Prescription or OTCLower-cost generic available



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Treats heartburn and stomach ulcers.

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Prescription or OTCLower-cost generic available

Our pharmacists’ bottom line

Nexium (Esomeprazole) gives you long-lasting heartburn relief. But this purple pill ain't cheap! The generic forms of alternative drugs work just as well, and are usually less expensive.

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Hassle?Is it a hassle?
  • Most people can take Nexium without any noticeable day-to-day side effects.
  • Nexium lasts longer than other types of antacids (like Zantac, Pepcid, or Tums), and you only need to take it once or twice a day.
  • You can take it in combination with a quick-acting antacid (like Maalox or Tums) if you need relief right away.
  • In studies it was better than a placebo (sugar pill) and as good as other proton pump inhibitors at treating heartburn.
  • Available as both a generic and over-the-counter option, so it's pretty affordable.
  • Doesn't start working as fast as some other antacids like Tums, Rolaids, or Maalox.
  • Like with other proton pump inhibitors, long-term use can cause weak or broken bones.
  • Can cause low levels of magnesium in the blood. You might need to take a magnesium supplement if you use Nexium long-term.
  • Can be expensive—especially the purple brand-name pill. Other alternatives are usually cheaper than Nexium and work just as well.
  • Can interact with other drugs so be sure your doctor knows all the medicine you're taking before starting Nexium.

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Side effects for Nexium (Esomeprazole)

From clinical trials of Nexium / Any condition 

  • DiarrheaDiarrhea9% for Nexium vs.0% for placebo
  • Change in tasteChange in taste7% for Nexium vs.0% for placebo
  • Abdominal painAbdominal pain4% for Nexium vs.0% for placebo

What to expect when you take Nexium (Esomeprazole) for Reduces stomach acid

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Tips from our pharmacists
  • Take 1 hour before a meal.
  • Don't chew or crush capsules; swallow them whole.
  • If you have trouble swallowing you can carefully open the capsules and sprinkle the inside pellets onto applesauce. Swallow the applesauce without chewing or crushing the pellets.
  • When using Nexium long-term, take a calcium citrate with vitamin D supplement daily to prevent bone loss. Be sure it's calcium citrate because it works the best when using a proton pump inhibitor.
  • Get a blood test for your magnesium level once a year; you may need a magnesium supplement while using Nexium.
  • Avoid drug interactions by telling your doctor all of the other medications or herbal supplements you take before starting Nexium.

Risks and Warnings for Nexium (Esomeprazole)

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  • Heartburn and feelings of upset stomach can be warning signs of a more serious stomach problem or cancer. If you need to take Nexium (Esomeprazole) for 2 weeks or more go see a doctor. It's safest to get checked out to make sure you do not have a serious stomach condition.

Means that some groups have a high risk of experiencing this side effect

Tips from pharmacists and people taking Nexium (Esomeprazole)

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The FDA category for this medication is B. It is advised that you: Probably safe
  • Tips from our pharmacists
  • Take 1 hour before a meal.