Nexium (Esomeprazole)

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Nexium (Esomeprazole) Medication Information

Uses

Nexium (esomeprazole) belongs to a group of drugs known as proton pump inhibitors (PPIs).  PPIs work by reducing the amount of acid in your stomach.  

Excess stomach acid can damage the stomach lining or esophagus, causing a burning sensation known as heartburn.  Nexium is prescribed to adults, children, and infants for many conditions related to stomach acid.  A few examples include:

• Acid reflux (aka gastroesophageal reflux disease or GERD)
• Heal or prevent ulcers of the stomach or esophagus
• H. Pylori stomach infection, along with antibiotics

Dosage

Nexium (esomeprazole) comes in several dosage forms and strengths:*

• Capsule: 20 mg and 40 mg
• Packets for oral suspension: 2.5 mg, 5 mg, 10 mg, 20 mg, and 40 mg

Take Nexium exactly as prescribed by your doctor, at least 1 hour before a meal.  

Instructions for using Nexium packets are available online and in the product packaging.

*Nexium is also available in an injectable (intravenous) form that is primarily used in hospitals. The information in this article pertains to the oral dosage forms of Nexium (capsule and suspension).   

Precautions

Nexium may not be safe for people with the following medical history or conditions:

• Kidney problems including acute interstitial nephritis
• Problems with diarrhea
• Bone fractures
• Specific forms of Lupus erythematosus (an autoimmune disorder)
• Low magnesium levels in your blood
• Liver problems
• Pregnant or plan to become pregnant
• Breastfeeding
• Allergic reaction to the ingredients of Nexium (esomeprazole) or any other PPI

Side Effects

Like all medications, Nexium may cause side effects.  The most common side effects of Nexium are mild, but severe side effects are also possible. 

Common side effects may include:

• Headache
• Diarrhea
• Stomach pain
• Dry mouth

Serious allergic reactions can rarely occur with Nexium and require emergency medical care.  Signs of a severe allergic reaction may include:

• Itchy or red rash
• Face swelling
• Trouble breathing
• Throat tightness

Long-term Nexium use (over three months to over a year) may increase the risk of specific side effects:

• Low vitamin B-12 levels
• Low magnesium levels
• Bone fractures
• Stomach growths

Your doctor will prescribe Nexium if the benefits outweigh the risks of severe side effects.  Your doctor may recommend vitamin supplements while you’re taking Nexium.  For more information about the side effects of Nexium, talk with your doctor or pharmacist. 

Interactions

Some potential drug interactions might cause harmful effects with Nexium. A few examples include:

• Cilostazol
• Clopidogrel
• Diazepam
• Digoxin
• Iron
• Ketoconazole
• Methotrexate
• Rifampin
• St. John's Wort
• Warfarin
  

Talk with your doctor or pharmacist before taking any medications or herbal supplements with Nexium.

Storage

Store Nexium at room temperature between 68°F and 77°F (20°C and 25°C). 

Pharmacists Tips

• Take Nexium at least 1 hour before eating. Nexium won’t work if you eat food with it.  
• If you miss a dose, take it as soon as possible.  If it is almost time for your next dose, skip the missed dose.  Don’t take two doses of Nexium at the same time.

Nexium FAQs

If I have trouble swallowing pills, can I open Nexium capsules?

Yes.  You can open Nexium capsules and sprinkle the granules onto a tablespoonful of applesauce right before taking it.  Don’t chew or crush the granules or save it for later.  Then wait at least an hour to eat any other food.  You can drink water.

I’ve seen Nexium 24HR being sold over-the-counter.  Is there a difference between Nexium 24HR and prescription Nexium?

The over-the-counter Nexium 24HR contains the same active ingredient as prescription (Rx) Nexium (esomeprazole).  But, Nexium 24HR is a 20-mg capsule and is only approved for use in adults with frequent heartburn.  Rx Nexium is available in multiple strengths of capsules and packets, and it is approved for many acid-related conditions in adults, children, and infants.

Related Medication

• Dexilant
• Prevacid
• Prilosec
• Protonix

Citations

1. Nexium Prescribing Information.  Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2019. https://www.azpicentral.com/nexium/nexium.pdf  Accessed November 24, 2020.