Generic Name

esomeprazole(es oh MEP ra zohl)


Trade Name

Nexium(20mg., 40 mg.)
This drug is not available in a generic form.


What is esomeprazole?

This medicine belongs to a group of drugs called proton pump inhibitors (PPIs). The proton pump is the site within the stomach cell where hydrochloric acid is actually made and pumped out into the stomach. The PPIs block the formation of acid in the stomach from 80% to over 90% if enough of the drug is taken.


What is it used for?

The drug is used for almost any condition where stomach acid is causing a problem or tissue injury. These include peptic ulcers in the stomach and duodenum and especially gastroesophageal reflux disease where acid splashes back into the food pipe causing injury. Esomeprazole is also used along with antibiotics to cure or eradicate a stomach infection caused by Helicobacter pylori. These bacteria have been shown to cause peptic ulcers. Some physicians will use the drug for simple hyperacidity. An uncommon disease, called Zollinger-Ellison Syndrome, results in the production of huge amounts of stomach acid because of uncontrolled stimulation of the stomach by a hormone called gastrin. Severe ulcers can then occur.


How do I take it?

Follow your physician’s instructions carefully. Esomeprazole is usually taken once or twice a day 60 minutes before a meal. The capsule may be opened and the pellets mixed with cold applesauce and swallowed. Do not crush or chew the pellets. Keep all medications away from children. Never share your medications with anyone else.


What do I do for a missed dose?

If you miss a dose in the morning but remember in the afternoon, take it for that day. Otherwise, continue the next day as before and don’t double up. The drug is most effective if taken 60 minutes before eating.


Are there interactions with food or beverages?

There are no known interactions with esomeprazole and food or beverages. However, nicotine, caffeine (coffee, tea, chocolate, cola) and alcohol can stimulate stomach acid or delay ulcer healing. This drug is so potent that many of the previous recommendations about dietary and other precautions for ulcer healing are no longer as important as they once were. Still, listen to your physician’s recommendations.


Are there interactions with other drugs?

An interaction generally means that one drug may increase or decrease the effect of another drug. Also, the more medications a person takes, the more likely there will be a drug interaction. Always inform the physician of all drugs being taken. Interactions with this drug may occur with the following:

  • diazepam (Valium) or similar sedating drugs

Certain other drugs require the presence of stomach acid to be effective. Since esomeprazole eliminates stomach acid so effectively, the absorption of the following drugs may be adversely affected:

  • ampicillin (Polycillin, Omnipen)
  • digoxin (Lanoxin)
  • iron preparations
  • ketoconazole (Nizoral)

If you take any of the above medications, ask your physician. It is okay to take antacids.


Is there a problem if I have another disorder or disease?

At times, a drug may have a different or enhanced effect when other diseases are present. At other times, the drug may worsen or effect another disease. Check with your physician if you have severe liver or kidney disease. Esomeprazole is also used along with antibiotics to cure or eradicate a stomach infection caused by Helicobacter pylori. These bacteria have been shown to cause peptic ulcers. While esomeprazole does not act directly on these bacteria, it does help the antibiotics to be more effective. It is possible that the use of the drug long-term while this infection is present could seriously damage the stomach. There is a simple blood test available to see if you have ever been infected with this bacteria. Ask your physician.


What about allergies?

People who have known allergies or asthma may be at an increased risk for a reaction from any new medication. The physician should always know a patient’s allergy history. Signs of an allergic reaction are skin rash, hives or itching. Of course, a person should not take esomeprazole if there has been a previous reaction to this or any PPI drug (Prilosec, Prevacid, Aciphex, Protonix).


What if I’m pregnant, considering pregnancy or breast-feeding?

Most females now know that, if possible, no drug, including alcohol, should be taken during pregnancy or lactation. The potential danger, of course, is an injury to the baby. However, some drugs are much safer than others in this regard. So, the FDA has a grading system for each drug which reflects what is known medically. It ranks drugs from A, where medical studies show no evidence for danger to the fetus or mother, to B, C, D and X, where the medical evidence indicates that the risk to the fetus outweighs any benefit to the mother. Esomeprazole is ranked B. Always consult your physician before taking any drug during or when planning pregnancy.


What are the effects on sexual function?

There are no known adverse effects of esomeprazole on sexual function.


Are there other precautions?

Check with your physician if you have severe liver disease (cirrhosis). This and all medications should be stored in a tight container and away from children.


How long is it safe to take esomeprazole?

This drug is likely to be safe long-term. However, patients should stay in touch with their physicians.


How about side effects?

Adverse reactions can occur with any drug, even over-the-counter medications. Some of these are mild such as a stomach upset, which may be avoided by taking the medication with food. Minor reactions may go away on their own but if they persist, contact the physician. For major reactions, the patient should contact the physician immediately.

For esomeprazole, the following are the observed side effects:

Minor :

  • headache
  • abdominal pain
  • nausea
  • diarrhea
  • constipation
  • dry mouth

Major :

  • severe skin rash


A physician’s comment…

Esomeprazole and similar PPI drugs have revolutionized the treatment of acid disorders, especially reflux esophagitis and ulcers. Patients often say “It’s like a miracle” and “I can eat anything now”. Not only can ulcer and acid pain be readily controlled, but the ulcer heals quickly, especially if aspirin or arthritis medications are not taken, or if the Helicobacter pylori bacteria infection is cured. A major and certainly welcomed finding is that the drug appears to be safe long-term. However, we still do not have complete data on its safety over the long-term. Patients should stay in touch with their physician.