Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.
Esomeprazole, Oral Capsule (Magnesium)
Magnesium vs. strontium vs. sodium
There are three types of esomeprazole: esomeprazole magnesium, esomeprazole strontium, and esomeprazole sodium. (This article is about esomeprazole magnesium.) They’re all esomeprazole, but they contain different salt forms. The different salt forms enable esomeprazole to be used to treat gastrointestinal issues in a range of people with different health needs.
Esomeprazole is a prescription drug. Some forms are also available over the counter, but this article covers the prescription version only.
Esomeprazole magnesium and esomeprazole strontium come as delayed-release capsules. Esomeprazole magnesium also comes as a liquid suspension. Esomeprazole sodium comes in an intravenous (IV) form, which is only given by a healthcare provider.
Esomeprazole magnesium is available as the brand-name drug Nexium and as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in every strength or form as the brand-name drug.
Esomeprazole magnesium may be used as part of a combination therapy. This means you may need to take it with other medications, especially to treat H. pylori.
Why it’s used
Esomeprazole magnesium is used to treat conditions caused by too much acid production in your stomach. These conditions include the following:
- Heartburn caused by gastroesophageal reflux disease (GERD) and erosive esophagitis. Erosive esophagitis is caused by acid-related damage to the esophagus.
- Zollinger-Ellison syndrome. This rare condition is characterized by the formation of tumors in the digestive tract.
- H. pylori infections when used in combination with other treatments, such as antibiotics. This infection causes ulcers in part of your intestine.
This drug is also used to prevent stomach ulcers due to the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
How it works
Esomeprazole magnesium belongs to a class of drugs called proton pump inhibitors. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.
Esomeprazole decreases the amount of acid your stomach produces. It works by blocking the proton pump in the stomach’s cells. When the proton pump is blocked, your stomach makes less acid.
Esomeprazole magnesium oral capsule doesn’t cause drowsiness, but it can cause other side effects.
More common side effects
The adult side effects for esomeprazole magnesium are slightly different from the side effects for children.
Adult side effects can include:
- headache
- diarrhea
- nausea
- flatulence (passing gas)
- stomach pain
- constipation
- dry mouth
Children’s side effects can include the above, plus:
- regurgitation (burping up food) in babies
- increased breathing rate in babies
If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.
Serious side effects
Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
- Severe diarrhea. Symptoms can include:
- watery stool
- stomach pain
- fever that doesn’t go away
- stomach pain
- nausea
- vomiting
- weight loss
- seizures
- dizziness
- abnormal or fast heart rate
- jitteriness
- tremors (jerking movements or shaking)
- muscle weakness
- spasms in your hands and feet
- cramps or muscle aches
- spasm of your voice box
- nervousness
- neuritis (inflammation of a nerve). symptoms can include:
- nerve pain
- tingling
- trouble breathing or swallowing
- shortness of breath
- angioedema (swelling of your face, throat, or tongue)
- itching
- symptoms of kidney damage, such as:
- decreased urination
- flank pain (pain in your side and back)
- nausea and vomiting
- diarrhea
- low blood pressure, which can cause dizziness and fainting
- decreased urination
- flank pain (pain in your side and back)
- rash on the skin and nose
- raised, red, scaly, red or purple rash on your body
- fever
- tiredness
- weight loss
- blood clots
- heartburn
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
Esomeprazole magnesium oral capsule can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.
To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.
Examples of drugs that can cause interactions with esomeprazole magnesium are listed below.
Drugs you should not use with esomeprazole
Do not take these drugs with esomeprazole. Doing so can cause dangerous effects in your body. Examples of these drugs include:
- Clopidogrel. Esomeprazole can block clopidogrel from working in your body. If you need to take esomeprazole, your doctor may consider a different antiplatelet drug.
- Side effects from other drugs: Taking esomeprazole magnesium with certain medications raises your risk of side effects from these drugs. Examples of these drugs include:
- Diazepam. Esomeprazole magnesium can cause diazepam to build up in your body. This can cause more side effects from diazepam.
- Warfarin. Esomeprazole magnesium can increase the blood-thinning effect of warfarin. This can increase your international normalized ratio (INR) test results and prothrombin time. This interaction can increase bleeding and be fatal (cause death). If you need to take these drugs together, your doctor will watch you closely and may adjust your warfarin dosage.
- Cilostazol. Esomeprazole magnesium can slow the breakdown of this drug. This can increase the levels of cilostazol in your body. If you need to take these drugs together, your doctor will decrease your dosage of cilostazol.
- Digoxin. Esomeprazole magnesium can increase the levels of digoxin in your body. Your doctor may check your digoxin blood levels and adjust your digoxin dosage if needed.
- Methotrexate. Esomeprazole magnesium can increase the levels of methotrexate in your body. This may cause dangerous side effects. These side effects can include nausea, vomiting, headache, fatigue, and liver and kidney damage. If you need to take a high dose of methotrexate, your doctor may have you stop taking esomeprazole for a short time.
- Saquinavir. Esomeprazole magnesium may increase the levels of saquinavir in your body. This may cause more side effects from saquinavir. These may include fatigue, confusion, stomach and back pain, nausea, vomiting, and liver damage. Your doctor may watch you more closely and decrease your dosage of saquinavir if needed.
- Tacrolimus. Esomeprazole magnesium can increase the levels of tacrolimus in your body. This may cause high blood pressure and kidney damage. Your doctor may check your tacrolimus levels and adjust your dosage if needed.
- Voriconazole. Voriconazole can double the levels of esomeprazole magnesium in your body. Your doctor may decrease your dose of esomeprazole. They may be more likely to lower your dosage if you have Zollinger-Ellison’s syndrome and take a high dosage.
- Clarithromycin.
- Certain antiretrovirals, such as atazanavir and nelfinavir. Esomeprazole magnesium may keep you from absorbing these drugs well. This means that they won’t work to treat your virus. You shouldn’t take esomeprazole with these drugs.
- Mycophenolate mofetil. Esomeprazole magnesium may change the balance of your stomach acid. This may decrease how well you absorb mycophenolate mofetil. It isn’t known how this will affect your transplant. Ask your doctor whether it’s safe for you to use these drugs together.
- St. John’s wort. You shouldn’t use these drugs together.
- Rifampin. You shouldn’t use these drugs together.
Interactions that increase your risk of side effects
Interactions that can make your drugs less effective
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
This drug comes with several warnings.
Allergy warning
Esomeprazole magnesium can cause a severe allergic reaction. Symptoms can include:
- trouble breathing or swallowing
- shortness of breath
- swelling of your face, throat, or tongue
- itching
- kidney damage, with symptoms such as:
- decreased urination
- flank pain (pain in your side and back)
If you develop these symptoms, call 911 or go to the nearest emergency room.
Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).
Food interactions warning
Taking this drug with food can decrease the amount of esomeprazole magnesium in your body. You should take this drug at least one hour before meals.
Warnings for people with certain health conditions
For people with severe liver problems: This drug is processed by your liver. If you have severe liver disease, your body may not be able to process this drug as well. This could cause the drug to build up in your body and cause more side effects.
For people with low magnesium blood levels: Taking this drug for three months or longer can decrease magnesium levels in your blood. This can further decrease your low magnesium levels. Your doctor may give you magnesium supplements and monitor your magnesium levels.
For people with a vitamin B-12 deficiency: Taking this drug for two to three years can decrease vitamin B-12 levels in your blood. This can further decrease your low vitamin B-12 levels. Your doctor may give you vitamin B-12 injections and monitor your vitamin B-12 levels.
For people with osteoporosis: Using this drug every day for a long time can increase your risk of hip, wrist, or spine fractures.
For people with plans to have neuroendocrine tumor test: This drug can change the balance of your stomach acid. This may cause a test for neuroendocrine tumors to be positive when there isn’t a tumor.
Warnings for other groups
For pregnant women: There haven’t been enough studies done in humans to be certain how esomeprazole magnesium might affect a fetus.
Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk.
For women who are breastfeeding: Esomeprazole magnesium may pass into breast milk and may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.
For children: Esomeprazole magnesium hasn’t been studied in children younger than one month.
When to call the doctor
Let your doctor know if you start taking any other drug. Your doctor will check to make sure your new drug will work with esomeprazole magnesium. Also tell your doctor if you still have symptoms of increased stomach acid even though you’re taking this drug.
Esomeprazole
Generic name: esomeprazole (oral) [ ee-so-MEP-ra-zol ]
Brand names: Esomeprazole Strontium, NexIUM
Dosage forms: oral delayed release capsule (20 mg; 40 mg; 49.3 mg), oral delayed release tablet (20 mg), oral powder for reconstitution, delayed release (10 mg; 2.5 mg; 20 mg; 40 mg; 5 mg)
Drug class: Proton pump inhibitorsMedically reviewed by Drugs.com on Dec 26, 2022. Written by Cerner Multum.
What is esomeprazole?
Esomeprazole is used to treat symptoms of gastroesophageal reflux disease (GERD) and other conditions involving excessive stomach acid such as Zollinger-Ellison syndrome. Esomeprazole is also used to promote healing of erosive esophagitis (damage to your esophagus caused by stomach acid).
Esomeprazole may also be given to prevent gastric ulcer caused by infection with Helicobacter pylori (H. pylori), or by the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
Esomeprazole is not for immediate relief of heartburn symptoms.
Esomeprazole may also be used for purposes not listed in this medication guide.
Warnings
Esomeprazole can cause kidney problems. Tell your doctor if you are urinating less than usual, or if you have blood in your urine.
Diarrhea may be a sign of a new infection. Call your doctor if you have diarrhea that is watery or has blood in it.
Esomeprazole may cause new or worsening symptoms of lupus. Tell your doctor if you have joint pain and a skin rash on your cheeks or arms that worsens in sunlight.
You may be more likely to have a broken bone while taking esomeprazole long term or more than once per day.
Related/similar drugs
Before taking this medicine
Heartburn can mimic early symptoms of a heart attack. Get emergency medical help if you have chest pain that spreads to your jaw or shoulder and you feel anxious or light-headed.
You should not use this medicine if:
- you had breathing problems, kidney problems, or a severe allergic reaction after taking esomeprazole in the past; or
- you are allergic to esomeprazole or to similar medicines such as lansoprazole, omeprazole, pantoprazole, rabeprazole, Dexilant, Nexium, Prevacid, Protonix, and others.
Tell your doctor if you have ever had:
- severe liver disease;
- lupus;
- osteoporosis or low bone mineral density (osteopenia); or
- low levels of magnesium in your blood.
You may be more likely to have a broken bone in your hip, wrist, or spine while taking a proton pump inhibitor long-term or more than once per day. Talk with your doctor about ways to keep your bones healthy.
Ask a doctor before using this medicine if you are pregnant or breastfeeding.
How should I take esomeprazole?
Use exactly as directed on the label, or as prescribed by your doctor.
Take each dose with a full glass (8 ounces) of water.
Esomeprazole should be taken at least one hour before a meal.
Swallow the pill whole and do not crush, chew, break, or open it.
If you cannot swallow a capsule whole, open it and sprinkle the medicine into a spoonful of pudding or applesauce. Swallow the mixture right away without chewing. Do not save it for later use.
The esomeprazole capsule can be given through a nasogastric (NG) feeding tube. Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.
Esomeprazole is usually given for 4 to 8 weeks only. Your doctor may recommend a second course of treatment if you need additional healing time.
Use esomeprazole for the full prescribed length of time, even if your symptoms quickly improve.
Call your doctor if your symptoms do not improve or if they get worse while you are taking this medicine.
This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using esomeprazole.
Some conditions are treated with a combination of esomeprazole and antibiotics. Use all medications as directed.
Store at room temperature away from moisture and heat.
What happens if I miss a dose?
Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking esomeprazole?
esomeprazole can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor before using anti-diarrhea medicine.
Esomeprazole side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Esomeprazole may cause serious side effects. Call your doctor at once if you have:
- severe stomach pain, diarrhea that is watery or bloody;
- seizure (convulsions);
- kidney problems– fever, rash, nausea, loss of appetite, joint pain, urinating less than usual, blood in your urine, weight gain;
- low magnesium–dizziness, fast or irregular heart rate, tremors (shaking) or jerking muscle movements, feeling jittery, muscle cramps, muscle spasms in your hands and feet, cough or choking feeling; or
- new or worsening symptoms of lupus–joint pain, and a skin rash on your cheeks or arms that worsens in sunlight.
Taking esomeprazole long-term may cause you to develop stomach growths called fundic gland polyps. Talk with your doctor about this risk.
If you use esomeprazole for longer than 3 years, you could develop a vitamin B-12 deficiency. Talk to your doctor about how to manage this condition if you develop it.
Common side effects of esomeprazole may include:
- headache;
- diarrhea;
- nausea, stomach pain, gas, constipation; or
- dry mouth.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect esomeprazole?
Tell your doctor about all your current medicines. Many drugs can affect esomeprazole, especially:
- cilostazol;
- clopidogrel;
- diazepam;
- digoxin;
- erlotinib;
- iron-containing medicines (ferrous fumarate, ferrous gluconate, ferrous sulfate, and others);
- methotrexate;
- mycophenolate mofetil;
- rifampin;
- St. John’s wort;
- tacrolimus;
- warfarin (Coumadin, Jantoven);
- antifungal medication–ketoconazole, voriconazole; or
- HIV/AIDS medication–atazanavir, nelfinavir, saquinavir.
This list is not complete and many other drugs may affect esomeprazole. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
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