Esomeprazole

Esomeprazole reduces acid in your stomach. It's used to treat indigestion, heartburn and gastroesophageal reflux disease (GERD).

It can also prevent and treat stomach ulcers.

Esomeprazole comes as capsules, tablets, granules and a liquid.

You need a prescription for full strength esomeprazole. A lower strength version is available at pharmacies.

Brand names include:

  • Nexium
  • Nexium Control

Esomeprazole also comes in a mixed tablet with naproxen. Naproxen reduces pain in joints and muscles. The brand name for this is Vimovo. It is only available on prescription.

How esomeprazole works

Esomeprazole is a 'proton pump inhibitor'.

Proton pumps are tiny substances that make acid to digest food. Esomeprazole temporarily stops these pumps working.

Get emergency help

You might need medical help if you get serious side effects, have a serious allergic reaction (anaphylaxis) or take too much.

Serious side effects

Serious side effects are rare.

Immediate action required: Phone your GP straight away if you have:

  • joint pain
  • a rash on parts of your body exposed to the sun
  • skin that's red, blistering or peeling
  • yellow skin, dark pee and tiredness
  • lose a lot of weight without trying
  • dark pee or poo
  • severe or constant diarrhoea

Serious allergic reaction

A serious allergic reaction after taking esomeprazole is rare.

Immediate action required: Call 112 or 999 or go to an emergency department (ED) if you:

  • get a rash that's itchy, red, swollen or blistered
  • are wheezing
  • get tightness in your chest or throat
  • have trouble breathing or talking
  • have swelling in your mouth, face, lips, tongue or throat

If you take too much

Urgent advice: Call your GP if you have taken too much and have any of these symptoms:

  • flushed skin
  • feeling sweaty
  • a fast heartbeat
  • feeling sleepy
  • blurred vision
  • feeling confused or agitated

When you start taking esomeprazole

You should start to feel better within 2 to 3 days.

It may take up to 4 weeks for esomeprazole to work properly. You may still have symptoms during this time.

The dose of your medicine depends on your condition. Your GP may increase or decrease your dose.

You might only take esomeprazole for a few weeks or months. But it will depend on your illness. You may need to take it for longer, even for many years.

You can get lower strength esomeprazole from a pharmacy. If you don't get any relief from heartburn and acid reflux symptoms after 2 weeks, talk to your GP.

Check if you can take esomeprazole

Esomeprazole can be taken by most adults. Children should only take it on prescription.

It may not be suitable if you:

  • have ever had an allergic reaction to other medicines
  • have liver problems
  • have a glucose, sucrose or lactose intolerance
  • are taking a medicine containing nelfinavir, for HIV infection

Pregnancy

Esomeprazole isn't recommended during pregnancy as there's no firm evidence it's safe.

If you're pregnant it's better to treat your symptoms without taking a medicine.

Your GP or midwife may suggest eating smaller meals and avoiding fatty and spicy food. They may also suggest raising an end of your bed so that your chest and head are above your waist.

Your GP may recommend a different medicine if you are pregnant.

Breastfeeding

You should not take esomeprazole if you are breastfeeding.

Esomeprazole may pass into breast milk, but we don't know for sure.

Your GP may recommend a different medicine if you are breastfeeding.

Contraception and fertility

Esomeprazole doesn't affect any type of regular contraception including the combined pill.

It may reduce the effectiveness of one type of emergency contraception called ellaOne (ulipristal).

There is no reason to believe esomeprazole reduces fertility.

How and when to take it

Always take esomeprazole exactly as your GP has told you. It's usual to take it once a day in the morning.

You can take it with or without food.

If you take esomeprazole twice a day, take 1 dose in the morning and 1 dose in the evening.

Swallow tablets whole with a drink of water.

If you have problems swallowing tablets, you can put them in a glass of water. Stir until the tablet breaks up and drink straight away.

If your child is under 12, their GP will prescribe granules which come in sachets. Mix granules with some water and drink straight away.

If you forget to take it

If you take esomeprazole once a day, take the missed dose as soon as you remember. Do this unless it's less than 12 hours until your next dose. In that case skip the missed dose.

If you take it twice a day, take the missed dose as soon as you remember, unless it's less than 4 hours until your next dose. In that case skip the missed dose.

Do not take a double dose to make up for a forgotten dose.

Side effects of esomeprazole

Most people who take esomeprazole do not have any side effects.

If you do they are usually mild and go away when you stop taking it.

Talk to your GP or pharmacist if they get worse or do not go away after a few days.

Common side effects can include:

  • headaches
  • diarrhoea
  • feeling sick or vomiting
  • constipation
  • stomach pain or wind

Long-term use

Levels of magnesium in your blood may fall if you take esomeprazole longer than 3 months.

This can make you feel tired, confused and dizzy. It can also cause muscle twitches and an irregular heartbeat.

Taking esomeprazole for more than 1 year can increase your chances of certain side effects, including:

If you've taken esomeprazole for a long time speak to your GP before you stop.

Taking esomeprazole with other medications

Tell your GP or pharmacist if you are taking, have recently taken or might take any other medicines before you take esomeprazole.

Always tell your GP or pharmacist that you are on esomeprazole before taking new medicines.

Tell your GP if you're taking these medicines, or any other medicine:

  • digoxin (a heart medicine)
  • cilostazol (used to treat painful legs caused by poor circulation)
  • anti-fungal medicines such as itraconazole, ketoconazole or posaconazole
  • methotrexate (for cancer and conditions like psoriasis and rheumatoid arthritis)
  • HIV medicines
  • phenytoin (for epilepsy)
  • rifampicin (an antibiotic)
  • blood thinners such as clopidogrel or warfarin
  • antidepressants such as citalopram, escitalopram, clomipramine or imipramine
  • tacrolimus (for eczema or to prevent organ rejection after a transplant)
  • other medicines that reduce the amount of acid in your stomach
  • medicines that reduce your immune system
  • any medicines for cancer

For a full list of medicines to avoid mixing see the leaflet inside your esomeprazole packet.

Herbal remedies or supplements

St. John's Wort may stop esomeprazole working as well as it should.

Tell your pharmacist or GP if you're taking herbal remedies, vitamins or supplements.

Other heartburn medicines

You can take esomeprazole with an antacid, for example Gaviscon.

Take it 2 hours before or after your dose of esomeprazole.

Painkillers

It's safe to take painkillers such as paracetamol or ibuprofen at the same time as esomeprazole.

Talk to your GP or pharmacist or before using ibuprofen as it can upset your stomach.

Food and drink

Avoid foods that make your indigestion worse, such as spicy and fatty foods.

You should also try to limit acidic foods, caffeinated drinks and alcohol.

If you have symptoms at night, try not to eat for at least 3 hours before you go to bed.

Finding your patient information leaflet online

Your patient information leaflet (PIL) is the leaflet that comes in the package of your medicine.

Information:

To find your PIL online, visit the Health Products Regulatory Authority (HPRA) website

  1. In the ‘Find a medicine’ search box, enter the brand name of your medicine. A list of matching medicines appears.
  2. To the right of your medicine, select ‘PIL’. A PDF of the PIL opens in a new window.

You can also:

  1. Select the brand name of your medicine.
  2. Scroll down to the Documents section.
  3. From the Package Leaflet line, select PDF version. A PDF of the PIL opens in a new window.

If your PIL is not on the HPRA website, the European Medicines Agency (EMA) website opens in a new window when you select ‘PIL’.

You can find your PIL on the EMA website.

Finding your PIL on the EMA website

If your PIL is not on the HPRA website, you will be sent to the European Medicines Agency (EMA) website.

To find your PIL on the EMA website:

  1. In the Medicines search box, enter the brand name of your medicine and the word ‘epar’. For example: ‘Zoely epar’. A list of matching medicines appears.
  2. Select the ‘Human medicine European public assessment report (EPAR)’ for your medicine
  3. From the table of contents, select Product information.
  4. Select the EPAR – Product Information link for your medicine. A PDF opens in a new window. The PIL information is in Annex III of the PDF under ‘labelling and package leaflet’

This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 24 September 2021
Next review due: 24 September 2024

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