The Nexium manufacturer's FDA prescribing sheet simply states to take Nexium "1 hour before a meal". I called AstraZeneca and customer service reiterated this statement. This is essentially what is reprinted at rxlist.com.
However, at this site and many others, there is an additional instruction, i.e., "with a glass of water" or even "with at least 8 oz of water". While I can speculate why this may have been added (to speed dissolving of the capsule and movement of the granules to the intestine), that is still just speculation. I have found that drinking water in the morning with the Nexium actually triggers reflux of acid produced during the night.
Has anyone by chance looked into this, received explicit instructions from a doctor to use water, been given an explanation for why water has been added to the instructions at sources such as drugs.com, etc.?