Nexum 20mg Tablets

Esomeprazole lowers the amount of acid your stomach produces. It belongs to a group of medicines called proton pump inhibitors (PPIs), which block the tiny 'pumps' in the stomach lining that make acid.

It may be used to:

• ease heartburn, acid reflux and indigestion
• treat gastro-oesophageal reflux disease (GORD) and help an irritated food pipe heal
• treat and help prevent stomach ulcers, including ulcers linked to painkillers called NSAIDs
• clear a stomach infection called H. pylori, together with antibiotics
• manage rare conditions where the stomach makes too much acid, such as Zollinger-Ellison syndrome

Take esomeprazole exactly as your doctor or pharmacist tells you. It is often taken once a day in the morning; some products are best taken about an hour before a meal, so follow your label.

• Swallow tablets or capsules whole with a glass of plain water. Do not chew or crush them.
• If swallowing is difficult, ask your pharmacist whether your product can be opened or dispersed in still water and drunk straight away.
• It may take a few days to start working, so it is not meant for instant heartburn relief.
• If you forget a dose, take it when you remember unless your next dose is close; then skip it. Never take two doses together.
• If you have taken it for a long time, talk to your doctor before stopping, as symptoms can come back.

Side effects are usually mild and may include:

• headache
• feeling or being sick
• diarrhoea or constipation
• tummy pain or wind

Get medical help straight away if you have:

• yellow skin or eyes, pale poo or dark pee
• severe diarrhoea, or diarrhoea that will not stop
• joint pain with a red rash, especially on skin exposed to the sun
• signs of a serious allergic reaction, such as swelling of the lips, tongue or throat, or trouble breathing (call emergency services)

Long-term use can lower magnesium or vitamin B12 levels and may raise the chance of bone fractures. Tell your doctor if you feel very tired, confused, dizzy, shaky, or notice muscle twitches or an irregular heartbeat.

Check with your doctor or pharmacist before taking it if you:

• have ever reacted badly to esomeprazole or another PPI
• have liver problems
• have low magnesium, calcium, potassium or vitamin B12, or weak bones (osteoporosis)
• have lupus
• are due to have an endoscopy
• are pregnant, trying for a baby or breastfeeding
• take other medicines, iron supplements or herbal remedies such as St John's wort

See a doctor before using it if you have unexplained weight loss, trouble swallowing, vomiting blood, black or bloody stools, or chest pain.

Keep it in its original, tightly closed pack at room temperature, away from heat and moisture (not in the bathroom), and out of the reach of children.

Pregnancy: esomeprazole is not usually recommended in pregnancy because there is little information on its safety; your doctor may suggest a different medicine. Ask your doctor before using it while breastfeeding.

Alcohol and food: alcohol does not stop it working but can make acid symptoms worse. Rich, spicy or fatty food, caffeine and fizzy drinks may also worsen symptoms.

Hidden problems: this medicine can mask signs of more serious stomach conditions, so tell your doctor about any new or changing symptoms. If you bought it without a prescription and you are not better after 2 weeks, see a doctor.