Reviewed by Virginia Chachati MPharm
(2013, University College London)
GPhC Registration number: 2087654
Information last reviewed 28/02/21
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.
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.
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.
Taking Esomeprazole for a long time can increase your risk of experiencing side effects. After three months this can include:
Potential side effects after one year of taking Esomeprazole include:
You should see your doctor on a regular basis if you have taken Esomeprazole for longer than a year.
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.
Heartburn is a temporary unpleasant burning sensation in the middle of the chest. It's usually caused by consuming certain types of food and drink, pregnancy, smoking and stress. However, acid reflux is an overproduction of stomach acid regardless of these scenarios. Other symptoms of acid reflux include:
Dose |
Either 1 capsule, twice per day, or 2 capsules, once per day, depending on required use |
Type of medicine |
Gastro-resistant capsule |
Mechanism |
Proton pump inhibitor (PPI) |
Available Size |
28 or 56 tablets |
Available Strengths |
20mg |
Active Ingredient |
Esomeprazole magnesium 20mg |
Price |
From 75p per tablet |
Side Effects |
Can include nausea, vomiting, headache, distrubed sleep, vertigo |
The active ingredient in Esomeprazole tablets is esomeprazole magnesium dihydrate.
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.
While a serious allergic reaction to this medication is rare, if you notice swelling of your throat, a rash/hives, severe dizziness, chest tightness or difficulty breathing you should seek immediate medical attention as this could mean you are having a serious allergic reaction to Esomeprazole. If you have previously taken Esomeprazole and experienced these symptoms, you should let your doctor know and should refrain from taking this medication again.
The dose of Esomeprazole prescribed by your doctor will depend on what you are being treated for. Here are some typical dose regimens:
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 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.
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.
Taking an extra dose of Esomeprazole is unlikely to harm you. However, if you experience any of the following symptoms, let your doctor know:
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.
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.
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.
Common side effects of Esomeprazole include:
Less common side effects of Esomeprazole may include:
Rare side effects of Esomeprazole can include:
The following side effects are signs of a serious allergic reaction to Esomeprazole which requires immediate emergency medical assistance:
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.
Esomeprazole should not be taken if:
Consult a doctor before using Esomeprazole if:
If you experience any of the following symptoms while you are taking Esomeprazole report this to a doctor right away:
This could indicate other conditions or illnesses which are being masked by Esomeprazole.
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:
Alternatives to Esomeprazole include Lansoprazole, Omeprazole, Pantoprazole and Rabeprazole. These are all proton pump inhibitors and work in the same way as Esomeprazole.
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.
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.
There are some lifestyle changes you can make to reduce acid reflux and heartburn. These include:
Avoid consuming foods which will trigger heartburn, eating large meals or eating too close to bedtime. Cut down on alcohol, quit smoking and try not to wear tight clothing which clings to your waist.
There are many reasons why you might be experiencing heartburn or acid reflux. Common causes include:
Foods which are known to trigger acid reflux or cause heartburn include:
There are some things you can do to reduce acid reflux and prevent symptoms from being triggered. You could try waiting for at least two to three hours, after eating your last meal, before you go to bed. If possible, eat smaller meals throughout the day rather than large meals. Avoid alcohol, smoking, caffeine and foods or drinks you know will trigger your heartburn or acid reflux. Take medicines like Esomeprazole or antacids to help manage your symptoms.
Esomeprazole stops acid reflux by blocking the production of acid in the stomach. You could try taking care not to overeat and avoiding spicy, fatty or oily foods. Avoid eating before bed to stop acid reflux affecting your sleep. Known acid reflux triggers such as smoking and drinking alcohol or caffeine should also be avoided.
Stress can trigger acid reflux. This is because your body produces “stress hormones”, such as cortisol and adrenaline, which can promote inflammation and stomach acid build up.
Drinking alcohol will not affect how Esomeperazole works. However, you should not drink alcohol during treatment as it can trigger acid reflux and further irritate the lining of your stomach.
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.
Esomeprazole is not known to have an effect on fertility in either men or women.
Esomeprazole is not known to have an impact on the effectiveness of hormonal or non-hormonal contraception. However, it may reduce the effectiveness of ellaOne which is an emergency contraceptive tablet.
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.
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
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