Esomeprazole at a glance
Medicine class
Proton pump inhibitor (PPI).
Main effect
Reduces acid made by the stomach.
Available forms
Gastro-resistant tablets, capsules and granules for oral suspension.
Not immediate relief
Improvement may take several days. Seek advice if symptoms worsen or persist with a non-prescription product.
What is Esomeprazole used for?
Licensed uses vary by product, formulation and age. Selected UK products cover:
Reflux symptoms and gastro-oesophageal reflux disease, including erosive oesophagitis and prevention of relapse after healing.
Non-prescription treatment of heartburn and acid regurgitation in adults.
Helicobacter pylori eradication therapy and management of associated duodenal ulcers.
Healing and prevention of ulcers associated with continued NSAID treatment in adults at risk.
Continued acid suppression after intravenous treatment to prevent recurrent peptic-ulcer bleeding.
Zollinger–Ellison syndrome in adults.
Prescription treatment of reflux disease in children covered by the granule licence; granules are also licensed as part of H. pylori treatment in eligible children.
How does Esomeprazole work?
Esomeprazole becomes active in the acidic channels of stomach parietal cells. It blocks the H+/K+-ATPase proton pump, reducing background and meal-stimulated acid secretion. Gastro-resistant coatings protect it from destruction before absorption.
Esomeprazole preparations and strengths
Gastro-resistant capsule
Route: Oral
Strengths: 20 mg
Gastro-resistant tablet
Route: Oral
Strengths: 20 mg, 40 mg
Oral suspension
Route: Oral
Strengths: 10 mg
How to take Esomeprazole
Follow the instructions for the specific product because formulations differ in preparation.
Swallow gastro-resistant tablets whole with liquid; do not chew or crush them.
Selected tablets may be dispersed in still water. Drink promptly, rinse the glass with water and swallow the rinse; do not chew the pellets.
Swallow the selected Nexium Control capsule whole with water. Do not chew, crush or open it.
Mix sachet granules only with the stated amount of still water, allow the mixture to thicken and stir again. Do not chew or crush the granules.
Esomeprazole can generally be taken with or without food, although food can delay absorption.
Esomeprazole side effects
Common or expected effects
- Headache
- Abdominal pain
- Diarrhoea or constipation
- Feeling or being sick
- Flatulence
Get urgent medical advice
- Sudden swelling, breathing difficulty or collapse suggesting anaphylaxis
- Blistering, peeling or widespread rash, particularly with fever or mouth sores
- Yellow skin or eyes, dark urine or pale stools suggesting liver injury
- Severe or persistent diarrhoea
- Joint pain with a red rash on sun-exposed skin
- Marked weakness, confusion, muscle twitching, seizures or an irregular heartbeat, which can occur with low magnesium
Esomeprazole in pregnancy
Evidence for esomeprazole is more limited than for omeprazole. Available PPI data do not show good evidence of increased miscarriage, congenital anomaly, stillbirth, preterm birth or low birth weight, but omeprazole is usually preferred because more safety information is available. Ask a prescriber before starting, stopping or changing treatment.
Esomeprazole while breastfeeding
Limited evidence suggests that only very small amounts enter breast milk. Cautious use is permitted for a full-term, healthy infant, although omeprazole or pantoprazole are preferred. Seek advice if the infant develops feeding difficulty, vomiting, diarrhoea, constipation, irritability, poor sleep or a rash.
Esomeprazole interactions
Check all prescribed, pharmacy and herbal medicines. Important examples include:
Nelfinavir; oral rilpivirine
Selected product information contraindicates these combinations because acid suppression can substantially reduce antiretroviral exposure.
Atazanavir or saquinavir
Esomeprazole can alter concentrations; combined use is generally not recommended or requires specialist management.
Clopidogrel
Esomeprazole can reduce formation of active clopidogrel, so combined use should be avoided where possible.
Common questions about Esomeprazole
Answers are fully visible for fast scanning and source review.
What does “esomeprazole magnesium trihydrate” mean?
It is the magnesium salt used to deliver esomeprazole. Esomeprazole produces the acid-suppressing effect.
Is Nexium the same medicine as esomeprazole?
Nexium is a brand name for products containing esomeprazole, including products formulated as esomeprazole magnesium trihydrate.
Can esomeprazole be taken with food?
Yes. It can generally be taken with or without food, although food can delay and reduce absorption without significantly changing stomach-acid control.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.