Experiences with
Esomeprazole

Esomeprazole reduces the amount of acid your stomach makes.

It's widely used to:

treat indigestion, heartburn and acid reflux, and gastro-oesophageal reflux disease (GORD) – a condition which means you keep getting acid reflux
prevent stomach ulcers

Sometimes, esomeprazole is taken for a rare condition caused by a tumour in the pancreas or gut called Zollinger-Ellison syndrome.

Esomeprazole comes as capsules, tablets, and granules to make a liquid that you swallow.

Sometimes, it's mixed with naproxen, a medicine that reduces swelling (inflammation) and pain in joints and muscles. This is known by the brand name Vimovo.

All types of esomeprazole are available on prescription. You can also buy the lowest-strength, 20mg tablets and capsules, from pharmacies and supermarkets.

Who can take esomeprazole

Esomeprazole can be taken by most adults. Children should only have esomeprazole if a doctor prescribes it.

Esomeprazole is not suitable for some people. To make sure it's safe for you, tell your doctor if you:

have ever had an allergic reaction to esomeprazole or any other medicine
have liver problems
are due to have an endoscopy

If you're going to have an endoscopy, ask your doctor if you should stop taking esomeprazole a few weeks before your procedure. This is because esomeprazole may hide some of the problems that would usually be spotted during an endoscopy.

Dosage and strength

Each tablet or capsule contains 20mg or 40mg of esomeprazole. Each sachet contains 10mg.

The usual dose to treat:

heartburn and acid reflux is 20mg a day
gastro-oesophageal reflux disease is 20mg to 40mg a day
stomach ulcers is 20mg a day
Zollinger-Ellison syndrome is 80mg a day – this can increase to 160mg a day depending on how well it works for you

Doses are usually lower for children and people with liver problems.

How to take it

You'll usually take esomeprazole once a day, first thing in the morning. You can take it with or without food.

If you take esomeprazole twice a day, take 1 dose in the morning and 1 dose in the evening.

Swallow tablets and capsules whole with a drink of water (non-fizzy). Do not use any other liquids.

If you have problems swallowing capsules, you can open up esomeprazole capsules and empty the contents into a glass. Mix with some water and drink it straight away.

If you have problems swallowing tablets, you can add them to a glass of water, wait for them to dissolve and then drink it straight away.

After, add more water to your glass and drink that as well to make sure there's no medicine left at the bottom of the glass.

How to take esomeprazole granules

If your child is under 12, their doctor may prescribe esomeprazole granules which come in sachets. Empty the granules into a glass and mix with some water, leave for a few minutes until the liquid has thickened, then encourage them to drink it straight away.

Changes to your dose

Sometimes your doctor will increase your dose if it is not working well enough.

Depending on the reason you're taking esomeprazole, you may take a higher dose to begin with, usually for a month or 2. After this, your doctor may recommend that you take a lower dose.

How long to take it for

If you bought the medicine yourself from a pharmacy or supermarket, tell your doctor if you feel no better after taking esomeprazole for 2 weeks. They may want to do tests to find out what's causing your symptoms or change you to a different medicine.

If it has been prescribed for you, you may only take it for a few weeks or months, depending on your condition. Sometimes your doctor may advise you to take it for longer, even many years.

Your doctor may suggest taking esomeprazole only when you have symptoms. This means you will not have to take it every day. Once you feel better, you can stop taking it, often after a few days or weeks. Taking esomeprazole for a short time to treat symptoms is not suitable for everyone. Speak to your doctor about what's best for you.

If you forget to take it

If you usually take it:

once a day – take the missed dose as soon as you remember, unless it's less than 12 hours until your next dose. If that happens, skip the missed dose and take the next one at the usual time
twice a day – take the missed dose as soon as you remember, unless it's less than 4 hours until your next dose. If that happens, skip the missed dose and take the next one at the usual time

Do not take 2 doses to make up for a forgotten dose.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember to take your medicine.

If you take too much

It's very unlikely that taking 1 or 2 extra doses will cause any problems. But check with a doctor if you're worried.

you take more than your prescribed dose of esomeprazole and have any of these symptoms:

feeling sick (nausea)
being sick (vomiting)
feeling dizzy
stomach pain
diarrhoea
headaches

Go to 111.nhs.uk or call 111

If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the esomeprazole packet or leaflet inside it, any remaining medicine, and any other medicines you take.

If you've taken esomeprazole for a long time, speak to your doctor before you stop taking it. Stopping suddenly could make your stomach produce a lot more acid, and make your symptoms come back.

Common side effects

These common side effects of esomeprazole happen in more than 1 in 100 people. There are things you can do to help cope with them:

Make sure you rest and drink plenty of fluids. It's best not to drink too much alcohol. Headaches usually go away after the first week, but ask your pharmacist to recommend a painkiller, or talk to your doctor if they last more than a week or are severe.

Try taking esomeprazole with or after a meal or snack. It may also help if you do not eat rich or spicy food while you're taking this medicine. Try drinking small, frequent sips of water to avoid dehydration.

Take, small, frequent sips of water to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.

If you take the combined contraceptive pill or the progestogen-only pill and you're being sick your contraception may not protect you from pregnancy. Check the pill packet for advice.

Drink plenty of fluids, such as water or squash, to prevent dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee.

If the diarrhoea does not get better, talk to your doctor.

If you take the combined contraceptive pill or the progestogen-only pill and you have diarrhoea, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Get more fibre into your diet such as fresh fruit and vegetables and cereals, and drink plenty of water. Try to exercise regularly, for example, by going for a daily walk or run. If this does not help, talk to your pharmacist or doctor.

Try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help. If you are in a lot of pain, speak to your pharmacist or doctor.

Try to avoid foods that cause farting, like pulses, lentils, beans and onions. It might help to eat smaller meals more frequently, eat and drink slowly, and exercise regularly. Some pharmacy remedies, such as simeticone, may improve the problem.

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Serious side effects happen in less than 1 in 1,000 people.

Call a doctor or call 111 if:

your skin becomes yellow (although this may be less obvious on brown or black skin), your pee becomes darker and you feel more tired – these can be signs of liver problems
you get joint pain along with a red skin rash, especially on parts of your body exposed to the sun, such as your arms, cheeks and nose – these can be signs of a rare condition called subacute cutaneous lupus erythematosus. This can happen even if you have been taking esomeprazole for a long time
you have diarrhoea that is severe or does not go away – this can be a sign of an inflamed bowel

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to esomeprazole.

Meds New IA (H4) - serious allergic reaction

If you take esomeprazole for more than 3 months, the levels of magnesium in your blood may fall.

Low magnesium can make you feel tired, confused, dizzy and cause muscle twitches, shakiness and an irregular heartbeat. If you get any of these symptoms, tell your doctor.

Taking esomeprazole for more than a year may increase your chances of certain side effects, including:

bone fractures
gut infections
vitamin B12 deficiency – symptoms include feeling very tired, a sore and red tongue, mouth ulcers and pins and needles

If you take esomeprazole for longer than 1 year, your doctor will regularly check your health to see if you should carry on taking it.

It's not known if esomeprazole works less well the longer you take it. If you feel like it is not working any more, talk to your doctor.

Other side effects

These are not all the side effects of esomeprazole. For a full list, see the leaflet inside your medicine packet.

Esomeprazole and pregnancy

There is little information about esomeprazole use during pregnancy, so it is not recommended.

Your doctor may suggest a similar medicine, called omeprazole, because there's more safety information available on it.

Esomeprazole and breastfeeding

If your doctor or health visitor says your baby is healthy, it is OK to take esomeprazole while you're breastfeeding.

The small amount of information we have about this shows that esomeprazole passes into breast milk in very small amounts. Your baby will not absorb a lot into their body from breast milk. It's unlikely that esomeprazole will cause side effects in your baby.

Esomeprazole and fertility

There is no evidence to suggest that taking esomeprazole will reduce fertility in either men or women. However, speak to a pharmacist or your doctor if you're trying to get pregnant. They may want to review your treatment.

Meds New IA (H2) - Pregnancy non-urgent care card

Cautions with other medicines

When taken at the same time, some medicines can affect the way esomeprazole works. Esomeprazole can also affect the way other medicines work.

Taking them together can make you more likely to have side effects or stop one of the medicines working as well.

Tell your doctor if you're taking any of these medicines before you start taking esomeprazole:

heart medicines such as digoxin
cilostazol, a medicine that treats peripheral arterial disease
antifungal medicines such as itraconazole, ketoconazole, posaconazole or voriconazole
methotrexate, a medicine that treats psoriasis and rheumatoid arthritis
HIV medicines
phenytoin, an epilepsy medicine
rifampicin, an antibiotic
clopidogrel or warfarin, medicines to prevent or treat blood clots

These are not all the medicines that may not mix well with esomeprazole. For a full list, see the leaflet inside your medicines packet.

Mixing esomeprazole with herbal remedies and supplements

Do not take St John's wort, the herbal remedy for depression, while you're taking esomeprazole. It may stop esomeprazole working as well as it should.

There's not enough information to say that other complementary medicines and herbal remedies are safe to take with esomeprazole. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.

Meds New IA (H2) - Cautions with other medicines alert