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What is esomeprazole?

Esomeprazole is a medicine used to treat acid reflux, heartburn and gastroesophageal reflux disease (GORD). It's a type of medicine known as a proton pump inhibitor.

How does esomeprazole work?

Esomeprazole works by decreasing the amount of acid in your stomach to relieve symptoms like heartburn, a persistent cough and having difficulty swallowing. Esomeprazole blocks proton pumps that line the stomach wall that normally produces acid. This reduces acid reflux and allows stomach ulcers to heal.

How long does esomeprazole take to work?

Esomeprazole starts working within one to two hours of taking it.You will notice reduced symptoms after two to three days. It can take a few days or weeks to help solve your health problem, depending on what you are being treated for.

Is esomeprazole safe for long term use?

Taking esomeprazole for a long time can increase your risk of experiencing side effects. After three months this can include:

• Tiredness
• Dizziness
• Confusion
• Muscle twitches
• Shaking
• Irregular heartbeat

Potential side effects after one year of taking esomeprazole include:

• Bone fractures
• Infections of the gut
• Vitamin B12 deficiency

You should see your doctor on a regular basis if you have taken esomeprazole for longer than a year.

Esomeprazole summary

Active ingredients

The active ingredient in esomeprazole tablets is esomeprazole magnesium dihydrate.

Inactive ingredients

The inactive ingredients in esomeprazole tablets are methacrylic acid-ethyl acrylate copolymer (1:1), talc, triethyl citrate, hypromellose, sugar spheres, magnesium stearate, hydroxypropyl cellulose, glycerol monostearate 40-55, polysorbate 80, microcrystalline cellulose, povidone, macrogol 6000, crospovidone, sodium stearyl fumarate.

Please Note: Different generic brands of esomeprazole could contain different active or inactive ingredients than those stated above. Please refer to the patient information leaflet provided.

How to take esomeprazole

Always take esomeprazole as your doctor or pharmacist has prescribed. The instructions may vary depending on why you are taking it and the severity of your symptoms. Esomeprazole is usually taken once a day without food. An esomeprazole tablet should be swallowed whole with a glass of water or it can be dissolved in water if you are unable to swallow tablets.

Esomeprazole dosage

The dose of esomeprazole prescribed by your doctor will depend on what you are being treated for. Here are some typical dose regimens:

• If you have heartburn and damage to your oesophagus (food pipe) the dose will be 40 mg once daily for four weeks, reducing to 20 mg a day.
• If you have heartburn with no oesophagus damage, the standard dose is 20 mg per day.
• If you have a stomach ulcer caused by the Helicobacter pylori bacteria the dose is 20 mg twice daily in combination with antibiotics.
• If you have a stomach ulcer caused by anti-inflammatory medicines the dose will be 20 mg once a day for four to eight weeks.

Can you dissolve esomeprazole in water?

You can dissolve an esomeprazole tablet in water if you have difficulty swallowing tablets. Do not crush or cut esomeprazole tablets, even if you want to dissolve them. Instead, place a tablet in half a glass of water and stir it gently until it dissolves, then drink the mixture straight away.

How long should I take esomeprazole for?

How long you should take esomeprazole will depend on why you are taking it. For example, if you have heartburn or acid reflux you might take esomeprazole for one to two weeks. To treat a stomach ulcer, you may need to take esomeprazole for up to eight weeks. After your initial symptoms or infection have been treated, you can then use esomeprazole as needed when you experience heartburn or acid reflux symptoms.

What should I do if I forget to take esomeprazole?

If you forget to take an esomeprazole tablet, take it as soon as you can. You should not take a missed dose at the same time as your next dose, and ideally, they should be a few hours apart. If you are unsure what to do, ask your doctor or pharmacist for advice if you miss a dose of esomeprazole.

What should I do if I take too much esomeprazole?

Taking an extra dose of esomeprazole is unlikely to harm you. However, if you experience any of the following symptoms, let your doctor know:

• Sweating
• Fast heartbeat
• Sleepiness
• Confusion or agitation
• Blurred vision

What food or drink should I avoid while taking esomeprazole?

You should only drink water with esomeprazole. Avoid having food at the same time as esomeprazole, especially foods which are known to trigger acid reflux. These include spicy, oily and fatty foods, chocolate, coffee, tea, alcohol and fizzy drinks. Smoking can also trigger acid reflux.

How do I come off esomeprazole?

In most cases, you can stop taking esomeprazole without any problems. If you have been taking esomeprazole for a long time, talk to your doctor before you stop taking it. They may advise you to reduce the dose over time to prevent your stomach from producing excess acid.

Esomeprazole side effects

Common side effects of esomeprazole include:

• Headaches
• Diarrhoea
• Stomach pain
• Flatulence
• Constipation
• Nausea
• Vomiting
• Benign polyps in the stomach

Less common side effects of esomeprazole may include:

• Swollen ankles or feet
• Insomnia
• Dizziness
• Pins and needles
• Sleepiness
• Vertigo
• Dry mouth
• Changes in blood tests that determine liver function
• Rash
• Hives
• Itchy skin
• Hip, wrist or spine fractures after long term use of high doses

Rare side effects of esomeprazole can include:

• A reduced number of white blood cells
• A reduced level of sodium in the blood
• Agitation or confusion
• Depression
• Altered taste
• Blurred vision
• Wheezing and feeling short of breath
• Mouth inflammation
• Thrush of the gut
• Hair loss
• Skin sensitivity to sunlight
• Muscle or joint pain
• Increased sweating
• Feeling generally unwell and lacking in energy

The following side effects are signs of a serious allergic reaction to esomeprazole which requires immediate emergency medical assistance:

• Sudden wheezing
• Swollen lips, tongue or throat
• Rash
• Fainting
• Having difficulty swallowing
• Jaundice

How to cope with esomeprazole side effects

Ensure you are drinking plenty of water while taking esomeprazole to avoid headaches or dehydration from diarrhoea. Some painkillers are suitable to take alongside esomeprazole if needed. If you experience nausea or vomiting, avoid eating anything spicy, fatty or oily. Eating high fibre foods daily can help relieve constipation. Avoiding lentils, beans, onions and overeating should ease stomach pain and wind.

Contraindications

Esomeprazole should not be taken if:

• You are allergic to any other proton pump inhibitors
• You are taking any medicines which contain Nelfinavir
• You are a child under 12 years old

Consult a doctor before using esomeprazole if:

• You have severe liver problems
• You have severe kidney problems
• You have ever experienced a skin reaction with similar medicines that treat excess stomach acid
• You are scheduled to have a blood test

If you experience any of the following symptoms while you are taking esomeprazole report this to a doctor right away:

• Sudden, unexplained weight loss
• Problems swallowing
• Stomach pain or indigestion
• Vomiting or vomiting blood
• Passing black stools

This could indicate other conditions or illnesses which are being masked by esomeprazole.

Drug interactions

Always let your doctor or pharmacist know about other medicines you are taking or planning to take. This includes herbal remedies and over the counter treatments.
esomeprazole is not suitable for individuals taking medicines that contain Nelfinavir to treat HIV.

If you are taking any of the following medicines, let your doctor know before taking esomeprazole:

• Atazanavir
• Saquinavir
• Clopidogrel
• Ketoconazole
• Itraconazole
• Voriconazole
• Erlotinib
• Citalopram
• Imipramine
• Clomipramine
• Diazepam
• Phenytoin
• Blood thinners
• Cilostazol
• Cisapride
• Digoxin
• Methotrexate
• Tacrolimus
• Rifampicin

Esomeprazole and pregnancy

If you are pregnant or planning a baby, then speak to your doctor before taking esomeprazole to make sure it is safe for you. Do not take esomeprazole while breastfeeding as it is not known if it passes into breast milk

Esomeprazole and alcohol

Drinking alcohol will not affect how esomeprazole works. However, you should not drink alcohol during treatment as it can trigger acid reflux and further irritate the lining of your stomach.

Can I drive while taking esomeprazole?

It's unlikely that esomeprazole will affect your ability to drive. However, if you experience dizziness or blurred vision after taking esomeprazole, then do not drive or operate heavy machinery.

Alternatives to esomeprazole

Alternatives to esomeprazole include lansoprazole, omeprazole, pantoprazole and rabeprazole. These are all proton pump inhibitors and work in the same way as esomeprazole.

Can I take esomeprazole with antacids?

Yes, you can take antacids such as Gaviscon or Rennies alongside esomeprazole. However, you must leave at least a two hour gap between taking each medicine.

Can I take esomeprazole with painkillers?

It is safe to take some painkillers alongside esomeprazole. Check with your doctor or pharmacist for the best way to take your painkillers whilst using esomeprazole.

Can esomeprazole cause stomach cancer?

Advice from the NHS states that the risk is very small. Conclusions drawn from clinical studies suggest that taking esomeprazole does not increase your chances of developing cancer.

Can you get esomeprazole over the counter?

A brand of esomeprazole, called Nexium, is available in small quantities over the counter at pharmacies. It is available as 20 mg tablets or capsules. Speak to a pharmacist about your symptoms, before you purchase Nexium over the counter, to make sure it’s suitable for you.