Nexium

• Used to treat stomach problems
• Also used as a stomach coater to prevent stomach problems
• Reduces the production of stomach acid

Nexium contains a medicine called esomeprazole and belongs to a group of medicines called proton pump inhibitors. They work by reducing the amount of acid that your stomach produces. Nexium is used treat the following conditions:

Adults:

• Gastroesophageal reflux disease (this is where acid from the stomach escapes into the gullet).
• Ulcers which are infected with bacteria called Helicobacter pylori. If you have this condition, your doctor may also prescribe antibiotics to treat the infection.
• Stomach ulcers caused by medicines called non-steroidal anti-inflammatory drugs (NSAIDs). Nexium can also be used to stop ulcers from forming if you are taking NSAIDs.
• Too much acid in the stomach caused by a growth in the pancreas (Zollinger-Ellison syndrome).

Children aged 12 years and above:

• Gastroesophageal reflux disease.
• Ulcers which are infected with bacteria called Helicobacter pylori. If you have this condition, your doctor may also prescribe antibiotics to treat the infection.

Nexium tablets are not suitable for children under 12 years of age. For this patient group, Nexium is available in sachets containing granules.

Nexium tablets should be taken with some liquid. Do not chew or crush the tablets. This is because the tablets contain coated pellets which stop the medicine from being broken down by the acid in your stomach. It is important not to damage the pellets. You can take your tablets with food or on an empty stomach, at any time of the day. If you have trouble swallowing the tablets, put them into a glass of still (non-fizzy) water and follow the instructions on the package leaflet.

Dosage

Dosage varies per person and is determined by a doctor depending on the symptoms. The general dosage guidelines are as follows:

Adults

To treat heartburn caused by gastroesophageal reflux disease:

• If your doctor has found that your food pipe (gullet) has been slightly damaged the recommended dose is one 40mg tablet once a day for four weeks. Your doctor may tell you to take the same dose for a further four weeks if your gullet has not yet healed.
• The recommended dose once the gullet has healed is one 20mg tablet once a day.
• If your gullet has not been damaged, the recommended dose is one 20mg tablet once a day. Once the condition has been controlled, your doctor may tell you to take your medicine as and when you need it, up to a maximum of one 20-mg tablet each day.

To treat ulcers caused by Helicobacter pylori infection and to stop them coming back:

• One 20mg tablet twice a day for one week.

To treat stomach ulcers caused by NSAIDs:

• One 20mg tablet once a day for four to eight weeks.

To prevent stomach ulcers if you are taking NSAIDs:

• One 20mg tablet once a day.

To treat too much acid in the stomach caused by a growth in the pancreas (Zollinger-Ellison syndrome):

• One 40mg tablet twice a day.Your doctor will adjust the dose depending on your needs and will also decide how long you need to take the medicine for. The maximum dose is 80 mg twice a day.

Children aged 12 years and above:

To treat heartburn caused by gastroesophageal reflux disease:

• If your doctor has found that your food pipe (gullet) has been slightly damaged the recommended dose is one 40mg tablet once a day for four weeks. Your doctor may tell you to take the same dose for a further four weeks if your gullet has not yet healed.
• The recommended dose once the gullet has healed is one 20mg tablet once a day.
• The recommended dose if the gullet has not been damaged is one 20mg tablet once a day.

To treat ulcers caused by Helicobacter pylori infection and to stop them coming back:

• One 20mg tablet twice a day for one week.

Alcohol/driving

Nexium does not interact with alcohol.

Nexium is not likely to affect you being able to drive or use any tools or machines. However, side effects such as dizziness and blurred vision may uncommonly or rarely occur. If affected, you should not drive or use machines.

If you use more/forget to use Nexium

If you take more tablets than you were told to, consult your doctor or pharmacist.

If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose. Do not take a double dose to make up for a forgotten one.

Nexium is not suitable for everyone. Do not use this medicine if:

• You are allergic to esomeprazole or any of the other ingredients of this medicine (see section ‘What Nexium contains').
• You are allergic to other proton pump inhibitor medicines (e.g., pantoprazole, lansoprazole, rabeprazole, omeprazole).
• You are taking a medicine containing nelfinavir (used to treat HIV infection).

When should this medicine be used with caution?

Talk to your doctor or pharmacist before taking Nexium if:

• You have severe liver problems.
• You have severe kidney problems.
• You have ever had a skin reaction after treatment with a medicine similar to Nexium that reduces stomach acid.

For more information about warnings, see the package leaflet. Read the package leaflet carefully before you start taking this medicine.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. Your doctor will decide whether you can take Nexium during this time.

It is not known if Nexium passes into breast milk. Therefore, you should not take Nexium if you are breastfeeding.

Other medicines and Nexium

Tell your doctor if you are taking, have recently taken or might take any other medicines. This includes medicines obtained without a prescription and herbal medicines.

Do not take Nexium tablets if you are taking a medicine containing nelfinavir (used to treat HIV infection). Tell your doctor or pharmacist if you are taking any of the following medicines:

• Atazanavir.
• Clopidogrel.
• Ketoconazole, itraconazole or voriconazole.
• Erlotinib.
• Citalopram, imipramine or clomipramine.
• Diazepam.
• Phenytoin.
• Medicines that are used to thin your blood.
• Cilostazol.
• Cisapride.
• Digoxin.
• Methotrexate.
• Tacrolimus.
• Rifampicin.
• St John's Wort.

See the package leaflet for more information.

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Get emergency medical help immediately if you notice rare but serious side effects such as an allergic reaction or liver problems (see the package leaflet for symptoms).

Other side effects include:

Common (may affect up to 1 in 10 people):

• Headache.
• Effects on your stomach or gut: diarrhoea, stomach pain, constipation, wind (flatulence).
• Nausea or vomiting.

Uncommon (may affect up to 1 in 100 people):

• Swelling of the feet and ankles.
• Disturbed sleep (insomnia).
• Dizziness, tingling feelings such as 'pins and needles', feeling sleepy.
• Spinning feeling (vertigo).
• Dry mouth.
• Changes in blood tests that check how the liver is working.
• Skin rash, lumpy rash (hives) and itchy skin.
• Fracture of the hip, wrist or spine (if Nexium is used in high doses and over long duration).

For a complete list of side effects, see the package leaflet. If you experience side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.

The active substance is esomeprazole. Nexium gastro-resistant tablets come in two strengths containing 20 mg or 40 mg of esomeprazole (as magnesium trihydrate).

Read the package leaflet before use. The official package leaflet of Nexium is available for download here.