Esomeprazole is a medication called a proton pump inhibitor (PPI) used to treat many health conditions, including acid reflux, heartburn, gastro-oesophageal reflux disease (GORD or GERD) and other conditions that involve excessive stomach acid.

Esomeprazole works by reducing the amount of stomach acid you produce which relieves the symptoms of acid reflux and other conditions caused by having excessive stomach acid. It is a proton pump inhibitor (PPI). Proton pumps can be found in the lining of the stomach. They’re tiny proteins that help with the production of stomach acid. Taking PPI medication will stop these proton pumps from working properly, which reduces the amount of stomach acid your body makes.

What is the difference between a PPI and an antacid?

The difference between PPIs and antacids are PPIs act on the proton pumps in the stomach lining to stop them from producing excess stomach acid. Antacids, on the other hand, are alkaline compounds that work to neutralise the acid that’s already in the stomach, rather than reducing it. Antacids offer quick, short-term relief from acid reflux and heartburn, whereas PPIs take longer to relieve symptoms, but are better for those who experience severe symptoms from acid reflux, heartburn and other gastrointestinal health conditions. It’s safe to take esomeprazole with an antacid. You can buy a 20mg dose over the counter, but a 40mg dose is only available on prescription.

How long does it take for esomeprazole to work?

Esomeprazole starts working within one hour, with many people noticing the effects after 2 to 3 days. After 5 days of a once daily 20mg esomeprazole dose, the stomach’s ability to produce acid falls by around 90% when measured 6 to 7 hours after the fifth dose. You may experience some symptoms of high stomach acid for up to 4 weeks after you start your treatment. If you’ve purchased esomeprazole without getting a prescription and you don’t feel any better after taking it for 2 weeks, then you should speak to your doctor.

How effective is esomeprazole?

Esomeprazole 40mg reduces the frequency of acid reflux by 78% from 4.4 days per week to 1 day per week after 8 weeks of treatment. It also heals reflux oesophagitis, inflammation of the oesophagus lining caused by chronic gastro-oesophageal reflux disease (GORD), in 78% of people after 4 weeks and 93% after 8 weeks.

Patients who use esomeprazole tend to see a significant improvement in their symptoms. However, some patients will remain symptomatic after using PPIs. The dosage and the form of the treatment will play a part in how a patient reacts to it. Every person is unique and will react to medication in a different way, but in general, the right dose of esomeprazole is an effective treatment.

In most cases, you’ll be told to take esomeprazole once a day. This should be the first thing in the morning before food. If you’re advised to take it twice a day, then you would take it once in the morning and once in the evening. The dose of esomeprazole will be determined by the medical condition you’re being treated for, your age and your general health.

Esomeprazole can be taken as tablets, capsules, liquids and granules. If you take tablets or capsules, then you should swallow them whole with water. If you struggle to swallow tablets or capsules, then you can crush them up or open the capsules and stir them into a glass of water. Granules or liquids are usually prescribed to children under the age of 12.

How long do I use esomeprazole?

If you purchase esomeprazole over the counter and you don’t notice any improvement after using it for 2 weeks, then you should talk to your doctor who may carry out further tests. If you take esomeprazole on prescription, then you should only take it for a few weeks up to a few months, depending on the illness it’s being used to treat. Your doctor may advise that you take it longer or they may suggest that you only take the medication when you experience symptoms.

How many esomeprazole tablets can I take?

Your doctor will determine how many esomeprazole you should take, but it will be either 1 or 2 a day. You should never take a double dose if you forget to take your medication. Setting reminders or alarms is a great way to remember taking it. If you’ve taken too much esomeprazole, then you should speak to your doctor.

Esomeprazole is available in 2 dosages for acid reflux: 20mg and 40mg. The dose you will be prescribed will depend on your symptoms and their severity.

Esomeprazole 20mg

Esomeprazole 20mg once daily is the standard acid reflux dose if your food pipe (oesophagus) has no signs of damage. You may also move down to a once-daily 20mg dose after taking esomeprazole 40mg for 4 weeks.

Esomeprazole 40mg

If your doctor has found that your food pipe has been damaged by acid reflux, the recommended dose is 1 esomeprazole 40mg tablet per day for 4 weeks.

You can conveniently buy esomeprazole from most online UK registered pharmacies like Superdrug Online Doctor. For higher doses, this treatment requires a prescription to purchase online or at a pharmacy, however, you can purchase a low dosage treatment over the counter.

Can I buy esomeprazole online?

Yes, you can request esomeprazole online from Superdrug Online Doctor by:

1. Completing a short and simple online health questionnaire for one of our doctors to review.
2. Make your payment.
3. If approved, your medication will be sent to your home address in plain, discreet packaging or you can choose to collect it from your nearest Superdrug Pharmacy.
4. If your request is not approved, one of our doctors will message you via your Patient Account with advice on what to do next or suggest an alternative.

Can I get esomeprazole over the counter?

Yes, you can get esomeprazole 20mg tablets over the counter from most UK pharmacies. It is commonly sold under the brand name Nexium Control, but is also available as a generic medication. It is usually only available without a prescription for up to 14 days. If you need it for longer, your symptoms do not improve, or you need a higher dose, you will need a prescription from a doctor.

Can I get esomeprazole on the NHS?

Yes, you can get esomeprazole on the NHS for acid reflux, but you will need to make an appointment with your GP to see if it is safe and suitable for you. Your GP is likely to prescribe 1 esomeprazole 20mg capsule per day for 4 to 8 weeks for mild to moderate cases of acid reflux. Alternatively, you can request esomeprazole from Superdrug Online Doctor without the need for a face-to-face appointment.

The side effects from taking esomeprazole vary between individuals, but most people who use this treatment will experience no side effects. If you do feel any side effects, they usually start mild and will disappear once you stop taking esomeprazole.

Common mild side effects, affecting up to 1 in 10 people, include:

• headaches
• feeling sick (nausea)
• stomach pain
• wind
• constipation
• diarrhoea
• being sick (vomiting)
• benign polyps in your stomach

Uncommon side effects, affecting up to 1 in 100 people, are:

• swollen feet and ankles
• disturbed sleep
• dizziness
• pins and needles
• sleepiness
• spinning feeling (vertigo)
• dry mouth
• skin rash, hives, itchy skin

Rare side effects, affecting up to 1 in 1000 people, are:

• low numbers of white blood cells or platelets
• low sodium levels
• feeling agitated, confused, or depressed
• taste changes
• eyesight issues
• feeling wheezy or short of breath
• inflammation in the mouth
• thrush
• liver problems
• hair loss
• skin rash after being out in the sun
• joint or muscle pains
• generally feeling unwell or low energy
• increased sweating

These usually affect 1 in 100 people. If you’re bothered by these side effects or they won’t go away, then you should talk to a pharmacist or doctor. More severe side effects that occur in less than 1 in 1,000 people include:

• joint pain and abnormal changes in skin – redness, raised rash, blistering.
• yellow skin, dark urine and extreme tiredness

In rare cases, people can experience a serious allergic reaction, also known as anaphylaxis. If you experience any of these serious side effects, you should contact your doctor immediately or go to A&E.

What to do if you get esomeprazole side effects

Even though side effects are rare, it’s important to seek medical attention if you do experience them. If you encounter any mild or common side effects, then you should keep an eye on them. Avoiding alcohol, drinking plenty of fluids, eating the right foods and speaking to your pharmacist about a suitable painkiller will manage most of the common side effects of using esomeprazole.

If you experience any of the severe side effects listed above or you start wheezing, have trouble breathing, a tight chest or swelling around your face or throat, then you should call 999 or get someone to take you to A&E. The full list of esomeprazole side effects will be located in the leaflet inside the packet of medicine.

What are the side effects of long-term use of esomeprazole?

It’s not known if the long-term use of esomeprazole will reduce the effectiveness of the medication. You should talk to your doctor if you feel like it isn’t working as well as it used to. If you take esomeprazole for over 3 months, the concentration of magnesium in your blood may drop. This can cause dizziness, confusion, tiredness, muscle twitches and an irregular heartbeat.

If you take esomeprazole for over a year, then it could increase your chances of getting a bone fracture, gut infection or a vitamin B12 deficiency. Signs of a B12 deficiency include extreme tiredness and fatigue, a red and sore tongue, pins and needles and mouth ulcers. If you’ve been told to stay on esomeprazole for more than a year, then your doctor should be checking your health regularly.

PPIs such as esomeprazole may not work for everyone. If you’re thinking about taking esomeprazole but you’re unsure about whether it’s right for you, then you should speak to your doctor or a pharmacist to ensure you’re making the right decision for your health and your body. If you’re taking other medications, then your doctor or a pharmacist will be able to tell you if esomeprazole is safe to take alongside them.

Esomeprazole contraindications

You shouldn’t use esomeprazole without a doctor’s consent if you’re under 18, pregnant or breastfeeding. If you’ve had an allergic reaction to this medication in the past, have problems with your liver, can’t absorb certain types of sugars or you’re due to have an endoscopy, then esomeprazole may not be suitable for you.

Medications that interact with esomeprazole

Before you start taking esomeprazole, you should tell your doctor if you’re on any of the following medications:

• antidepressants – citalopram, clomipramine, escitalopram or imipramine
• antifungal medicines – itraconazole, ketoconazole or posaconazole
• blood-thinning medicines – clopidogrel
• cilostazol for painful legs
• digoxin – heart medicine
• HIV medicines
• phenytoin for epilepsy
• methotrexate for cancer, psoriasis or rheumatoid arthritis
• rifampicin – antibiotic
• tacrolimus for eczema or to prevent organ rejection

These are only some of the medications that may interact with esomeprazole. You should be able to eat normally when taking esomeprazole but you should cut down on spicy food, fatty food, caffeine and alcohol, as these can overstimulate stomach acid. However, these foods and drinks will not affect the effectiveness of this medication. You can take antacids, like Gaviscon, 2 hours before or after taking esomeprazole.

Alternative treatments to esomeprazole include other proton pump inhibitors, which work in a similar way to reduce acid reflux and are as effective as esomeprazole. They can be given in different doses and have similar side effects. Esomeprazole alternatives include:

• Lansoprazole
• Omeprazole
• Pantoprazole

Lansoprazole

Lansoprazole is another commonly prescribed PPI for acid reflux. It works by blocking the proton pumps in the stomach that produce acid, providing effective relief from symptoms such as heartburn, acid reflux, and indigestion. Lansoprazole is available in 15 or 30mg doses and may be a more suitable option if you have had side effects from esomeprazole.

Omeprazole

Omeprazole is another PPI used to treat acid reflux and is commonly prescribed as the first-line treatment. Esomeprazole is a refined version of omeprazole that can provide a faster, stronger, and longer effect.

Pantoprazole

Pantoprazole works in the same way as other PPIs to relieve acid reflux symptoms, but it may be a more suitable option if you:

• take multiple medications because it has fewer drug interactions
• need long-term treatment
• have not responded well to other PPIs

Pantoprazole is usually prescribed in 20 or 40mg doses, depending on the severity of your symptoms.

If esomeprazole doesn’t work for you, then your doctor may recommend that you take one of these alternative medicines to reduce the acid in your stomach. If you would prefer a natural alternative, then chamomile, ginger root, marshmallow root and slippery elm may be able to relieve some symptoms of excessive stomach acid, but there is little clinical research to support this.