Esomeprazole reduces the amount of acid produced in your stomach.
The most common side-effects are headache and stomach upset. These effects are generally mild and soon pass.
|Type of medicine||Proton pump inhibitor|
|Used for||Gastric ulcers; duodenal ulcers; gastro-oesophageal reflux disease; Helicobacter pylori infection; Zollinger-Ellison syndrome|
|Also called||Emozul®; Guardium®; Nexium®|
Combination brand: Vimovo® (esomeprazole with naproxen)
|Available as||Tablets, capsules, sachets and injection|
Acid is produced naturally in your stomach to help you digest food and to kill germs (bacteria). This acid is irritant so your body produces a natural mucous barrier which protects the lining of your stomach. In people who take painkillers called non-steroidal anti-inflammatory drugs (NSAIDs), this barrier can break down, allowing the acid to damage the stomach, causing inflammation, ulcers and other conditions. Other people can have a problem with the muscular band at the top of the stomach that keeps the stomach tightly closed. This may allow the acid to escape and irritate the oesophagus, causing heartburn. This is often referred to as 'acid reflux'.
Proton pump inhibitors such as esomeprazole stop cells in the lining of the stomach from producing too much acid. This helps to prevent ulcers from forming, or assists the healing process where damage has already occurred. By decreasing the amount of acid, they can also help to reduce the symptoms of acid reflux disease, such as heartburn.
Esomeprazole is available on prescription and can be bought from pharmacies and other retail outlets for the relief of reflux symptoms.
Esomeprazole is also used as one part of a treatment to get rid of Helicobacter pylori, a bacterium found in the stomach, which can cause ulcers.
Before taking esomeprazole
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking esomeprazole it is important that your doctor or pharmacist knows:
- If you are pregnant, trying for a baby or breastfeeding.
- If you have any problems with the way your liver works, or with the way your kidneys work.
- If you have any of the following symptoms: difficulty swallowing, loss of blood, weight loss, or if you are being sick (vomiting).
- If you have ever had an allergic reaction to a medicine.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
How to take esomeprazole
- Before you start this treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about esomeprazole and will provide you with a full list of the side-effects which you may experience from taking it.
- Take esomeprazole exactly as your doctor tells you to. There are different strengths of tablets and capsules available so your doctor will tell you which is right for you. It is common to take just one dose a day, although if you are taking it for either Helicobacter pylori eradication or for Zollinger-Ellison syndrome, you will be asked to take two doses a day. Your doctor will tell you which dose is right for you and the directions will also be on the label of the pack to remind you.
- It is important that you don't chew esomeprazole before you swallow. The tablets, capsules and granules (in the sachets) are all manufactured with a special coating which must not be crushed. If you have difficulties swallowing, you can stir the tablets into a glass of water to make swallowing easier. The capsules likewise can be opened up and the contents mixed into water to make swallowing easier. If you make up your doses in this way, make sure that you drink the mixture within 30 minutes of making it. If you have been given sachets, pour the contents of each sachet into 15 ml of water. Stir the liquid and then leave it to thicken for a minute or so before stirring it again. Then swallow the liquid, rinse out the glass with a little more water, and then swallow this water too.
- You can take esomeprazole before or after food.
- If you forget to take a dose at your usual time, you can take it when you remember (unless it is nearly time for your next dose, in which case leave out the missed dose). Do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your progress can be checked. If you are taking esomeprazole on a long-term basis your doctor will want to review your treatment at least once a year to make sure it is still right for you.
- Some foods may make your symptoms worse. Foods and drinks that have been suspected of this include peppermint, tomatoes, chocolate, spicy foods, hot drinks, coffee, and alcoholic drinks. If it seems that a food is aggravating your symptoms, try avoiding it for a while to see if your symptoms improve. Also, try avoiding eating large meals, as these can make your symptoms worse too.
- If you are overweight, it puts extra pressure on your stomach and encourages the symptoms of acid reflux. Losing some weight and eating a healthy balanced diet may help you.
- Smoking increases the amount of acid produced by the stomach and may make your symptoms worse. If you are a smoker, speak with your doctor or pharmacist about how to quit.
- Recent studies suggest that there may be a slight increase in the risk of bone fractures when proton pump inhibitors like esomeprazole are taken for longer than a year. If this affects you, your doctor will check that you are taking enough vitamin D and calcium to reduce this risk.
- If you buy any medicines 'over the counter', always check with a pharmacist that they are safe to take alongside your other medicines.
Can esomeprazole cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with esomeprazole. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common esomeprazole side-effects (these affect fewer than 1 in 10 people)||What can I do if I experience this?|
|Headache||Drink plenty of water and ask a pharmacist to recommend a suitable painkiller. If the headaches continue, let your doctor know|
|Constipation||Try to eat a well-balanced diet and drink several glasses of water each day|
|Diarrhoea||Drink plenty of water to replace lost fluids|
|Feeling sick (nausea) or being sick (vomiting), stomach ache, wind||Stick to simple meals - avoid rich or spicy foods|
Important: long-term use of esomeprazole (for at least three months) may lead to low levels of magnesium in your blood. Initial signs this might be happening include feeling tired, dizzy or confused and an irregular heartbeat (palpitations). Let your doctor know if you think this applies to you
If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.
How to store esomeprazole
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Nexium® 20 mg, 40 mg Tablets; AstraZeneca UK Limited, The electronic Medicines Compendium. Dated December 2021.
Manufacturer's PIL, Nexium® 10 mg gastro-resistant granules for oral suspension, sachet; AstraZeneca UK Limited, The electronic Medicines Compendium. Dated December 2021.
Medicines Complete BNF 86th Edition; British Medical Association and Royal Pharmaceutical Society of Great Britain, London.