{"id":41382,"date":"2021-09-15T10:50:56","date_gmt":"2021-09-15T14:50:56","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=41382"},"modified":"2021-10-06T15:34:27","modified_gmt":"2021-10-06T19:34:27","slug":"nexium-side-effects","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/nexium-side-effects\/","title":{"rendered":"Nexium side effects and how to avoid them"},"content":{"rendered":"<p><span style=\"font-weight: 400;\"><a href=\"#common-side-effects\">Common Nexium side effects<\/a> | <a href=\"#nausea-diarrhea\">Nausea and diarrhea<\/a> | <a href=\"#serious-side-effects\">Serious side effects<\/a> | <a href=\"#long-term-use\">Long-term use<\/a> | <a href=\"#how-long-do-side-effects-last\">How long do side effects last?<\/a> | <a href=\"#warnings\">Warnings<\/a> | <a href=\"#interactions\">Interactions<\/a> | <a href=\"#how-to-avoid-side-effects\">How to avoid side effects<\/a><\/span><\/p>\n<p><span style=\"font-weight: 400;\">Marketed as \u201cThe Purple Pill\u201d for decades, Nexium (esomeprazole magnesium) has been a popular treatment for acid reflux or <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/gerd-treatment-and-medications\"><span style=\"font-weight: 400;\">gastroesophageal reflux disease (GERD)<\/span><\/a><span style=\"font-weight: 400;\">. Nexium is a potent reducer of stomach acid and is also <\/span><a href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2014\/022101s014021957s017021153s050lbl.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">approved by the FDA<\/span><\/a><span style=\"font-weight: 400;\"> to treat <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/ulcer-treatment-and-medications\"><span style=\"font-weight: 400;\">stomach ulcers<\/span><\/a><span style=\"font-weight: 400;\"> and helicobacter pylori (H. pylori) stomach infections. It can also reduce the risk of gastric ulcers from nonsteroidal anti-inflammatory drugs (NSAIDs). Nexium is a <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/proton-pump-inhibitors\"><span style=\"font-weight: 400;\">proton pump inhibitor (PPI)<\/span><\/a><span style=\"font-weight: 400;\">, which includes alternatives like <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/nexium-vs-prilosec\/\"><span style=\"font-weight: 400;\">Prilosec<\/span><\/a><span style=\"font-weight: 400;\"> (omeprazole), <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/prevacid\"><span style=\"font-weight: 400;\">Prevacid<\/span><\/a><span style=\"font-weight: 400;\"> (lansoprazole), and <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/protonix-vs-nexium\/\"><span style=\"font-weight: 400;\">Protonix<\/span><\/a><span style=\"font-weight: 400;\"> (pantoprazole). Being aware of Nexium side effects and drug interactions can be particularly helpful, as they may be avoidable.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/prescription\/nexium\"><b>Get Nexium coupons<\/b><\/a><b> | <\/b><a href=\"https:\/\/www.singlecare.com\/prescription\/nexium\/what-is\"><b>What is Nexium?<\/b><\/a><\/p>\n<h2 id=\"common-side-effects\"><span style=\"font-weight: 400;\">Common side effects of Nexium<\/span><\/h2>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nausea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diarrhea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Constipation<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Abdominal pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Flatulence (excess gas)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Headache<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dizziness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dry mouth<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vitamin B12 deficiency with long-term use<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Stomach polyps with long-term use<\/span><\/li>\n<\/ul>\n<h3 id=\"nausea-diarrhea\"><span style=\"font-weight: 400;\">Nausea and diarrhea<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Gastrointestinal side effects may occur when taking Nexium. Nausea occurs in about 2% of people taking Nexium, and <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15264050\/\"><span style=\"font-weight: 400;\">diarrhea is experienced by about 3%<\/span><\/a><span style=\"font-weight: 400;\">. If nausea is persistent or progresses to vomiting, then the attention of a healthcare professional is warranted. Also requiring medical attention, unrelenting diarrhea could be an indicator of a serious adverse effect called colitis. Two varieties of this disease of the large intestine occur at <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/16414946\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">increased rates in those treated with PPIs<\/span><\/a><span style=\"font-weight: 400;\">. Microscopic colitis is related to inflammation of the bowel and c<\/span><span style=\"font-weight: 400;\">lostridium difficile colitis <a href=\"https:\/\/www.singlecare.com\/conditions\/clostridium-difficile-treatment-and-medications\">(C.Diff)<\/a><\/span><span style=\"font-weight: 400;\"> is caused by the proliferation of the bacterium clostridium difficile, usually due to the lack of good intestinal bacteria following antibiotic use. Both types of colitis manifest as severe, watery diarrhea.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/antibiotics-that-cause-c-diff\/\"><b>Antibiotics that cause C.Diff<\/b><\/a><\/p>\n<h2 id=\"serious-side-effects\"><span style=\"font-weight: 400;\">Serious side effects of Nexium<\/span><\/h2>\n<ul>\n<li><span style=\"font-weight: 400;\">C.Diff-associated diarrhea<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Microscopic colitis<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Hives, allergic reactions, or anaphylaxis<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Severe skin rashes or blistering (Stevens-Johnson syndrome, toxic epidermal necrolysis, and erythema multiforme)<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Kidney problems such as kidney function impairment or acute interstitial nephritis (inflammation within the kidney)<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Liver function impairment<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Pancreas inflammation<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Bone fractures<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Systemic lupus erythematosus<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Barrett&#8217;s esophagus or esophageal ulcers, swollen veins, or tightening<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Stomach ulcers<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Low magnesium levels (hypomagnesemia) with prolonged use<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Hernia<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Abnormal blood cell counts<\/span><\/li>\n<\/ul>\n<h2 id=\"long-term-use\"><span style=\"font-weight: 400;\">Side effects from long-term use of Nexium<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Certain <\/span><a href=\"https:\/\/online.epocrates.com\/drugs\/233905\/Nexium\/Adverse-Reactions\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">side effects of Nexium<\/span><\/a><span style=\"font-weight: 400;\"> become a concern with prolonged use. For example, low levels of magnesium and vitamin B12 can be an issue after months to years of treatment. Long-term and even lifelong treatment with PPIs is not uncommon. At times, this may be related to an ongoing risk of stomach ulcers or GERD symptoms, and in other instances, the option for stoppage has simply never been revisited after an initial indication.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Consulting with a healthcare professional about whether or not to stop PPIs like Nexium has become more pertinent in recent years, largely due to questions being raised about other possible long-term PPI side effects. One such concern involves <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/osteoporosis-treatment-and-medications\"><span style=\"font-weight: 400;\">reduced bone density (osteoporosis)<\/span><\/a><span style=\"font-weight: 400;\">, which may explain the finding of increased fracture risk after years of PPI use, although further study is still needed.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Cancer<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Another worrisome question is related to a potential link between Nexium\u2019s drug category and cancer. Stomach cancer risk has been elevated in <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/30886648\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">clinical studies of long-term PPI use<\/span><\/a><span style=\"font-weight: 400;\">, but researchers are unsure whether this was coincidental or was caused by PPI use. Conversely,<\/span> <span style=\"font-weight: 400;\">PPIs are recommended in the setting of <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29948566\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Barrett\u2019s esophagus <\/span><\/a><span style=\"font-weight: 400;\">to reduce the risk of esophageal cancer. The issue of cancer risk is one that calls for a discussion between the patient and their healthcare provider.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Dementia<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Providers are also frequently asked about dementia risk with Nexium or other PPIs. Alarm was generated when <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25341874\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">a study<\/span><\/a><span style=\"font-weight: 400;\"> found a heightened dementia risk among older users of PPIs. Other <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28728964\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">studies<\/span><\/a><span style=\"font-weight: 400;\"> and <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28128476\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">reviews<\/span><\/a><span style=\"font-weight: 400;\"> have not found the risk to be elevated. For the time being, PPI-related dementia risk has not been proven.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Kidney damage<\/span><\/h3>\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26752337\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Clinical trials<\/span><\/a><span style=\"font-weight: 400;\"> have demonstrated a higher risk of chronic kidney disease among PPI users. However, it is uncertain if this has been merely coincidental. Coupled with the knowledge that Nexium and its fellow PPIs are linked to the acute kidney disease interstitial nephritis, the concern relating to chronic kidney disease may generate fear both in the short and long term. These risks, along with the medication\u2019s benefits, are best discussed with a healthcare professional.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Hair loss<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Another fear among some long-term Nexium users is hair loss. The concern is based on <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32359802\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">study data<\/span><\/a><span style=\"font-weight: 400;\"> showing PPI use associated with an increased risk of alopecia areata, a condition marked by patchy hair loss. The jury is still out on whether PPIs can actually cause the condition.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/why-is-my-hair-falling-out\/\"><b>Why is my hair falling out?<\/b><\/a><\/p>\n<h2 id=\"how-long-do-side-effects-last\"><span style=\"font-weight: 400;\">How long do Nexium side effects last?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The duration of an adverse effect from Nexium can be quite variable. Short-term side effects like mild diarrhea, nausea, or headache will likely resolve with cessation of the medication. Long-term side effects, like <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/common-nutrient-deficiencies\/\"><span style=\"font-weight: 400;\">low magnesium or vitamin B12 levels<\/span><\/a><span style=\"font-weight: 400;\">, may require treatment in order to resolve.<\/span><\/p>\n<h2 id=\"warnings\"><span style=\"font-weight: 400;\">Nexium contraindications and warnings<\/span><\/h2>\n<h3><span style=\"font-weight: 400;\">Abuse and dependence<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Nexium is not habit-forming. Nonetheless, it can be difficult to stop taking it. The reason is that GERD symptoms like\u00a0<\/span><a href=\"https:\/\/www.singlecare.com\/blog\/heartburn-how-to-treat-nausea-and-stomachaches\/\"><span style=\"font-weight: 400;\">heartburn and indigestion<\/span><\/a><span style=\"font-weight: 400;\"> can strongly recur upon discontinuing Nexium. This experience is related to a surge in stomach acid production when a PPI is stopped. Consequently, slowly tapering off Nexium may be best.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Overdose<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The <\/span><a href=\"https:\/\/online.epocrates.com\/drugs\/233901\/Nexium\/Adult-Dosing\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">maximum dose of Nexium<\/span><\/a><span style=\"font-weight: 400;\"> is 40 mg twice daily, used for conditions like Zollinger-Ellison in which the amount of acid production is extremely high. High doses of Nexium can produce uncomfortable and sometimes dangerous effects, so emergency medical attention and a call to the Poison Control center at 1-800-222-1222 are necessary.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Restrictions<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Age is typically not a restriction that applies often with Nexium use since dosing guidelines exist for 1-month-olds all the way up to seniors. Advanced liver disease and pre-existing low magnesium levels are two reasons for caution when considering the use of Nexium. Likewise, caution is advisable prior to use during <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/safe-medication-during-pregnancy\/\"><span style=\"font-weight: 400;\">pregnancy<\/span><\/a><span style=\"font-weight: 400;\">, as other types of acid reducers may have more safety data. Data on the safety of Nexium use while breastfeeding is also inadequate.<\/span><\/p>\n<h2 id=\"interactions\"><span style=\"font-weight: 400;\">Nexium interactions<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The list of potential <\/span><a href=\"https:\/\/online.epocrates.com\/drugs\/233904\/Nexium\/Drug-Interactions\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">drug interactions for Nexium<\/span><\/a><span style=\"font-weight: 400;\"> is a long one. This relates to its metabolism through the liver\u2019s p450 enzymes. Genetic differences can cause some individuals to have more severe interactions than others. A healthcare professional must review the medication list at the start and during the course of Nexium therapy. Certain examples are worth mentioning here.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Rilpivirine should not be used with Nexium. Other antivirals like saquinavir, nelfinavir, and atazanavir may need to be avoided or monitored.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Methotrexate, digoxin, tacrolimus, and warfarin are all medications with dangerous side effect potentials which may require extra monitoring if used concurrently with Nexium.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Concurrent Nexium may need to be avoided with the antifungals ketoconazole and voriconazole and the antibiotic rifampin.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Concerns exist about the blood thinner clopidogrel\u2019s effectiveness being reduced when used alongside Nexium.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The antidepressant St. John\u2019s Wort may diminish Nexium\u2019s effectiveness.<\/span><\/li>\n<\/ul>\n<h2 id=\"how-to-avoid-side-effects\"><span style=\"font-weight: 400;\">How to avoid Nexium side effects<\/span><\/h2>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Taking Nexium on an empty stomach at least 30 minutes before the morning meal helps to generate maximum effectiveness.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Review the list of medications for interactions at every appointment with the healthcare provider. Interactions may occur between Nexium and prescription drugs, over-the-counter (OTC) medicine, and even natural products.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Discuss the intended duration of Nexium or potential discontinuation at each appointment.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ask about monitoring magnesium and vitamin B12 levels during long-term Nexium use.<\/span><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Common Nexium side effects | Nausea and diarrhea | Serious side effects | Long-term use | How long do side effects last? | Warnings | Interactions | How to avoid side effects Marketed as \u201cThe Purple Pill\u201d for decades, Nexium (esomeprazole magnesium) has been a popular treatment for acid reflux or gastroesophageal reflux disease (GERD). [&hellip;]<\/p>\n","protected":false},"author":87,"featured_media":41402,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[16414,12752,10708],"coauthors":[20732],"class_list":["post-41382","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-digestive-health","tag-medication-side-effects","tag-over-the-counter-medications","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Nexium side effects and how to avoid them<\/title>\n<meta name=\"description\" content=\"Nausea and diarrhea are common Nexium side effects. 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