Nexium Side Effects
Generic Name: esomeprazole
Note: This page contains side effects data for the generic drug esomeprazole. It is possible that some of the dosage forms included below may not apply to the brand name Nexium.
It is possible that some side effects of Nexium may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.
For the Consumer
Applies to esomeprazole: oral capsule delayed release
As well as its needed effects, esomeprazole (the active ingredient contained in Nexium) may cause unwanted side effects that require medical attention.
If any of the following side effects occur while taking esomeprazole, check with your doctor immediately:Rare
- Bloody, black, or tarry stools
- chest pain or chest tightness
- difficulty swallowing
- excess air or gas in the stomach
- fast heartbeat
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- pain or discomfort in the chest, upper stomach, or throat
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- shortness of breath
- skin rash, hives, or itching
- unusual tiredness or weakness
- vomiting of blood or material that looks like coffee grounds
- Blistering, peeling, or loosening of the skin
- dark-colored urine
- high fever
- joint or muscle pain
- light-colored stools
- loss of appetite
- mood or mental changes
- muscle spasms (tetany) or twitching
- nausea or vomiting
- sore throat
- unexplained bleeding or bruising
- watery and severe diarrhea, which may also be bloody
- yellow eyes or skin
Some esomeprazole side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:More common
- Difficulty having a bowel movement (stool)
- dry mouth
- passing gas
- Back pain
- change in taste
- changes in vision
- continuing ringing or buzzing or other unexplained noise in the ears
- fast, pounding, or irregular heartbeat or pulse
- hearing loss
- slow heartbeat
- Hair loss or thinning of the hair
- swelling of the breasts or breast soreness in both females and males
For Healthcare Professionals
Applies to esomeprazole: intravenous powder for injection, oral delayed release capsule, oral powder for reconstitution delayed release
Gastrointestinal (GI) side effects have included bowel irregularity, aggravated constipation, dyspepsia, dysphagia, dysplasia, epigastric pain, eructation, esophageal disorder, frequent stools, gastroenteritis, GI hemorrhage, rectal disorder, increased appetite, anorexia, ulcerative stomatitis, and vomiting. Pancreatitis has also been reported. Postmarketing reports of microscopic colitis, GI candidiasis, and clostridium difficile associated diarrhea have been received.
Nervous system side effects have included confusion, dizziness, hypoesthesia, insomnia, migraine aggravation, paresthesia, sleep disorder, somnolence, tremor, vertigo, and seizures.
Cardiovascular side effects have included hypertension, angioedema, tachycardia, chest pain, irregular heartbeat, and substernal chest pain.
Musculoskeletal side effects have included muscle spasm (tetany), arthralgia, aggravation of arthritis, arthropathy, cramps, fibromyalgia syndrome, hernia, hypertonia, polymyalgia rheumatica, and back pain. Muscle weakness, myalgia and bone fracture have also been reported postmarketing.
An increased risk of hip fracture has been reported in a cohort study. The risk was significantly increased among patients prescribed long-term high PPIs.
Hematologic side effects have included anemia, hypochromic anemia, cervical lymphadenopathy, epistaxis, leukocytosis, leukopenia, and thrombocytopenia. Agranulocytosis and pancytopenia have also been reported.
Hepatic side effects have included bilirubinemia, abnormal hepatic function, and increase in SGOT and SGPT. Hepatic failure, hepatic encephalopathy and hepatitis, with or without jaundice, have also been reported postmarketing.
Metabolic side effects have included glycosuria, hyperuricemia, hyponatremia, increased alkaline phosphatase, excessive thirst, vitamin B12 deficiency, and weight increase/decrease. FDA warns that prescription proton pump inhibitor (PPI) drugs may cause low serum magnesium levels (hypomagnesemia) if taken for prolonged periods of time (in most cases, longer than one year).
FDA warns that prescription proton pump inhibitor (PPI) drugs may cause low serum magnesium levels (hypomagnesemia) if taken for prolonged periods of time (in most cases, longer than one year). Patients who develop hypomagnesemia may experience seizures, dizziness, abnormal or fast heart beat, or skipped heartbeat, jitteriness, jerking movements or tremors, muscle weakness, spasms of the hands and feet, cramps or muscle aches, and spasm of the voice box.
Genitourinary side effects have included abnormal urine, albuminuria, cystitis, dysuria, hematuria, micturition frequency, moniliasis, genital moniliasis, impotence, dysmenorrhea, menstrual disorder, vaginitis, and polyuria.
A 42-year-old female with previously normal sexual function experienced loss of libido during esomeprazole (the active ingredient contained in Nexium) therapy. She had been prescribed 40 mg esomeprazole twice daily for one month for symptoms of acid reflux disease. Over a 10 week period, she experienced a decline in sexual function until she could no longer respond sexually. After discontinuation of esomeprazole, her symptoms improved but did not return to what she considered normal.
Psychiatric side effects have included apathy, confusion, aggravated depression, and nervousness. At least one case of loss of libido has been reported. Postmarketing side effects of aggression, agitation and hallucinations have been reported.
Respiratory side effects have included aggravated asthma, coughing, dyspnea, larynx edema, pharyngitis, rhinitis, and sinusitis. Postmarketing side effects of bronchospasm have been reported.
General side effects including hot flushes, fatigue, fever, flu-like disorder, leg edema, malaise, pain, earache, tinnitus, otitis, parosmia, taste loss, taste perversion, and enlarged abdomen have been reported.
Ocular side effects have included abnormal vision, conjunctivitis, and visual field defect. Blurred vision has also been reported.
Dermatologic side effects have included acne, dermatitis, pruritus, erythematous rash, maculopapular rash, skin inflammation, and increased sweating. Alopecia and erythema multiforme have also been reported. Duodenitis, esophagitis, esophageal stricture, esophageal ulceration, esophageal varices, gastric ulcer, gastritis, hernia, benign polyps or nodules, Barrett's esophagus, and mucosal discoloration have also been reported. Postmarketing side effects of gynecomastia, hyperhidrosis, photosensitivity, Stevens-Johnson syndrome and toxic epidermal necrolysis (some fatal) have been reported.
Endocrine side effects have included goiter.
Hypersensitivity side effects have rarely included allergic reactions (less than 1%). Toxic epidermal necrolysis (some cases fatal) and Stevens-Johnson syndrome have also been reported.
Immunologic side effects have included anaphylactic reaction or shock.
A 63-year-old female with dyspepsia experienced acute interstitial nephritis coincident with esomeprazole (the active ingredient contained in Nexium) therapy. She presented to the hospital with a 1-month history of nausea and intermittent vomiting. Three weeks before presentation, she was empirically prescribed esomeprazole for the treatment of dyspepsia. A week before presentation, she stopped taking this drug, as she suspected it was exacerbating the malaise, nauseas, and vomiting. On day 4 of admission, a renal biopsy showed acute interstitial nephritis. Prednisolone therapy was continued for 4 weeks. Supportive dialysis was needed for 4 days, by which time renal function had improved. However, at follow-up 8 months later, serum creatinine levels remained abnormal.
Renal side effects including at least two cases of interstitial nephritis have been reported.
More about Nexium (esomeprazole)
- Nexium delayed-release capsules
- Nexium suspension
- Nexium (Advanced Reading)
- Nexium Oral (Advanced Reading)
Related treatment guides
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