Can I take Calcium and Esomeprazole together?

Why this happens

Esomeprazole reduces the amount of acid in your stomach. Some forms of calcium (like calcium carbonate) need stomach acid to dissolve properly so they can be absorbed into your bloodstream. Additionally, long-term use of acid-blockers may interfere with the cells that build and maintain bone strength.

What you should do

If you need a calcium supplement while taking esomeprazole, choose 'calcium citrate' as it does not require stomach acid to be absorbed. Ensure you have adequate Vitamin D intake. If you have been taking esomeprazole for more than a year, discuss your bone health and the necessity of the medication with your doctor.

Important precautions

Drug interaction timing

Esomeprazole reduces stomach acid, which can significantly lower the absorption of certain calcium supplements (specifically calcium carbonate). Take calcium citrate instead, or ensure calcium is taken at a different time of day if advised.

Severe diarrhoea

Seek immediate medical help if you develop severe or persistent watery diarrhoea, as esomeprazole increases the risk of a serious bacterial infection called Clostridium difficile.

Magnesium deficiency

Long-term use (over 3 months) can cause dangerously low magnesium levels. Contact your doctor if you experience muscle twitches, tremors, or a racing heartbeat.

Food and drink warnings

Caffeine (Coffee, tea, energy drinks)

Caffeine can slightly reduce the amount of calcium your body absorbs. It also increases the amount of calcium lost through urine. Try to limit your caffeine intake or avoid consuming high amounts of caffeine at the same time as your calcium supplement.

High-fibre foods (e.g., whole grains, bran, beans) and foods high in oxalates (e.g., spinach, rhubarb)

Foods very high in fibre or oxalates can bind to calcium and prevent it from being absorbed properly. If you eat a meal very high in these, try to wait 2 hours before taking your calcium supplement.

Alcohol

Heavy alcohol consumption can interfere with calcium balance and the body's ability to absorb calcium. It is best to limit alcohol intake to moderate levels.

Food (General)

For the best results in treating acid-related symptoms, esomeprazole should be taken at least one hour before a meal. Taking it with food can slow down its absorption and make it less effective.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.