Esomeprazole

Esomeprazole is not suitable for some people. For example, check with your doctor if you have liver problems or need to have an endoscopy.

Esomeprazole is not usually recommended during pregnancy. Talk to your doctor about a more suitable medicine.

It can cause problems to take esomeprazole with some other medicines, such as antifungal medicines and medicines to prevent blood clots.

Most adults can take esomeprazole. Children should only have esomeprazole if a doctor prescribes it.

Esomeprazole is not suitable for some people. To make sure it's safe for you, tell your doctor if you:

• have ever had an allergic reaction to esomeprazole or any other medicine
• have liver problems
• are due to have an endoscopy - problems usually found during this procedure may not show up if you've used esomeprazole

If you're using esomeprazole that you have bought from a shop or pharmacy without a prescription, then you should speak to your doctor before taking it if you:

• are losing weight without trying
• keep being sick (vomiting), or are vomiting blood (this might look like dark coffee grounds)
• feel weak or your skin looks paler than usual (this may not be as noticeable on brown or black skin)
• have blood in your poo (your poo may look black or like tar)
• have chest or stomach pain
• have diarrhoea that is severe or does not get better
• have problems with swallowing

Tablets or capsules contain 20mg or 40mg of esomeprazole.

One sachet of granules contains 10mg of esomeprazole.

The usual dose to treat:

• heartburn and acid reflux is 20mg a day
• gastro-oesophageal reflux disease is 20mg to 40mg a day
• stomach ulcers is 20mg a day
• Zollinger-Ellison syndrome is 80mg a day – this can increase to 160mg a day depending on how well it works for you

Changes to your dose

Sometimes your doctor will increase your dose if it’s not working well enough.

If you start on a higher dose, your doctor may recommend lowering it after the first 1 to 2 months.

Doses are usually lower for children and people with liver problems.

How to take it

You'll usually take esomeprazole once a day, first thing in the morning. You can take it with or without food.

If you take esomeprazole twice a day, take 1 dose in the morning and 1 dose in the evening.

How to take tablets and capsules

Swallow tablets and capsules whole with a drink of still (non-fizzy) water. Do not take it with other liquids. Do not chew or crush the tablets or capsules.

If you have problems swallowing esomeprazole capsules, you can open them up and empty the medicine into a glass. Mix with some water and drink straight away.

If you have problems swallowing tablets, you can add them to a glass of still water. Stir with a spoon until the tablet has broken up and the water is not clear. Drink straight away. Half fill the glass with still water again, and drink. This makes sure you get all the medicine. Do not chew or crush the bits of the tablet that are in the water.

How to take granules

If your child is under 12, their doctor may prescribe esomeprazole granules which come in sachets. Empty the granules into a glass and mix with some water, leave for a few minutes until the liquid has thickened, then encourage them to drink it straight away. The granules should not be chewed or crushed.

If you get esomeprazole on prescription, or buy it from a pharmacy or shop, follow your doctor’s advice, or the information in the pack.

These common side effects of esomeprazole happen in more than 1 in 100 people. There are things you can do to help cope with them:

Make sure you rest and drink plenty of fluids. It's best not to drink too much alcohol. Ask your pharmacist to recommend a painkiller, or talk to your doctor if they do not go away or are severe.

Try taking esomeprazole with or after a meal or snack. It may also help if you do not eat rich or spicy food while you're taking this medicine.

Take small, frequent sips of water to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.

If you take the combined pill or the progestogen-only pill and you're being sick your contraception may not protect you from pregnancy. Check the pill packet for advice.

Drink plenty of fluids, such as water or squash, to prevent dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee.

If the diarrhoea does not get better, talk to your doctor.

If you take the combined pill or the progestogen-only pill and you have severe, watery diarrhoea, or any diarrhoea that lasts for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Get more fibre into your diet such as fresh fruit and vegetables and cereals, and drink plenty of water. Try to exercise regularly, for example, by going for a daily walk or run. If this does not help, talk to your pharmacist or doctor.

Try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help. If you are in a lot of pain, speak to your pharmacist or doctor.

Try to avoid foods that cause farting, like pulses, lentils, beans and onions. It might help to eat smaller meals more frequently, eat and drink slowly, and exercise regularly. Some pharmacy remedies, such as simeticone, may improve the problem.

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

There is little information about taking esomeprazole during pregnancy, so it's not recommended.

Your doctor may suggest a similar medicine, called omeprazole, because there's more safety information available on it.

You may be able to take esomeprazole while you're breastfeeding, but check with your doctor first.

There is not much information about taking esomeprazole while breastfeeding, it shows that some esomeprazole passes into breast milk but the amount is probably too small to be harmful.

It's rare for breastfed babies to get any side effects from medicines you're taking, but speak to a healthcare professional or call NHS 111 if you notice that your baby:

• is not feeding as well as usual
• has constipation, diarrhoea or is being sick (vomiting)
• is being irritable
• has a rash
• is not sleeping well

If your baby has any symptoms that are not listed, or if you're worried about them, you can also call 111 or contact any healthcare professional.

When taken at the same time, some medicines can affect the way esomeprazole works. Esomeprazole can also affect the way other medicines work.

Taking them together can make you more likely to have side effects or stop one of the medicines working as well.

Tell your doctor if you're taking any of these medicines before you start taking esomeprazole:

• heart medicines such as digoxin
• cilostazol, a medicine that treats peripheral arterial disease
• antifungal medicines such as itraconazole, ketoconazole, posaconazole or voriconazole
• methotrexate, a medicine that treats psoriasis and rheumatoid arthritis
• HIV medicines
• phenytoin, an epilepsy medicine
• rifampicin, an antibiotic
• clopidogrel or warfarin, medicines to prevent or treat blood clots
• citalopram, diazepam, imipramine and other medicines used to treat anxiety and low mood

These are not all the medicines that may not mix well with esomeprazole. For a full list, see the leaflet inside your medicines packet.