Medication·Interactions & depletion·Reviewed June 9, 2026
Esomeprazole interactions.
Esomeprazole has 7 documented interactions in the NutriStack database. Prolonged use is also associated with lower Magnesium, Vitamin B12, Calcium, and Iron. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Esomeprazole at a glance.
A quick, data-grounded summary. The full tables are below.
Esomeprazole has 7 documented interactions in the NutriStack database. Prolonged use is also associated with lower Magnesium, Vitamin B12, Calcium, and Iron. The full interaction list, depletion table, and replacement suggestions are below. None of this is a substitute for your prescriber's advice.
Substances that interact with esomeprazole.
Every supplement and medication in the NutriStack database with a documented interaction with this drug, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| Beta-Carotene | Caution | Gastric acid contributes to the dispersion and absorption of beta-carotene from food. In a crossover study, raising gastric pH above 4.5 with... |
| Calcium | Caution | Esomeprazole reduces absorption of calcium carbonate, which depends on stomach acid to dissolve. Long-term PPI use is associated with a modest but... details → |
| Iron | Caution | Esomeprazole reduces absorption of oral iron, particularly non-heme iron salts like ferrous sulfate that require gastric acid for solubilization. In... details → |
| Magnesium Glycinate | Caution | Long-term esomeprazole use can cause hypomagnesemia, sometimes severe enough to trigger tetany, seizures, or arrhythmia. The FDA has issued a class... details → |
| Vitamin B12 | Caution | Long-term esomeprazole therapy reduces vitamin B12 absorption. PPIs suppress the gastric acid and pepsin needed to liberate dietary B12 from food... details → |
| Vitamin C | Caution | Esomeprazole lowers the concentration of bioavailable vitamin C in the stomach. In healthy volunteers, four weeks of a PPI reduced plasma vitamin C... details → |
| Zinc | Caution | Chronic esomeprazole therapy reduces zinc absorption and lowers body zinc stores. In a controlled study, plasma zinc rose 126% with supplementation... details → |
What esomeprazole can deplete.
Nutrients this medication is associated with lowering over time, with the mechanism, a suggested replacement where one applies, and the biomarker to monitor. Discuss any replacement with your prescriber first.
| Nutrient | Severity | How it happens | Replace with | Monitor |
|---|---|---|---|---|
| Magnesium | Significant | Chronic acid suppression impairs active intestinal magnesium transport, especially via TRPM6/7-mediated uptake. | Magnesium Glycinate | Serum magnesium or RBC magnesium |
| Vitamin B12 | Moderate | Reduced gastric acid impairs release of food-bound vitamin B12 from proteins, lowering long-term absorption. | Methylcobalamin | Serum B12 + methylmalonic acid |
| Calcium | Moderate | Lower gastric acidity reduces dissolution and absorption of less-soluble calcium salts, especially calcium carbonate. | Calcium | Serum calcium or bone density trend |
| Iron | Moderate | Reduced gastric acidity lowers conversion and solubility of non-heme iron, decreasing long-term absorption. | Iron Bisglycinate | Ferritin + transferrin saturation |
The full esomeprazole profile.
Uses, typical dosing, side effects, and the cited evidence for this medication.
Common esomeprazole questions.
Quick answers drawn from the tables above.
What interacts with Esomeprazole?
In the NutriStack database, Esomeprazole has 7 documented interactions. The most notable include Beta-Carotene, Calcium, Iron, Magnesium Glycinate, and Vitamin B12. Check any specific combination before taking it and confirm with your prescriber.
Does Esomeprazole deplete any nutrients?
Esomeprazole is associated with lowering Magnesium, Vitamin B12, Calcium, and Iron with prolonged use. Useful biomarkers to monitor include Serum magnesium or RBC magnesium, Serum B12 + methylmalonic acid, and Serum calcium or bone density trend. Ask your prescriber before adding any replacement supplement.
Is it safe to take Beta-Carotene with Esomeprazole?
NutriStack classifies the Beta-Carotene and Esomeprazole pairing as caution: Gastric acid contributes to the dispersion and absorption of beta-carotene from food. In a crossover study, raising gastric pH above 4.5 with omeprazole significantly... If you use beta-carotene as a vitamin A source while on esomeprazole, take it with a fat-containing meal to maximize what acid-independent... Always confirm with your prescriber.
Check your whole stack
See how esomeprazole fits your supplements.
NutriStack screens your full routine for interactions and depletions, and updates the moment you change it.