How to Take Nexium: Side Effects, Dosage
How to take Nexium (esomeprazole): dosage, common side effects, and precautions for heartburn and acid reflux management.
Not medical advice. Speak with a healthcare professional before using any medication.
Reviewed by:
Updated Feb, 15
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Information sourced from FDA-approved prescribing information and peer-reviewed medical references.
How to Take Nexium
How to Take Nexium (esomeprazole)
Per OTC labeling, the following reflects standard label instructions for Nexium (esomeprazole). For prescription use, follow your prescriber's specific directions.
- Per OTC labeling, take it before eating — ideally at least 1 hour before a meal.
- Per OTC labeling, swallow capsules whole with a glass of water. Do not crush or chew.
- Per OTC labeling, if you cannot swallow capsules:
- Open the capsule and sprinkle the granules on 1 tablespoon of applesauce.
- Swallow immediately without chewing.
- Per OTC labeling, adults generally take 20 mg once daily for up to 14 days for frequent heartburn, unless directed otherwise by a clinician.
- Per FDA-approved prescribing information, teens 12–17 years:
- Mild GERD: 20 mg once daily
- Erosive esophagitis: 20–40 mg once daily
- Per FDA-approved prescribing information, children 1–11 years:
- Weight under 20 kg (44 lb): 10 mg once daily
- Weight 20 kg (44 lb) or more: 10–20 mg once daily
- Per OTC labeling, liquid Nexium (packets for suspension) should be mixed with water only, stirred well, and taken promptly.
- Per OTC labeling, if you miss a dose: take it when you remember unless it is close to the next scheduled dose. In that case, skip the missed dose — do not double up.
- Per OTC labeling, take it at the same time each day for consistent acid control.
Warnings Before Taking Nexium
Per OTC labeling, tell your doctor if you have liver disease or known low magnesium levels before use.
Per OTC labeling, report a history of osteoporosis or bone fractures to your clinician.
Per OTC labeling, inform your clinician if you take medicines such as warfarin, digoxin, or HIV treatments, as interactions may occur.
Per OTC labeling, seek medical evaluation if you have persistent vomiting, unexplained weight loss, or trouble swallowing before using this product.
Nexium Side Effects
Common
Mild
Headache
Per OTC labeling, headache is a commonly reported adverse effect of esomeprazole.
Per OTC Drug Facts labeling. If symptoms persist or worsen, stop use and consult a healthcare provider.
Normally lasts for:
2–12 hours
Common
Mild
Abdominal Pain
Per OTC labeling, mild stomach discomfort or cramping may occur with esomeprazole use.
Per OTC Drug Facts labeling. If symptoms persist or worsen, stop use and consult a healthcare provider.
Normally lasts for:
1–6 hours
Common
Mild
Diarrhea
Per OTC labeling, loose stools or diarrhea have been reported with esomeprazole use. Maintaining adequate hydration is recommended.
Per OTC Drug Facts labeling. If symptoms persist or worsen, stop use and consult a healthcare provider.
Normally lasts for:
4–12 hours
Common
Mild
Nausea
Per OTC labeling, nausea has been reported with esomeprazole use, particularly when first starting treatment.
Per OTC Drug Facts labeling. If symptoms persist or worsen, stop use and consult a healthcare provider.
Normally lasts for:
1–4 hours
Uncommon
Mild
Constipation
Per OTC labeling, constipation is a less common reported adverse effect of esomeprazole.
Per OTC Drug Facts labeling. If symptoms persist or worsen, stop use and consult a healthcare provider.
Normally lasts for:
6–24 hours
Common
Mild
Gas or Bloating
Per OTC labeling, changes in gastric acid levels may lead to increased gas or bloating in some patients.
Per OTC Drug Facts labeling. If symptoms persist or worsen, stop use and consult a healthcare provider.
Normally lasts for:
1–6 hours
Contact Us for a Personalized Care Plan
Have questions about compounding? Contact Voshell's Pharmacy — we prepare patient-specific medications pursuant to valid prescriptions from your licensed prescriber.
What If You Forgot to Take Nexium
What If You Forgot to Take Nexium?
Per OTC labeling, if you miss a dose, take it as soon as you remember, unless you are already close to the time for your next scheduled dose. In that case, skip the missed dose and return to your usual schedule.
Per OTC labeling, do not take two doses at the same time. Contact your clinician or pharmacist if you have questions about your dosing routine.
What If You Took Too Much Nexium
What If You Took Too Much Nexium?
Contact Poison Control at 1-800-222-1222 right away. For children or if a large amount was taken, seek urgent medical care immediately.
- Do not take additional doses until you have spoken with Poison Control or a clinician.
- If symptoms such as unusual dizziness, persistent vomiting, or other serious effects occur, seek emergency medical care.
- Keep this and all medications out of reach of children.
How Much Does Nexium Cost
Nexium Cost With Insurance
The cost of Nexium with insurance varies depending on your plan's formulary, tier placement, and whether generic esomeprazole or brand-name Nexium is dispensed.
- Generic esomeprazole is typically placed on a lower formulary tier than brand-name Nexium.
- Brand-name Nexium may be placed on a higher tier with a higher patient cost-share.
Contact your insurer or pharmacist for current formulary information and estimated out-of-pocket costs specific to your plan.
How Much Does Nexium Cost without Insurance
Nexium Cost Without Insurance
Nexium is available in both brand-name and generic (esomeprazole) forms. Cash-pay prices vary by dose, quantity, and pharmacy.
- Generic esomeprazole is typically available at lower cash-pay prices than brand-name Nexium.
- Prices vary by pharmacy location, quantity dispensed, and any applicable discount programs.
Contact your local pharmacy for current cash pricing. Discount programs offered by pharmacy chains and third-party services may reduce out-of-pocket costs.
