Esomeprazole is a gastric medicine.
It is used to treat conditions caused by excessive acidity in your stomach, such as ulcers in the stomach or duodenum (upper portion of the small intestine), reflux disease (also known as "heartburn", in which food or acid from your stomach backs up into your mouth, leaving a sour or bitter taste) and hypersecretory conditions such as Zollinger-Ellison syndrome (a condition in which a growth in the pancreas or duodenum or both secretes too much acid).
This medicine can also be used to relieve stomach irritation and ulceration caused by certain painkillers such as non-steroidal anti-inflammatory drugs (NSAIDs).
Esomeprazole treats these conditions by reducing the amount of acid your stomach makes.
This medicine may also be used together with other medicines to treat a specific type of stomach problem caused by the Helicobacter pylori bacteria.
Esomeprazole may be used to treat other conditions as decided by your doctor.
Take Esomeprazole exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
This medicine is available as enteric-coated tablet, delayed-release capsule, gastro-resistant capsule, and granules for oral suspension.
If you are taking the enteric-coated tablet (usually labelled as “EC”), take it at least 1 hour before breakfast. Swallow it whole; do not divide, chew or crush the tablet. If you have trouble swallowing, you may disperse the tablet in half a glass of non-carbonated ("non-fizzy") water and drink the liquid with the pellets immediately or within 30 minutes. The pellets also must not be chewed or crushed.
If you are taking the delayed-release or gastro-resistant capsule (usually labelled as “DR”), take it at least 1 hour preferably before breakfast. Swallow the capsule whole; do not chew or crush it. If you have trouble swallowing, you may open up the capsule, mix the contents with applesauce and swallow the mixture immediately. The mixture also must not be chewed or warmed.
Esomeprazole also comes as a sachet of granules for oral suspension. Empty the contents of the sachet into a glass then add sufficient volume of plain water depending on your dose. Do not use carbonated (“fizzy”) water. Stir the contents until dispersed and leave for a few minutes to thicken. Stir again then drink immediately or within 30 minutes. If some medicine remains, rinse glass with water and drink immediately. The granules must not be chewed or crushed.
Try to take it at the same time each day.
You may need to take Esomeprazole for some time before the full benefits can be felt. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by your doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Do not take Esomeprazole with nelfinavir, atazanavir or rilpivirine (medicines for HIV infection).
Inform your doctor if you have the following conditions:
- severe liver disease
- severe kidney disease
- stomach cancer
- at risk of osteoporosis (soft, brittle bones)
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving this medicine to a child.
If your gastric problem seems to be getting worse, let your doctor know.
Do not take Esomeprazole for a long period of time unless instructed otherwise.
If you are going for certain laboratory test (e.g. Chromogranin A), inform your doctor that you are taking Esomeprazole.
Some genetic traits can affect this medicine’s efficacy. Individuals who are ultrarapid metaboliser of CYP2C19
may respond poorer to this medicine and may require dose adjustment. Although not routinely done, your doctor may advise you to take genetic testing to check if this medicine is best suited for you. If you know you have this gene type, inform your doctor.
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly. You may need to have routine blood tests (magnesium level) to check your body’s response to the medicine. Your doctor will advise you about how often you need to have these tests.
Esomeprazole may cause dizziness or visual disturbances. If affected, do not drive or take part in any activity in which you need to be alert.
This medicine may cause any of the following side effects: headache, nausea, vomiting, dry mouth, diarrhoea, constipation, stomach pain and wind in the stomach.
Some side effects may be serious, although they are not common. Alert your doctor quickly if you experience:
- rashes with skin peeling or blisters
- severe stomach pain or cramps, loose, watery or bloody stools, or severe diarrhoea
- signs of low levels of magnesium e.g. muscle cramps, weakness, seizures, abnormal heartbeat
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
DO NOT take Esomeprazole with nelfinavir, atazanavir or rilpivirine (medicines for HIV infection).
Inform your doctor and pharmacist if you are taking any of these medicines:
- other medicine for HIV infection e.g. saquinavir
- blood-thinning medicines e.g. warfarin, clopidogrel, cilostazol
- medicines for fungal infection e.g. ketoconazole, itraconazole, voriconazole
- medicine used in organ transplant or certain immune disorders e.g. tacrolimus
- medicine for sleep disorder or anxiety e.g. diazepam
- medicines for cancer e.g. methotrexate, erlotinib
- digoxin (medicine for heart disease)
- phenytoin (medicine for epilepsy or fits)
- rifampicin (medicine to treat TB)
This list does not include all medicines that may interact with Esomeprazole.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicine, supplements and medicines that you buy without a prescription.
It may be helpful to discuss your diet with your doctor or dietitian. A change in diet may help improve your symptoms. For example, spicy food tends to worsen reflux and should be avoided. Likewise, carbonated ("fizzy") drinks such as soft drinks should also be avoided.
You should also try to avoid lying down soon after eating as this will worsen the reflux symptoms.
Avoid St. John’s wort.
Store in a cool, dry place away from the reach of children.
Protect from light and moisture.
Medicines must not be used past the expiry date.