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Nexium Patient Tips

Medically reviewed on Oct 19, 2017 by C. Fookes, BPharm.

How it works

  • Nexium is a brand (trade) name of esomeprazole. Esomeprazole reduces the production of stomach acid by irreversibly blocking the actions of an enzyme responsible for acid production, called H+/K+ ATPase (also known as the gastric proton pump). The proton pump is located in the parietal cells of the stomach wall. Both baseline gastric acid secretion and stimulated gastric acid secretion are affected.
  • This allows damaged tissue in the esophagus, stomach, and duodenum to heal.
  • Nexium belongs to the class of medicines known as proton pump inhibitors (PPIs).

Upsides

  • Effective at healing erosive esophagitis (a severe inflammation of the lining of the esophagus- the tube that carries food from the mouth to the stomach), and relieving symptoms of gastro-esophageal reflux disease (also known as heartburn).
  • May be taken at the same time as NSAIDs to reduce the risk of NSAID-associated gastric ulcers in those people on continuous NSAID therapy.
  • May be used in conjunction with amoxicillin and clarithromycin in people with Helicobacter pylori infection and duodenal ulcer disease.
  • Usually given for 4 to 8 weeks only, although a second course may be given for those who need additional healing time. May be used long-term in people with certain conditions.
  • Useful in the treatment of hypersecretory conditions such as Zollinger-Ellison syndrome.
  • The dosage of Nexium does not need adjusting in people with kidney disease.
  • Nexium is available as a generic under the name esomeprazole.

Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • A headache, diarrhea or constipation, flatulence, nausea, abdominal pain, dry mouth or drowsiness are the most commonly reported side effects.
  • May also interfere with some laboratory tests.
  • In some people, Nexium may cause drowsiness and affect your ability to drive. Do not drive or operate machinery until you know how Nexium affects you.
  • A dosage of 20mg Nexium should not be exceeded in people with severe liver disease.
  • May not be suitable for everybody including those with significant liver disease, osteoporosis, osteopenia (low bone mineral density) or low levels of magnesium in their blood.
  • PPIs (including Nexium) have been associated with an increased risk of osteoporosis-related fractures of the hip, wrist, or spine. The risk is higher in those who take high dosages for prolonged periods of time or who are aged 50 and older.
  • Has also been associated with other conditions such as lupus erythematosus and magnesium deficiency.
  • Prolonged treatment (greater than 24-36 months) may cause vitamin B12 deficiency. The risk is greater in women, people aged less than 30, and with higher dosages.
  • Administration of PPIs (such as Nexium), has been associated with acute interstitial nephritis, a severe inflammation of the kidneys. May occur on medication initiation or at any point of therapy. Symptoms include fever, rash and generalized aches and pains. Discontinue Nexium and seek medical advice.
  • Has been associated with a greater risk of Clostridium difficile-associated diarrhea. See your doctor if you develop diarrhea that does not improve.
  • Nexium should not be given with clopidogrel because it can reduce the activity of clopidogrel. Nexium may also interact with several other medications particularly those that induce the CYP2C19 or CYP3A4 hepatic enzymes such as St. John's Wort or rifampin. Nexium can also reduce the absorption of drugs that are dependant on a certain gastric pH for their absorption.
  • Usually, only up to 8 weeks of treatment is recommended. Controlled studies have not investigated use beyond 6 months; however, Nexium has been used long-term for the treatment of hypersecretory conditions such as Zollinger-Ellison syndrome.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

Bottom Line

Nexium effectively heals inflamed tissue in the gastrointestinal tract and relieves symptoms of heartburn. Nexium is usually only taken short-term, as long-term use of proton pump inhibitors (such as Nexium) has been associated with a higher risk of fractures, kidney conditions, magnesium and vitamin B12 deficiency.

Tips

  • Take each dose at least one hour before food and with a full glass of water.
  • Do not crush or chew delayed-release capsules. Swallow whole or carefully open the capsule and sprinkle the contents onto pudding or a spoonful of applesauce. Swallow right away without chewing.
  • Take exactly as directed by your doctor. Talk to your doctor if your symptoms appear to be getting worse.
  • Heartburn often causes similar symptoms to those of a heart attack - seek emergency medical attention if you have chest pain or a heavy feeling in your chest, or pain that spreads up your neck or down your arm.
  • See your doctor if you develop any unexplained fever, rash (particularly one that gets worse after you have been in the sun), new or worsening joint pain, persistent diarrhea or generalized aches and pains.
  • Also see your doctor if you develop any muscle cramps, spasms, or weakness; jitteriness; abnormal heartbeat; dizziness; seizures; or any other symptoms of concern.
  • Do not take Nexium if you are allergic to other proton pump inhibitors.
  • May sometimes cause unusual results with medical tests.

Response and Effectiveness

  • Peak concentrations of Nexium occur within one to four hours of an oral dose. However, it may take several days of dosing before the maximum effect of Nexium is reached. One dose of Nexium will provide an effect for up to 24 hours.

References

Nexium (esomeprazole) [Package Insert] Revised 12/2016. AstraZeneca Pharmaceuticals LP https://www.drugs.com/pro/nexium.html

  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Nexium only for the indication prescribed.

Copyright 1996-2018 Drugs.com. Revision Date: 2017-10-19 01:00:17

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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