DEXLANSOPRAZOLE) CAPSULE, DELAYED RELEASE [TAKEDA PHARMACEUTICALS AMERICA, INC.]
Source url:
Exact phrase from label:
Concomitant use of esomeprazole with methotrexate (primarily at high dose) may elevate and prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity.
Label source:
FDA label: ESOMEPRAZOLE MAGNESIUM CAPSULE, DELAYED RELEASE [REMEDYREPACK INC.]
Source url:
Exact phrase from label:
Concomitant use of PPIs with methotrexate (primarily at high dose) may elevate and prolong serum concentrations of methotrexate and/or its metabolite hydroxymethotrexate, possibly leading to methotrexate toxicities.
Label source:
FDA label: LANSOPRAZOLE TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE [CARDINAL HEALTH 107, LLC]
Source url:
Exact phrase from label:
Concomitant use of PPIs with methotrexate (primarily at high dose) may elevate and prolong serum concentrations of methotrexate and/or its metabolite hydroxymethotrexate, possibly leading to methotrexate toxicities.
Label source:
FDA label: PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) TABLET, DELAYED RELEASE PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) GRANULE, DELAYED RELEASE [WYETH PHARMACEUTICALS LLC, A SUBSIDIARY OF PFIZER INC.]
Source url:
Exact phrase from label:
Concomitant use with PPIs may elevate and/or prolong serum concentrations of methotrexate and/or its metabolite, possibly leading to toxicity.
Label source:
FDA label: ACIPHEX (RABEPRAZOLE SODIUM) TABLET, DELAYED RELEASE [WAYLIS THERAPEUTICS LLC]
Action type:
adjust_with_prescriber
Target id:
/intervention/mycophenolate-mofetil
Target name:
mycophenolate mofetil
Severity:
moderate
Interaction type:
diminishing
Nature:
conditional
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Changes in stomach pH caused by dexlansoprazole can prevent the proper absorption of this drug, potentially affecting its ability to prevent organ rejection.
Actionable advice:
Caution is warranted, and monitoring advised, when combining proton pump inhibitors with mycophenolate mofetil; dose adjustment may be needed.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Coadministration of PPIs in healthy subjects and in transplant patients receiving MMF has been reported to reduce the exposure to the active metabolite, mycophenolic acid (MPA)
Label source:
FDA label: DEXILANT (DEXLANSOPRAZOLE) CAPSULE, DELAYED RELEASE [TAKEDA PHARMACEUTICALS AMERICA, INC.]
Source url:
Exact phrase from label:
Use esomeprazole with caution in transplant patients receiving MMF
Label source:
FDA label: ESOMEPRAZOLE MAGNESIUM CAPSULE, DELAYED RELEASE [REMEDYREPACK INC.]
Source url:
Exact phrase from label:
Coadministration of PPIs in healthy subjects and in transplant patients receiving MMF has been reported to reduce the exposure to the active metabolite, mycophenolic acid (MPA)
Label source:
FDA label: LANSOPRAZOLE TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE [CARDINAL HEALTH 107, LLC]
Source url:
Exact phrase from label:
Co-administration of pantoprazole sodium in healthy subjects and in transplant patients receiving MMF has been reported to reduce the exposure to the active metabolite, mycophenolic acid (MPA)
Label source:
FDA label: PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) TABLET, DELAYED RELEASE PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) GRANULE, DELAYED RELEASE [WYETH PHARMACEUTICALS LLC, A SUBSIDIARY OF PFIZER INC.]
Source url:
Exact phrase from label:
Use ACIPHEX delayed-release tablets with caution in transplant patients receiving MMF.
Label source:
FDA label: ACIPHEX (RABEPRAZOLE SODIUM) TABLET, DELAYED RELEASE [WAYLIS THERAPEUTICS LLC]
Action type:
adjust_with_prescriber
Target id:
/intervention/nelfinavir
Target name:
nelfinavir
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Reduced stomach acid significantly lowers nelfinavir levels in the blood, making the antiviral treatment less effective.
Actionable advice:
Proton pump inhibitors should not be combined with nelfinavir.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Nelfinavir: Avoid concomitant use with DEXILANT. See prescribing information for nelfinavir.
Label source:
FDA label: DEXILANT (DEXLANSOPRAZOLE) CAPSULE, DELAYED RELEASE [TAKEDA PHARMACEUTICALS AMERICA, INC.]
Source url:
Exact phrase from label:
Nelfinavir: Avoid concomitant use with esomeprazole.
Label source:
FDA label: ESOMEPRAZOLE MAGNESIUM CAPSULE, DELAYED RELEASE [REMEDYREPACK INC.]
Source url:
Exact phrase from label:
Nelfinavir: Avoid concomitant use with lansoprazole. See prescribing information for nelfinavir.
Label source:
FDA label: LANSOPRAZOLE TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE [CARDINAL HEALTH 107, LLC]
Source url:
Exact phrase from label:
Nelfinavir: Avoid concomitant use with PROTONIX.
Label source:
FDA label: PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) TABLET, DELAYED RELEASE PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) GRANULE, DELAYED RELEASE [WYETH PHARMACEUTICALS LLC, A SUBSIDIARY OF PFIZER INC.]
Source url:
Exact phrase from label:
Nelfinavir: Avoid concomitant use with ACIPHEX delayed-release tablets.
Label source:
FDA label: ACIPHEX (RABEPRAZOLE SODIUM) TABLET, DELAYED RELEASE [WAYLIS THERAPEUTICS LLC]
Action type:
avoid
Target id:
/intervention/rifampin
Target name:
rifampin
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Rifampin induces enzymes that process dexlansoprazole, causing the medication to be cleared from your system too quickly.
Actionable advice:
Proton pump inhibitors should not be combined with rifampin.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
St. John's Wort, rifampin: Avoid concomitant use with DEXILANT.
Label source:
FDA label: DEXILANT (DEXLANSOPRAZOLE) CAPSULE, DELAYED RELEASE [TAKEDA PHARMACEUTICALS AMERICA, INC.]
Source url:
Exact phrase from label:
Interaction with St. John's Wort or Rifampin: Avoid concomitant use of esomeprazole magnesium delayed-release capsules.
Label source:
FDA label: ESOMEPRAZOLE MAGNESIUM CAPSULE, DELAYED RELEASE [REMEDYREPACK INC.]
Action type:
avoid
Target id:
/intervention/rilpivirine
Target name:
rilpivirine-containing products
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Dexlansoprazole reduces stomach acid, which is needed for rilpivirine to be absorbed properly, potentially leading to HIV drug resistance.
Actionable advice:
Proton pump inhibitors should not be combined with rilpivirine-containing products.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
PPIs, including DEXILANT, are contraindicated with rilpivirine-containing products [see Drug Interactions (7)].
Label source:
FDA label: DEXILANT (DEXLANSOPRAZOLE) CAPSULE, DELAYED RELEASE [TAKEDA PHARMACEUTICALS AMERICA, INC.]
Source url:
Exact phrase from label:
Proton Pump Inhibitors (PPIs), including lansoprazole delayed-release orally disintegrating tablets, are contraindicated with rilpivirine-containing products
Label source:
FDA label: LANSOPRAZOLE TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE [CARDINAL HEALTH 107, LLC]
Action type:
avoid
Target id:
/intervention/saquinavir
Target name:
saquinavir
Severity:
moderate
Interaction type:
synergistic
Nature:
conditional
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
This drug combination can lead to higher levels of saquinavir in the body, potentially increasing the risk of dangerous side effects.
Actionable advice:
Caution is warranted, and monitoring advised, when combining proton pump inhibitors with saquinavir; dose adjustment may be needed.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Increased exposure of other antiretroviral drugs (e.g., saquinavir) when used concomitantly with dexlansoprazole may increase toxicity of the antiretroviral drugs.
Label source:
FDA label: DEXILANT (DEXLANSOPRAZOLE) CAPSULE, DELAYED RELEASE [TAKEDA PHARMACEUTICALS AMERICA, INC.]
Source url:
Exact phrase from label:
Increased exposure of other antiretroviral drugs (e.g., saquinavir) when used concomitantly with esomeprazole may increase toxicity
Label source:
FDA label: ESOMEPRAZOLE MAGNESIUM CAPSULE, DELAYED RELEASE [REMEDYREPACK INC.]
Source url:
Exact phrase from label:
Increased exposure of other antiretroviral drugs (e.g., saquinavir) when used concomitantly with lansoprazole may increase toxicity of the antiretroviral drugs.
Label source:
FDA label: LANSOPRAZOLE TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE [CARDINAL HEALTH 107, LLC]
Source url:
Exact phrase from label:
Increased exposure of other antiretroviral drugs (e.g., saquinavir) when used concomitantly with pantoprazole may increase toxicity
Label source:
FDA label: PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) TABLET, DELAYED RELEASE PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) GRANULE, DELAYED RELEASE [WYETH PHARMACEUTICALS LLC, A SUBSIDIARY OF PFIZER INC.]
Source url:
Exact phrase from label:
Increased exposure of other antiretroviral drugs (e.g., saquinavir) when used concomitantly with rabeprazole may increase toxicity.
Label source:
FDA label: ACIPHEX (RABEPRAZOLE SODIUM) TABLET, DELAYED RELEASE [WAYLIS THERAPEUTICS LLC]
Action type:
adjust_with_prescriber
Target id:
/intervention/st-johns-wort
Target name:
St. John's Wort
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
This herbal supplement can speed up the breakdown of dexlansoprazole in the body, making the heartburn treatment significantly less effective.
Actionable advice:
Proton pump inhibitors should not be combined with St. John's Wort.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
St. John's Wort, rifampin: Avoid concomitant use with DEXILANT.
Label source:
FDA label: DEXILANT (DEXLANSOPRAZOLE) CAPSULE, DELAYED RELEASE [TAKEDA PHARMACEUTICALS AMERICA, INC.]
Source url:
Exact phrase from label:
Interaction with St. John's Wort or Rifampin: Avoid concomitant use of esomeprazole magnesium delayed-release capsules.
Label source:
FDA label: ESOMEPRAZOLE MAGNESIUM CAPSULE, DELAYED RELEASE [REMEDYREPACK INC.]
Action type:
avoid
Target id:
/intervention/tacrolimus
Target name:
tacrolimus
Severity:
moderate
Interaction type:
synergistic
Nature:
conditional
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Dexlansoprazole may interfere with the metabolism of tacrolimus, leading to higher blood levels and an increased risk of toxicity.
Actionable advice:
Caution is warranted, and monitoring advised, when combining proton pump inhibitors with tacrolimus; dose adjustment may be needed.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Potentially increased exposure of tacrolimus, especially in transplant patients who are intermediate or poor metabolizers of CYP2C19.
Label source:
FDA label: DEXILANT (DEXLANSOPRAZOLE) CAPSULE, DELAYED RELEASE [TAKEDA PHARMACEUTICALS AMERICA, INC.]
Source url:
Exact phrase from label:
Potentially increased exposure of tacrolimus, especially in transplant patients who are intermediate or poor metabolizers of CYP2C19.
Label source:
FDA label: ESOMEPRAZOLE MAGNESIUM CAPSULE, DELAYED RELEASE [REMEDYREPACK INC.]
Source url:
Exact phrase from label:
Potentially increased exposure of tacrolimus, especially in transplant patients who are intermediate or poor metabolizers of CYP2C19.
Label source:
FDA label: ACIPHEX (RABEPRAZOLE SODIUM) TABLET, DELAYED RELEASE [WAYLIS THERAPEUTICS LLC]
Action type:
adjust_with_prescriber
Target id:
/intervention/warfarin
Target name:
warfarin
Severity:
major
Interaction type:
synergistic
Nature:
conditional
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Dexlansoprazole can enhance the blood-thinning effects of warfarin, significantly increasing the risk of serious or fatal bleeding.
Actionable advice:
Caution and close monitoring are important when combining proton pump inhibitors with warfarin; dose adjustment may be needed.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Increased INR and prothrombin time in patients receiving PPIs and warfarin concomitantly. Increases in INR and prothrombin time may lead to abnormal bleeding and even death.
Label source:
FDA label: DEXILANT (DEXLANSOPRAZOLE) CAPSULE, DELAYED RELEASE [TAKEDA PHARMACEUTICALS AMERICA, INC.]
Source url:
Exact phrase from label:
Increased INR and prothrombin time in patients receiving PPIs, including esomeprazole, and warfarin concomitantly. Increases in INR and prothrombin time may lead to abnormal bleeding and even death.
Label source:
FDA label: ESOMEPRAZOLE MAGNESIUM CAPSULE, DELAYED RELEASE [REMEDYREPACK INC.]
Source url:
Exact phrase from label:
Increased INR and prothrombin time in patients receiving PPIs and warfarin concomitantly. Increases in INR and prothrombin time may lead to abnormal bleeding and even death.
Label source:
FDA label: LANSOPRAZOLE TABLET, ORALLY DISINTEGRATING, DELAYED RELEASE [CARDINAL HEALTH 107, LLC]
Source url:
Exact phrase from label:
Increased INR and prothrombin time in patients receiving PPIs, including pantoprazole, and warfarin concomitantly. Increases in INR and prothrombin time may lead to abnormal bleeding and even death.
Label source:
FDA label: PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) TABLET, DELAYED RELEASE PROTONIX DELAYED-RELEASE (PANTOPRAZOLE SODIUM) GRANULE, DELAYED RELEASE [WYETH PHARMACEUTICALS LLC, A SUBSIDIARY OF PFIZER INC.]
Source url:
Exact phrase from label:
Monitor for increases in INR and prothrombin time... Increases in INR and prothrombin time may lead to abnormal bleeding and even death.
Label source:
FDA label: ACIPHEX (RABEPRAZOLE SODIUM) TABLET, DELAYED RELEASE [WAYLIS THERAPEUTICS LLC]
Action type:
adjust_with_prescriber