Nexium

Written by Sarah Lewis, PharmD
Medically reviewed by Melissa Badowski, PharmD, MPH, FCCP
Updated on June 27, 2023

The Food and Drug Administration (FDA) has approved esomeprazole for:

• treating erosive esophagitis (damage to the esophagus from stomach acid) in adults and certain children
• treating gastroesophageal reflux disease (GERD) in adults and certain children
• treating Helicobacter pylori infection in adults when prescribed together with antibiotics
• treating Zollinger-Ellison syndrome and other similar conditions in adults
• reducing the risk of stomach ulcers in adults taking nonsteroidal anti-inflammatory drugs
• reducing the risk of bleeding returning with specific ulcers in adults after certain procedures

These approved uses differ based on the form of esomeprazole your doctor prescribes.

This article describes esomeprazole’s uses, side effects, and more. You’ll also find some coupon options to help save on the cost of esomeprazole.

This article doesn’t provide coupons for all forms of esomeprazole. To find coupons for esomeprazole intravenous (IV) injection or infusion,* see this article.

* An IV injection is an injection into a vein, and an IV infusion is an injection into a vein given over time.

Below you’ll find answers to a few commonly asked questions about esomeprazole.

Is it safe to take esomeprazole along with domperidone or naproxen?

Yes, it’s safe to take esomeprazole along with domperidone or naproxen (Aleve, Naprosyn). In fact, there is a prescription drug that combines esomeprazole and naproxen in one product called Vimovo.

Domperidone is prescribed to treat certain digestive system problems and help ease nausea and vomiting in certain situations. Domperidone is only available through a special program in the United States. The Food and Drug Administration (FDA) limits the drug’s use to this expanded access program.

Naproxen is a nonsteroidal anti-inflammatory drug. It’s prescribed to treat inflammation (swelling and damage) and pain. The prescription drug that combines naproxen and esomeprazole is prescribed to ease pain from certain forms of arthritis while also helping prevent stomach ulcers from forming.

To learn more about taking esomeprazole with other drugs, talk with your doctor or pharmacist.

How does esomeprazole compare with omeprazole?

Esomeprazole and omeprazole are both proton pump inhibitors (PPIs). They are similar drugs that generally treat the same conditions related to stomach acid, such as gastroesophageal reflux disease (GERD). These PPIs also have similar side effects and warnings.

Talk with your doctor or pharmacist to find out more about how esomeprazole and omeprazole compare.

Is there a brand-name version of esomeprazole available?

Esomeprazole is available as the brand-name drug Nexium. If you’d like to know more about Nexium or generic drugs and their brand-name versions in general, talk with your doctor.

How does esomeprazole work? And how long does it take to start working?

Esomeprazole works by decreasing stomach acid production. It does this by binding to sites on stomach cells called proton pumps. This blocks the final step in the process of making stomach acid.

Esomeprazole will start to work within a couple of hours of taking it. But it can take a few days to feel symptoms of your condition lessening.

If you’d like to know more about how esomeprazole works, talk with your doctor or pharmacist.

The Food and Drug Administration (FDA) approves prescription drugs such as esomeprazole for certain conditions. Approved uses for esomeprazole are described below. These uses differ based on the form of esomeprazole prescribed.

Use for certain digestive conditions

Doctors may prescribe esomeprazole delayed-release (DR)* oral capsule and DR oral liquid suspension (a type of liquid mixture) for:

• Treating erosive esophagitis. For treating erosive esophagitis (damage to the esophagus† from stomach acid), the DR oral capsule is prescribed to adults and children ages 12 years and older. The DR oral liquid suspension is prescribed for this condition to adults and children ages 1 year and older. Adults may take esomeprazole as a short-term or long-term treatment for erosive esophagitis. Children usually take the drug as a short-term treatment for this condition.
• Treating gastroesophageal reflux disease (GERD). For treating GERD, a severe form of acid reflux, esomeprazole is prescribed to adults and children ages 12 years and older. For this purpose, the drug is usually a short-term treatment.
• Reducing the risk of stomach ulcers due to nonsteroidal anti-inflammatory drugs (NSAIDs). Esomeprazole is prescribed to reduce the risk of stomach ulcers in adults taking NSAIDs. In this case, it’s usually prescribed as a long-term treatment.
• Treating Helicobacter pylori (H. pylori) infection. Esomeprazole may be prescribed to adults to treat an H. pylori infection. For this purpose, esomeprazole is taken together with antibiotics. In this case, the drug is usually prescribed as a short-term treatment.
• Treating Zollinger-Ellison syndrome and other similar conditions. Esomeprazole may be prescribed to adults to treat Zollinger-Ellison syndrome. This is a rare condition that causes too much stomach acid. The drug may also be prescribed to treat other similar conditions. For this purpose, esomeprazole is usually a long-term treatment.

Doctors may prescribe esomeprazole intravenous (IV) injection or infusion‡ for:

• Treating GERD with erosive esophagitis. Esomeprazole is prescribed for this purpose in adults and children ages 1 month and older. It’s usually prescribed as a short-term treatment.
• Reducing the risk of bleeding starting again after an endoscopy procedure to stop certain ulcers from bleeding. Endoscopy involves using a thin, lighted tube to view the inside of the body. Through this tube, it’s possible to treat certain conditions, such as a bleeding ulcer. Esomeprazole is prescribed to adults to reduce the risk of bleeding starting again from ulcers in the stomach or duodenum (the first part of the small intestine) after such a procedure. In this case, the drug is usually a short-term treatment.

* “Delayed release” means the drug is released slowly over time in your body.
† The esophagus is a tube that runs from your mouth to your stomach.
‡ An IV injection is an injection into a vein, and an IV infusion is an injection into a vein given over time.

About conditions related to stomach acid

With conditions related to stomach acid, excess stomach acid irritates the lining of the digestive tract. Certain drugs, such as nonsteroidal anti-inflammatory drugs, may also cause such irritation. This can lead to heartburn and other symptoms, such as an ulcer (open sore). Esomeprazole can help relieve these symptoms and promote healing.

Esomeprazole may be prescribed together with other drugs to treat conditions related to stomach acid.

Doctors may not prescribe esomeprazole in certain situations. For example, esomeprazole should not be used in people who take oral drugs containing rilpivirine (Edurant).

Esomeprazole may cause mild or serious side effects. More common mild side effects of esomeprazole and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about esomeprazole’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for esomeprazole listed in the “Article resources” section.

Mild side effects

More common mild side effects reported with esomeprazole are listed below. These side effects may differ based on the form of esomeprazole you’re prescribed.

This article doesn’t include all possible mild side effects of the drug. To learn more about esomeprazole’s side effects based on the form, refer to the prescribing information for esomeprazole listed in the “Article resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Mild side effects of esomeprazole delayed-release (DR)* oral capsule and DR oral liquid suspension (a type of liquid mixture) include:

• diarrhea
• gas
• headache
• nausea
• mild allergic reaction†

Mild side effects of esomeprazole intravenous (IV) injection or infusion‡ include:

• abdominal pain
• gas
• headache
• nausea
• mild allergic reaction†

* “Delayed release” means the drug is released slowly over time in your body.
† For details about this side effect, see the “Interactions and warnings for esomeprazole” section.
‡ An IV injection is an injection into a vein, and an IV infusion is an injection into a vein given over time.

Serious side effects

Serious side effects of esomeprazole are listed below. These side effects may differ based on the form of esomeprazole you’re prescribed.

This article doesn’t include all possible serious side effects of the drug. To learn more about esomeprazole’s side effects based on the form, refer to the prescribing information for esomeprazole listed in the “Article resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, esomeprazole’s serious side effects include:

• acute nephritis (sudden inflammation of the kidneys)
• increased risk of osteoporosis-related broken bones in the wrist, hip, or spine with high doses or long-term use
• low level of magnesium with long-term use
• low level of vitamin B12 with long-term use
• new or worsening lupus (an autoimmune disease that can affect the skin and joints)
• polyps (noncancerous growths) in the lining of the upper part of the stomach with long-term use
• severe skin reactions, which can be fatal
• severe, watery diarrhea due to a Clostridioides difficile bacterial infection
• severe allergic reaction*

* For details about this side effect, see the “Interactions and warnings for esomeprazole” section.

Below you’ll find information about esomeprazole’s possible interactions and warnings.

Interactions of esomeprazole

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you start esomeprazole, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for esomeprazole” section just below.

Warnings for esomeprazole

Some people should not take esomeprazole, and others should take it cautiously.

Esomeprazole could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether esomeprazole is a safe option for you. These warnings may differ based on the form of esomeprazole you’re prescribed.

Ask your doctor about specific warnings for esomeprazole, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Esomeprazole can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to esomeprazole or any of its ingredients, your doctor will likely not prescribe esomeprazole. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• severe skin rashes that may blister and peel
• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to esomeprazole, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of esomeprazole

If you take esomeprazole by mouth, you should not take more esomeprazole than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much esomeprazole, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and esomeprazole

Information about esomeprazole and pregnancy and breastfeeding is described below.

Esomeprazole and pregnancy

It’s not known whether esomeprazole should be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.

Esomeprazole and breastfeeding

It’s not known whether esomeprazole should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.

This article describes esomeprazole’s uses and side effects, ways to save on cost, and more. Let your doctor know if you have questions about esomeprazole or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• How does esomeprazole compare with other medications that could treat my condition?
• What is the most important information I should know about esomeprazole?
• Do any of my other medications interact with esomeprazole?
• How should I take esomeprazole?

• Esomeprazole magnesium delayed release capsule, for oral use. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/e50b093a-76e4-4082-bba4-9d804009d1f4/spl-doc
• Esomeprazole magnesium for delayed release oral suspension. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/c1319da6-bf0d-4dd6-a713-1677bfbfbdae/spl-doc
• Esomeprazole sodium for injection, for intravenous use. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/23395673-116d-4a8e-b0ce-59f9ca5b3daf/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.