Esomeprazole is used to treat conditions where there is too much acid in the stomach. It is used to treat duodenal and gastric ulcers, erosive esophagitis, gastroesophageal reflux disease (GERD), and Zollinger-Ellison syndrome, a condition wherein the stomach produces too much acid. Esomeprazole is also used with antibiotics (eg, amoxicillin, clarithromycin) to treat ulcers that are caused by the H. pylori bacteria. This medicine is also used to prevent stomach ulcers and stomach irritation in patients taking NSAIDs (eg, aspirin, ibuprofen) for long periods of time.

Esomeprazole is a proton pump inhibitor (PPI). It works by decreasing the amount of acid that is produced by the stomach.

This medicine is available both over-the-counter (OTC) and with your doctor's prescription.

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine comes with a Medication Guide and patient instructions. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Take this medicine at least 1 hour before a meal and for the full time of treatment, even if you begin to feel better after a few days.

If you are taking this medicine to treat an ulcer caused by an H. pylori infection, take it together with the antibiotics (eg, amoxicillin, clarithromycin) at the same time of day.

To use the capsule:

Swallow the capsule whole. Do not crush or chew it.
If the capsule cannot be swallowed, open it and sprinkle the contents on one tablespoonful of applesauce.
Swallow the mixture right away. Do not chew or crush the granules.
To use the capsule with a nasogastric (NG) tube:

Open the capsule and empty the granules into a 60 mL catheter-tipped syringe and mix it with 50 mL of water.
Shake the syringe well for 15 seconds.
Inject or pour the mixture into the nasogastric tube.
Refill the syringe with a small amount of water and shake.
Flush the tube to rinse all of the medicine into the stomach.
To use the oral suspension:

Empty the contents of a 2.5 mg or 5 mg packet into a container with 5 mL of water.
Empty the contents of a 10 mg, 20 mg, or 40 mg packet into a container with 15 mL of water.
Stir and leave it for 2 to 3 minutes to thicken.
Stir well and drink within 30 minutes.
If any medicine remains after drinking, add more water, stir, and drink immediately.
To use the oral suspension with a nasogastric or gastric tube:

Add 5 mL of water to a catheter-tipped syringe and add the contents of a 2.5 mg or 5 mg packet.
Add 15 mL of water to a catheter-tipped syringe and add the contents of a 10 mg, 20 mg, or 40 mg packet.
Shake the syringe right away and leave it for 2 to 3 minutes to thicken.
Shake the syringe again and inject or pour the mixture into the tube within 30 minutes.
Refill the syringe with 15 mL of water and shake.
Flush the tube to rinse all of the medicine into the stomach.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

Blistering, peeling, or loosening of the skin

bloating

chills

constipation

cough

darkened urine

difficulty with swallowing

dizziness

drowsiness

fast heartbeat

fever

indigestion

joint or muscle pain

loss of appetite

mood or mental changes

muscle spasms (tetany) or twitching

nausea

pains in the stomach, side, or abdomen, possibly radiating to the back

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

red skin lesions, often with a purple center

red, irritated eyes

seizures

skin rash, hives, itching

sore throat

sores, ulcers, or white spots in the mouth or on the lips

tightness in the chest

trembling

unusual tiredness or weakness

vomiting

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Bad, unusual, or unpleasant (after) taste

change in taste

Less common

Sleepiness or unusual drowsiness

Rare

Acne

back pain

Incidence not known

Agitation

dry mouth

excess air or gas in the stomach or bowels

full feeling

hair loss or thinning of the hair

muscular weakness

passing gas

seeing, hearing, or feeling things that are not there

swelling of the breasts or breast soreness in both females and males

swelling or inflammation of the mouth

swollen joints

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

It is very important that your doctor check your or your child's progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood, urine, and other laboratory tests may be needed to check for unwanted effects. If your condition does not improve, or if it becomes worse, check with your doctor.

This medicine is sometimes given together with amoxicillin (Amoxil®) and clarithromycin (Biaxin®) to treat ulcers caused by H. pylori infection. Be sure you understand the risks and proper use of any other medicines your doctor prescribes.

Check with your doctor right away if you have a fever, joint pain, skin rash, swelling of the body, feet, or ankles, or unusual weight gain after using this medicine. These could be symptoms of a serious kidney problem called acute interstitial nephritis.

Taking this medicine for a long time may make it harder for your body to absorb vitamin B12. Tell your doctor if you have concerns about vitamin B12 deficiency.

This medicine may cause diarrhea, and in some cases it can be severe. Do not take any medicine to treat diarrhea without first checking with your doctor. Check with your doctor right away if you have a watery stool that does not go away, stomach pain, and fever with this medicine.

This medicine may increase your risk of having fractures of the hip, wrist, and spine. This is more likely if you are 50 years of age and older, use high doses, or use it for one year or more. Call your doctor right away if you have severe bone pain or are unable to walk or sit normally.

This medicine may cause hypomagnesemia (low magnesium in the blood). This is more likely to occur if you are using this medicine for more than one year, or if you are using it together with digoxin (Lanoxin®) or certain diuretics (water pills). Check with your doctor right away if you have convulsions (seizures), a fast, racing, or uneven heartbeat, muscle spasms (tetany), tremors, or unusual tiredness or weakness.

Cutaneous or systemic lupus erythematosus may occur or gets worse in lupus patients and are taking PPI. Call your doctor right away if you or your child have a joint pain or skin rash on your cheeks or arms that gets worse when exposed in the sun.

This medicine may increase your risk for fundic gland polyps (abnormal tissue growth in the upper part of your stomach). This is more likely if you are using this medicine for more than 1 year. Talk to your doctor if you have concerns.

Do not stop using this medicine without first checking with your doctor.

Make sure any doctor or dentist who treats you knows that you or your child are using this medicine. This medicine may affect the results of certain medical tests.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription (eg, clopidogrel, atazanavir, nelfinavir, Plavix®, Reyataz®, Viracept®) or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.