Uses
What is esomeprazole used for?
Esomeprazole is used to treat heartburn and certain other conditions caused by too much acid in the stomach.
- Gastroesophageal reflux disease (GERD), where stomach acid backs up into your esophagus
- To treat or help prevent ulcers
- To treat or help prevent erosive esophagitis (EE)
- Other conditions where your stomach makes too much acid
- Treatment of Helicobacter pylori (H. pylori) infections
Esomeprazole may also be used for other conditions as determined by your healthcare provider.
How does esomeprazole work (mechanism of action)?
Esomeprazole works by reducing the amount of acid your stomach makes.
How is esomeprazole supplied (dosage forms)?
Esomeprazole is available as Nexium, Nexium 24HR, and generic esomeprazole in the following dosage forms that are taken by mouth.
- 20 mg delayed-release oral capsules
- 40 mg delayed-release oral capsules
- 20 mg delayed-release oral tablets
- 2.5 mg packets of powder for oral suspension
- 5 mg packets of powder for oral suspension
- 10 mg packets of powder for oral suspension
- 20 mg packets of powder for oral suspension
- 40 mg packets of powder for oral suspension
Esomeprazole is also available in injectable forms.
How should I store esomeprazole?
Esomeprazole should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place.
Side Effects
What are the most common side effects of esomeprazole?
The most common side effects of esomeprazole are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Headache
- Diarrhea
- Nausea
- Gas
- Stomach pain
- Constipation
- Dry mouth
- Injection site reaction (esomeprazole IV)
- Dizziness (esomeprazole IV)
There may be other side effects of esomeprazole that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of esomeprazole?
While less common, the most serious side effects of esomeprazole are described below, along with what to do if they happen.
Kidney problems. A type of kidney problem called acute tubulointerstitial nephritis can happen at any time during treatment with esomeprazole. If you notice a decrease in the amount of your urine or see blood in your urine, call your doctor right away.
Antibiotic-associated Diarrhea. An overgrowth of germs called Clostridioides difficile, or “C. diff,” can happen in your gut during treatment with esomeprazole. Call your healthcare provider right away if you have any of the following symptoms of this condition.
- Watery diarrhea
- Diarrhea that does not go away
- Blood in your stool (poop)
- Severe stomach cramps
- Fever that starts after you start or finish the medicine
Severe Skin Reactions. Esomeprazole can cause severe skin reactions, such as Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), that can lead to death if not treated. If you develop a rash, stop esomeprazole and call your healthcare provider right away. Get emergency help right away if you have any of the following symptoms of SJS or TEN.
- Painful red or purple skin that looks burned and peels off
- Flat red rash or blisters on your skin, mouth, nose, and genitals
- Red, painful, watery eyes
Severe Allergic Reaction called DRESS. Esomeprazole can cause a specific type of allergic reaction called DRESS. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multi-organ hypersensitivity. This is a reaction that can affect multiple parts of the body including your liver, kidneys, and heart. Stop using the medicine and get help right away if you have any of the following symptoms of this serious allergic reaction.
- Skin rash or pale red bumps on the skin called hives
- Fever or general ill feeling
- Swollen lymph nodes
- Shortness of breath
- Swelling in your feet, ankles, or legs
- Dark colored urine
- Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
Lupus. Some medicines, such as esomeprazole, can cause certain types of lupus or cause worsening of lupus you already have. Lupus is an autoimmune disorder where your immune cells attack other cells or organs in your body. Tell your provider right away if you have new or worsening joint pain or a rash on your arms or cheeks.
Vitamin B-12 deficiency. Esomeprazole can cause you to absorb less vitamin B-12 than usual, which can cause low vitamin B-12 levels. You have a higher risk of this if you take esomeprazole for a long time (3 years or longer). Stop using esomeprazole and call your healthcare provider if you have any of the following symptoms.
- Sore tongue
- Weakness
- Tingling or numbness in your hands or feet
Hypomagnesemia. Esomeprazole can cause low magnesium levels, also known as hypomagnesemia, which can be serious. Decreased magnesium levels can cause seizures or heart rhythm problems. Some people have a higher risk of this, including people who take the esomeprazole for a long time or those that take other medicines that can cause low magnesium. Stop using esomeprazole and call your healthcare provider if you have any of the following symptoms.
- Changes in your heart rate or rhythm, such as fast or skipping heartbeat
- Muscle spasms
- Seizures
Severe Allergic Reactions. Esomeprazole may cause allergic reactions, which can be serious. Stop using esomeprazole and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Warnings & Precautions
Who should not use esomeprazole?
Allergies to Ingredients. People who are allergic to any of the following should not use esomeprazole.
- Nexium
- Nexium 24 HR
- Nexium IV
- Esomeprazole
- Any other medicine known as a proton pump inhibitor
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific esomeprazole products they stock.
Drug Interactions. Esomeprazole should not be taken while you are using certain other medicines. Before taking esomeprazole, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
What should I know about esomeprazole before using it?
Do not take esomeprazole unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share esomeprazole with other people, even if they have the same condition as you. It may harm them.
Keep esomeprazole out of the reach of children.
Do not chew, cut, or crush esomeprazole.
Antacids may be taken with esomeprazole if needed.
Esomeprazole should not be used for immediate relief of heartburn. It may take 1 to 4 days for the medicine to fully work.
If you are having difficulty swallowing the esomeprazole capsule, you may open them and sprinkle the contents on 1 tablespoon of applesauce. Swallow the applesauce right away. Don’t mix the contents with any other food.
Use an accurate measuring device to measure the amount of water needed to mix your esomeprazole oral liquid dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device.
What should I tell my healthcare provider before using esomeprazole?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if esomeprazole is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Low blood potassium level (hypokalemia)
- Low blood magnesium level (hypomagnesemia)
- Low blood calcium level (hypocalcemia)
- Liver problems
Other Medicines and Supplements. Esomeprazole may interact with other medicines and supplements. Before using esomeprazole, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Pregnancy. It is not known if or how esomeprazole could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take esomeprazole while you are pregnant or trying to get pregnant.
Breastfeeding. Do not take esomeprazole while you are breastfeeding. Esomeprazole can pass into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed.
Interactions
Does esomeprazole interact with foods or drinks?
Esomeprazole should be taken on an empty stomach. Avoid taking esomeprazole within 1 hour before meals.
It is unknown if drinking alcohol will affect esomeprazole.
Does esomeprazole interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before using esomeprazole.
- Clopidogrel (Plavix), which is a blood thinner used to prevent or treat blood clots
- Cilostazol (Pletal), which is a medicine used to decrease the symptoms of intermittent claudication
- Citalopram, which is a medicine used to treat depression
- Methotrexate (Trexall and others)
- Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
- Warfarin, which is a blood thinner
- Certain antiretroviral medicines, such as rilpivirine (Edurant), nelfinavir (Viracept), or saquinavir (Invirase), which are used for HIV or AIDS
- St. John’s Wort
- Rifampin, which is a medicine commonly used to treat an infection called tuberculosis
Some other medicines may alter the blood levels of esomeprazole, and vice versa. Tell your healthcare provider about all medicines that you take or have recently taken. Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
Esomeprazole may affect the absorption of some other medicines. Tell your healthcare provider about all medicines that you take or have recently taken.
Overdose/Missed Dose
What should I do if I accidentally use too much esomeprazole?
If you or someone else has used too much esomeprazole, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of esomeprazole?
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.
Are you currently using Esomeprazole (Nexium)?
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