Esomeprazole reduces acid in your stomach.
It's used to treat:
- indigestion
- heartburn
- gastro-oesophageal reflux disease (GORD)
It can also prevent and treat stomach ulcers. Sometimes, you take it for a rare condition called Zollinger-Ellison syndrome.
Types of esomeprazole
Esomeprazole comes as capsules and tablets. You need a prescription for full-strength esomeprazole.
You can buy low-strength 20mg tablets from pharmacies without a prescription.
Brand names include:
- Emazole and Emazole Control
- Nexazole
- Nexium and 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.
When you start taking esomeprazole
You should start to feel better within 2 to 3 days. But it may take up to 4 weeks for esomeprazole to work properly. You may still have symptoms during this time.
Dosage
The dose of your medicine depends on your condition. Your GP may increase or decrease your dose.
If you have been prescribed esomeprazole, you might only take it 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.
Esomeprazole without a prescription
Low-strength esomeprazole is available from a pharmacy without a prescription. You can take it for up to 14 days.
Contact a GP after 14 days if you are taking low-strength esomeprazole for heartburn or acid reflux and:
- you do not get any relief
- your symptoms get worse
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
- are due to have an endoscopy
- are taking a medicine containing nelfinavir, for HIV infection
Pregnancy and esomeprazole
Esomeprazole is not recommended during pregnancy. 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 the end of your bed so that your chest and head are above your waist.
Your GP may also recommend a different medicine.
Breastfeeding and esomeprazole
You should not take esomeprazole if you are breastfeeding.
Esomeprazole may pass into breast milk, but we do not know for sure.
Your GP may recommend a different medicine if you are breastfeeding.
Non-urgent advice: Tell your GP if you're:
- trying to get pregnant
- pregnant
- breastfeeding
Contraception and fertility
Esomeprazole does not 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.
Tablets
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.
Capsules
If you have problems swallowing capsules, open them up and empty the contents into a glass. Mix with some water and drink it 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.
If you take too much
It's very unlikely that taking 1 or 2 extra doses will cause any problems. But check with a GP if you're worried.
Non-urgent advice: Contact 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
Side effects
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.
Common side effects
There are things you can do to help cope with common side effects of esomeprazole:
Headaches
Make sure you rest and drink plenty of fluids. It's best not to drink too much alcohol. Headaches usually go away after the first week, but ask your pharmacist to recommend a painkiller, or talk to your doctor if they last more than a week or are severe.
Feeling sick
Try taking esomeprazole with or after a meal or snack. It may also help if you do not eat rich or spicy food while you're taking this medicine. Try drinking small, frequent sips of water to avoid dehydration.
Getting sick
Take, small, frequent sips of water to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.
If you take the combined contraceptive pill or the progestogen-only pill and you're getting sick your contraception may not protect you from pregnancy. Check the pill packet for advice.
Diarrhoea
Drink plenty of fluids, such as water or squash, to prevent dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee.
If the diarrhoea does not get better, talk to your GP.
If you take the combined contraceptive pill or the progestogen-only pill and you have diarrhoea, your contraception may not protect you from pregnancy. Check the pill packet for advice or ask a pharmacist.
Constipation
Get more fibre into your diet such as fresh fruit and vegetables and cereals, and drink plenty of water. Try to exercise regularly, for example, by going for a daily walk or run. If this does not help, talk to your pharmacist or GP.
Stomach pain
Try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help. If you are in a lot of pain, speak to your pharmacist or GP.
Farting (flatulence)
Try to avoid foods that cause farting, like pulses, lentils, beans and onions. It might help to eat smaller meals more frequently, eat and drink slowly, and exercise regularly.
Serious side effects
Serious side effects are rare.
Urgent advice: Contact your GP straight away if you have:
- joint pain along with a rash on parts of your body exposed to the sun
- skin that's red, blistering or peeling
- yellow skin, dark pee and tiredness - these can be signs of liver problems
- lose a lot of weight without trying
- dark pee or poo
- severe or constant diarrhoea - this can be a sign of an inflamed bowel
Serious allergic reaction
A serious allergic reaction after taking esomeprazole is rare.
Non-urgent advice: 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
Talk to your GP or pharmacist if your side effects get worse or do not go away after a few days.
Read the patient information leaflet that came with your medicine for a full list of side effects.
Non-urgent advice: Find your patient information leaflet
Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.
Report side effects
You can report any suspected side effects to the Health Products Regulatory Authority (HPRA): report an issue - hpra.ie
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. Tell your GP if you get any of these symptoms.
Taking esomeprazole for more than 1 year can increase your chances of certain side effects, including:
- bone fractures, especially if you have osteoporosis
- gut infections
- vitamin B12 deficiency
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 weaken 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.
What antacids do
Antacids relieve indigestion and heartburn by reducing the damage that acid can do to your stomach.
Types of antacids include calcium carbonate (Rennie), sodium bicarbonate, Maalox and Milk of Magnesia.
Antacids give quick relief that lasts for a few hours. They're ideal for occasional stomach acid symptoms.
Some antacids, such as Gaviscon, have an extra ingredient called alginic acid. They work by making a lining so juices from your stomach do not splash up into your food pipe. They're especially good for relieving acid reflux.
Antacids are available from pharmacies and supermarkets.
Painkillers
It's safe to take painkillers such as paracetamol or ibuprofen at the same time as esomeprazole.
Talk to your GP or pharmacist 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.
Try to limit acidic foods such as tomatoes, citrus fruits, salad dressings and fizzy drinks.
Limit caffeinated drinks such as tea, coffee and cola, as well as alcohol and smoking.
If you have symptoms at night, try not to eat for at least 3 hours before you go to bed. Prop your head and shoulders up when you go to bed. This can stop stomach acid coming up while you sleep.
Alcohol and esomeprazole
Alcohol does not affect the way esomeprazole works. But it makes your stomach produce more acid than normal. This can irritate your stomach lining and make your symptoms worse.
Fact check
This content was fact checked by a pharmacist, a GP, and the National Medication Safety Programme (Safermeds).
