Nexium is a prescription delayed-release capsule or injection for people with serious gastrointestinal disorders such as GERD, erosive esophagitis, and ulcers. Its active ingredient is esomeprazole, a proton pump inhibitor (PPI) that reduces stomach acid production. It’s not to be confused with Nexium 24HR, an over-the-counter low-dose version of Nexium that helps people manage frequent heartburn.
Nexium overview
BRAND NAMES:
Nexium, Nexium I.V.
Generic Names:
Esomeprazole magnesium, esomeprazole sodium
Uses:
Treats gastroesophageal reflux disorder, duodenal and stomach ulcers, H. pylori infection, and overproduction of stomach acid
Therapeutic Classes:
Proton pump inhibitor, gastric acid secretion inhibitor, gastrointestinal agent
Forms:
Delayed-release capsule, granules, injection
How it’s taken:
By mouth, by intravenous injection
What is Nexium used for?
The FDA has approved prescription Nexium to treat gastroesophageal reflux disease (GERD), erosive esophagitis associated with GERD, H. pylori infection, and conditions that cause too much stomach acid (hypersecretory conditions). Nexium injections are FDA-approved to treat erosive esophagitis associated with GERD and to prevent bleeding in ulcer patients who have just undergone an endoscopy.
What form(s) does Nexium come in
Delayed-release capsule
20 mg
40 mg
Granules for oral suspension
2.5 mg
5 mg
10 mg
20 mg
40 mg
Injection
40 mg/vial
What are common Nexium doses?
For GERD:
In adults: 20 mg taken once per day for four weeks
In children 12–17 years of age: 20 mg taken once per day for four weeks
In children 1–11 years of age: 10 mg taken once per day for four weeks
For GERD-related erosive esophagitis:
In adults: 20–40 mg taken once per day for four to eight weeks
In children 12–17 years of age: 20–40 mg taken once per day for four to eight weeks
In children 1–11 years of age: 10–20 mg taken once per day for eight weeks
In children 1 month to 1 year of age: Dosage based on weight
For maintenance treatment of GERD-related erosive esophagitis in adults: 20 mg taken once per day
For H. pylori infection in adults: 20–40 mg taken once per day with antibiotics for 10–14 days
For hypersecretory conditions in adults: 40 mg taken once per day
For gastric ulcer prevention in adults on NSAID therapy: 20–40 mg taken once per day for up to six months
To reduce the risk of ulcer rebleeding in adults after an endoscopy examination: 80 mg intravenous infusion followed by a 71.5-hour intravenous infusion at 8 mg per hour
Find more detailed information about Nexium dosage, forms, and strengths here.
Common Nexium prescriptions
NexIUM
10 capsules delayed release bottleNexIUM
30 capsules delayed release bottleNexIUM
60 capsules delayed release bottleNexIUM
90 capsules delayed release bottleNexIUM
20mg capsule delayed releaseNexIUM
40mg capsule delayed releaseNexIUM
10mg packetNexIUM
2.5mg packetNexIUM
20mg packetNexIUM
40mg packetNexIUM
5mg packet
How to take Nexium
Follow the prescriber’s instructions. Do not use more than directed or take doses more often than prescribed. Take all of the medicine in your prescription, even if you feel better after a few days.
Take Nexium capsules or oral suspension at least one hour before a meal.
Some healthcare providers suggest the best time to take Nexium is in the morning before breakfast.
It is okay to take antacids with Nexium.
How to take Nexium capsules:
Swallow the capsule whole with a glass of water. Do not crush, break, or chew the capsule.
The delayed-release capsule can be opened, and the contents mixed into one tablespoon of applesauce. Do not mix the granules with any other type of food.
Stir the mixture well and swallow it right away. Do not chew.
Throw away any remaining mixture.
The capsules can be mixed with water for use with a nasogastric feeding tube. Read the Instructions for Use that come with the medicine.
Store Nexium capsules in a tightly closed container at room temperature between 59° and 86°F.
How to take Nexium granules for oral suspension:
Mix the contents of a 2.5 mg or 5 mg packet with 1 teaspoon (5 mL) of water and stir well.
Mix the contents of a 10 mg, 20 mg, or 40 mg packet with 1 tablespoon (15 mL) of water and stir well.
Ask a pharmacist how to mix multiple packets if that’s necessary.
Dose young children with the oral syringe. Older children or adults can take doses from a small glass or similar container.
Stir the mixture and allow it to thicken for two or three minutes.
Stir it again and drink the mixture within 30 minutes.
If it’s not taken within 30 minutes, throw it away and start a new mixture.
Add more water to any leftover medicine and drink it right away.
The mixture can be prepared for administration through a nasogastric feeding tube. Read the Instructions for Use that come packaged with the medicine.
Store Nexium packets unopened at room temperature (59° to 86°F).
What to do if you miss a dose of Nexium
If a dose is missed, take it when remembered.
If it’s the next day, skip the missed dose and take the next day’s dose as scheduled.
Nexium contraindications
This medicine is not right for everyone.
Do not use it if you have had an allergic reaction to esomeprazole or similar medicines called proton pump inhibitors. You can find a complete list of PPIs here.
Nexium warnings
Tell any doctor or other healthcare provider who treats you that you are using this medicine.
Your doctor may need regular visits and lab tests to monitor treatment effectiveness and spot any side effects. Keep all appointments.
Before using prescription Nexium, make sure the prescribing healthcare provider knows if you are pregnant, breastfeeding, or if you have:
Liver problems
Low magnesium, low calcium, or low potassium levels
Kidney problems
Osteoporosis
Vitamin B12 deficiency
Nexium can cause serious problems, including:
Kidney problems
Increased risk of fractures
Stomach growths
Lupus
This medicine can cause diarrhea up to two months after stopping Nexium. Call your doctor if the diarrhea becomes severe, does not stop, or is bloody. Do not take any medicine to stop diarrhea until you have talked to your doctor.
Nexium interactions
Because it reduces stomach acid, Nexium can make many drugs ineffective that rely on stomach acid to be broken down in the stomach. The list is long, so make sure the prescriber and the pharmacist know about all the prescription drugs being taken.
Nexium can also cause significant drug interactions with:
Blood thinners, particularly warfarin or clopidogrel
Drugs that make you pee
Drugs that treat HIV/AIDS or other viral infections, particularly ritonavir
Iron supplements
Cilostazol, citalopram, digoxin, methotrexate, rilpivirine, St. John’s wort, rifampin, tacrolimus, voriconazole
Nexium should only be used as needed. Long-term use of esomeprazole can cause serious problems including:
Low magnesium
Vitamin B12 deficiency
Osteoporosis
Increased risk of cancer
Kidney problems
Increased risk of dementia
Hair loss
Tell other healthcare providers you are using Nexium before they prescribe new medications.
Nexium side effects
Serious side effects
Talk to a doctor if you notice any signs or symptoms of a possible serious side effect, including:
Severe diarrhea that does not go away (up to two months after stopping Nexium)
Fever, joint pain, swelling in your body, unusual weight gain, changes in how much or how often you urinate
Stomach pain, nausea, vomiting, weight loss, bloody or black stools
Severe pain in the upper abdomen, tenderness, fever, racing heartbeats
Joint pain, rash on your cheeks or arms that gets worse in the sun
Blistering, peeling, red skin rash
Skin rash, fever, facial swelling, enlarged lymph nodes
Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
Less serious side effects
Mild diarrhea, constipation, or gas
Headache
Injection site reactions (IV injection)
Find more detailed information about Nexium side effects here.
Sources:
Nexium drug summary, Prescriber’s Digital Reference (PDR)
Nexium esomeprazole magnesium delayed-release capsule prescribing information, DailyMed (NIH National Library of Medicine)
Nexium I.V. esomeprazole sodium injection prescribing information, DailyMed (NIH National Library of Medicine)
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