Nexium (Esomeprazole)

What is Nexium?

Nexium is a branded medication primarily used to treat acid reflux, a condition in which stomach acid travels up the oesophagus (food pipe) and causes discomfort. Manufactured by AstraZeneca, the treatment is an acid suppression agent, which means it works to reduce the amount of acid produced by the stomach.

You're more likely to be prescribed Nexium if you're experiencing severe acid reflux symptoms or if excess acid has caused damage to your oesophagus. If you're dealing with minor heartburn discomfort, an over-the-counter solution like Nexium Control may be more suitable.

How Does Nexium Work?

Nexium works by preventing proton pumps from secreting hydrochloric acid. Proton pumps are enzymes in the stomach that help produce acid to aid digestion. As such, Nexium is classified as a proton pump inhibitor (PPI). Its effect on the body reduces the likelihood of acid reflux and associated symptoms such as heartburn.

In addition, Nexium tablets and Nexium sachets help any damaged tissue in the oesophagus, duodenum, and stomach to heal. The medication's active ingredient, esomeprazole, can also be used to treat and prevent ulcers in the stomach and intestines, which may be caused by non-steroidal anti-inflammatory drugs (NSAIDs) or the bacterium Helicobacter pylori (H. pylori).

How Long Does Nexium Take to Work?

You should start to see an improvement in your symptoms within the first 2-3 days, though esomeprazole can take up to 4 weeks to reach its full effectiveness. Because of this, you may still experience bouts of acid reflux and discomfort during this period. Once at full strength, Nexium can offer relief for up to 24 hours.

If you're still having difficulties after a few weeks, it's important that you speak to a doctor, who may recommend an alternative medication.

How Effective is Nexium for Heartburn?

Clinical trials show Nexium works well to heal the damage caused by acid reflux. In patients with reflux oesophagitis, where stomach acid has irritated or damaged the lining of the food pipe, the 40 mg dose heals the oesophagitis in around 78% of patients after four weeks of treatment, rising to 93% after eight weeks. For people with heartburn symptoms but no visible damage to the food pipe, the 20 mg dose is used to bring symptoms under control, and your doctor will assess your progress after four weeks to see whether more time is needed.

Nexium can also help when heartburn hasn't settled on another PPI. A UK study of patients whose symptoms persisted despite a full daily dose of a different PPI found that switching to Nexium 40 mg reduced the average number of heartburn days from 4.4 to 1 per week over eight weeks, with similar improvements seen across other reflux symptoms.

How to Take Nexium

How to take Nexium depends on whether you're using tablets or sachets. That being said, both variations need to be taken with still water (not fizzy). You can also take them at any time of day, with or without food.

How to Take Nexium Tablets

It's important to swallow Nexium tablets whole, so you should take care not to chew or crush them. This is because the pills contain coated pellets that stop the medication from being digested by the stomach. Damaging these will render the treatment ineffective.

Should you have difficulty swallowing Nexium tablets, you can put them in a glass of water and stir until they break up. Drink the mixture immediately, or at least within 30 minutes, stirring thoroughly just before consumption. Again, be careful not to damage the pellets. To make sure you have taken all of the medication, refill the glass with water and drink again.

How to Take Nexium Sachets

Empty the Nexium granules into a glass of water. Use 15ml (3 teaspoonfuls) of water for each sachet. Stir the medication into the water and let the mixture sit for a few minutes to thicken. Once this has happened, stir again before swallowing. Be sure not to chew or crush the granules.

Your doctor will prescribe the number of sachets you will need to take. You should not allow the mixture to sit for more than 30 minutes before drinking. If any mixture remains in the glass, refill it with water and drink again.

Nexium Dosage Information

The recommended Nexium dosage for heartburn and acid reflux depends on whether you're taking the tablets or sachets, as well as the severity of your condition. Either way, the medication is designed to be taken daily. Be sure to only take the correct dosage as prescribed by your doctor.

Nexium tablets are available in two strengths: 20 mg and 40 mg. Nexium sachets, meanwhile, just come in one dose.

Nexium Tablets Dosage

If your doctor has found damage to your oesophagus, they may prescribe 1 40 mg Nexium tablet to be taken daily for 4 weeks. If there is no damage, the recommended dosage is one 20 mg tablet each day until the condition is under control.

If any oesophageal damage does not heal within the initial 4 weeks, your doctor may decide to keep you on a daily 40 mg dose for an additional 4 weeks to see how things go. Once the problem has been rectified, the recommended dosage will drop to 20 mg per day.

Nexium Granules Dosage

Each Nexium sachet contains 10 mg of esomeprazole. Your doctor will instruct you on the number of sachets to take each day and the duration of treatment. If you are ever unsure about what to do, it's essential to contact your GP immediately for further advice.

What if I Miss a Dose of Nexium?

If you miss a dose of Nexium, take it as soon as you remember. This is unless it's almost time for your next dose, in which case you should just skip the one you've forgotten. You must never take a double dose to catch up.

If You Take Too Much Nexium

If you take more Nexium than prescribed, speak to your doctor or clinician straight away for further advice.

Nexium Side Effects and Cautions

Nexium sachets and tablets have the potential to cause side effects, much like any other medication. However, not everyone will experience them. Nevertheless, it's always a good idea to familiarise yourself with potential adverse reactions before starting treatment, so you have a good idea of what to expect.

Side Effects of Nexium Tablets and Nexium Sachets

Since both Nexium tablets and Nexium sachets contain the same active ingredient (esomeprazole), they are likely to cause similar side effects. If you find these difficult to manage, consult a GP, who may recommend an alternative treatment.

Examples of Nexium side effects include:

Please note that the above information does not contain a full list of potential Nexium side effects. More details can be found within the Patient Information Leaflets for Nexium tablets and Nexium sachets. If you experience any adverse reactions, you can report them to your clinician or use the MHRA's Yellow Card Scheme.

Long-Term Use of Nexium

If you take Nexium for three months or longer, there's a small risk of your magnesium levels dropping too low. This can cause:

• Tiredness
• Muscle spasms or twitching
• Dizziness
• An irregular heartbeat

Your doctor may check your magnesium levels before you start long-term treatment, and periodically afterwards, particularly if you also take other medicines that can lower magnesium, such as diuretics.

Long-term, higher-dose use has also been linked to a modest increase in fracture risk, so your doctor will usually recommend the lowest effective dose for the shortest time needed.

When to Stop Taking Nexium

If you notice any of the following serious side effects of Nexium (esomeprazole), you should stop taking the treatment and seek medical assistance immediately:

• Yellow skin, tiredness, and dark urine. These can be symptoms of liver problems and may impact up to 1 in 1,000 people
• Sudden wheezing, swelling of your lips, tongue, and throat, or body, rash, fainting, or difficulty swallowing. These are potential signs of a severe allergic reaction and can affect up to 1 in 1,000 people
• Sudden onset of a severe rash or reddening of the skin with blisters or peeling. These may occur even after several weeks of treatment and might affect up to 1 in 10,000 people

More information about the serious Nexium side effects can be found within the Patient Information Leaflets.

When to Speak to Your Doctor

It's possible for Nexium to hide the symptoms of other diseases or medical conditions. If you notice any of the following symptoms after starting treatment (or before you start), consult your doctor immediately:

• Losing a lot of weight for no reason and having problems swallowing
• Getting stomach pain or indigestion
• Vomiting food or blood
• Passing black stools

Nexium Interactions and Warnings

Although Nexium tablets and sachets are effective treatments for heartburn, they may not be suitable for everyone. For example, you should not take the medication if you:

• Are allergic to esomeprazole or any other ingredient
• Take medicines containing nelfinavir
• Are allergic to other proton pump inhibitors (omeprazole, pantoprazole, etc)

Precautions Before Taking Nexium

You should talk to your doctor before you start taking Nexium if you:

• Have severe kidney or liver problems
• Have ever had a skin reaction after using medicines similar to Nexium that reduce stomach acid
• Are due to have a Chromogranin A blood test
• Are scheduled to have an endoscopy

If you are due to have an endoscopy, you must follow the instructions of your clinician or endoscopy team about whether to continue or temporarily stop taking Nexium. This is because esomeprazole may mask some of the issues that would typically be identified during the procedure.

If you are unsure if any of these apply to you, or you'd like more information to determine whether Nexium is suitable for you to take, speak to a clinician before you start treatment.

Nexium and Other Medicines

It's essential to inform your doctor about any other medications you're taking before they prescribe Nexium. This is especially the case for treatments such as:

• Atazanavir
• Citalopram, imipramine or clomipramine
• Cilostazol
• Clopidogrel
• Diazepam
• Cisapride
• Digoxin
• Methotrexate
• Phenytoin
• Warfarin or other coumarin anticoagulants
• St. John's Wort

More information about the types of medication you should inform your doctor about is included in the Patient Information Leaflets.

Where Can I Buy Nexium Sachets and Nexium Tablets?

Both Nexium sachets and Nexium tablets are available from pharmacies following a medical consultation to ensure the treatments are safe for you to use. They can be obtained both in person or online; however, the former will usually require making an appointment and a face-to-face consultation, which may put people off.

Can You Buy Nexium Over the Counter?

No, Nexium is classified as a prescription-only medication. This means it can only be authorised by a GP or clinician and is not available over the counter. If you have only mild heartburn symptoms, you may obtain Nexium Control without a prescription. However, a clinician will still need to review your information to determine if the medication is suitable for your circumstances.

Can You Buy Nexium Online?

Yes, you can buy Nexium online from reputable companies such as Prescription Doctor. With us, there's just a simple questionnaire to fill in, and no need to organise a doctor's appointment. Our process is as follows:

• Provide us with information about your medical history
• Our clinicians will assess your suitability for the medication or recommend an alternative treatment
• If your order is approved before 3 pm on a weekday, we aim to deliver your item the next day in discreet packaging
• Should the order be cancelled, we will provide you with a full refund

At Prescription Doctor, we also offer Nexium Control and generic esomeprazole to help treat heartburn and acid reflux.

Frequently Asked Questions About Nexium (Esomeprazole)