Nexium Side Effects

Nexium side effects and drug information

Nexium or esomeprazole magnesium is a PPI or proton pump inhibitor that helps in decreasing the acid’s measure inside the stomach. This inhibitor has been used to provide aid for the different symptoms of gastroesophageal reflux disease (GERD). Nexium can also treat some other conditions that involve excessive acid in the stomach like Zollinger-Ellison syndrome.

Drug ClassProton Pump Inhibitors
ChEMBL Id1201320
ChemSpider ID7843323
CAS ID161796-78-7
Molar mass345.417 g/mol
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Other medical professionals prescribe Nexium to treat erosive esophagus, prevent the development of gastric ulcer that is commonly caused by infection, and it is partnered with Helicobacter pylori or by using nonsteroidal anti-inflammatory drugs. 

If you experience various symptoms of heartburn, Nexium is not an immediate solution for your condition.

Important Information About Nexium

Before you start taking Nexium, you have to know the following important information about this inhibitor:

  • This inhibitor may begin the development of kidney problems. When you notice blood in your urine, or you are urinating less than usual.
  • One of the signs of new infection while taking Nexium is diarrhea. If you experience this, you need to tell your doctor immediately.
  • When you are taking Esomeprazole, it may cause new symptoms of lupus, or worsen your existing symptoms. If you experience joint pain and skin rashes on cheeks or arms that get worse with exposure to sunlight, tell your doctor immediately.
  • You have a high chance of developing broken bones if you take this medicine for a long time, or you take it two or more times in a day.
  • Never take Nexium if you have an allergy to medicines such as Esomeprazole, lansoprazole, omeprazole, pantoprazole, or rabeprazole.
  • If you often experience heartburn, it may be an early sign of a heart attack. When you feel chest pain that goes to your shoulder or jaw, and you feel light-headed or anxious, seek emergency medical help immediately.

Side Effects

This proton pump inhibitor is used to treat various stomach and duodenal ulcers, Zollinger-Ellison syndrome, and gastroesophageal reflux disease (GERD). But like any other medication, some of the side-effects that you need to know are:

The patient’s dosage will depend on his condition. There are necessary laboratory exams and medical tests that anyone must undergo so the doctor can determine the right dose of Nexium. If the patient is pregnant, this inhibitor must only be used if it is needed. For those breastfeeding mothers, they have to decide whether to stop breastfeeding or stop taking this drug to avoid other complications for both the mother and the baby. 

Dosage and Administration

The Nexium I. V. for injection must not be given accompanied by other medicines through the same site or/and tubing. The intravenous line used for a patient must be flushed with either USP, 0.9% Sodium Chloride Injection, USP or 5% Dextrose Injection, Lactated Ringer’s Injection, USP for both before and after Nexium I. V. for injection has been administered. 

When oral therapy can be given to the patient, the administration of NEXIUM I.V. for Injection must be discontinued, and the medication can be continued orally.

GERD with Erosive Esophagitis

For adults, the recommended dosage is 20mg or 40mg of Nexium, and it must be given once a day by intravenous injection (must be less than 3 minutes) or intravenous infusion (between 10 to 30 minutes). When the patient has a mild to moderate liver impairment, adjustment of dosage must not be made. While with those patients who have severe liver impairment, the maximum dosage must be 20mg each day. 

For patients with age one month up to 17 years, the specific dosage for different age bracket are shown below:

  • Bodyweight less than 55 kg: 10 mg
  • Bodyweight 55 kg or greater: 20 mg
  • One month to less than one year of age: 0.5 mg/kg

Risk Reduction Of Rebleeding Of Gastric Or Duodenal Ulcers Following Therapeutic Endoscopy In Adults

For adult patients, the recommended dosage is 80mg, and it must be administered through intravenous infusion that will last up to 30 minutes. This must be followed by a consecutive infusion of 8mg every hour. The total duration of the treatment will be 72 hours. Intravenous therapy is administered during the acute initial management of bleeding duodenal or gastric ulcer, and it is not the solution for full treatment. Every Intravenous therapy must be accompanied by oral acid-suppressive therapy. For every patient who has liver problems, there is no adjustment needed when given the initial esomeprazole 80mg. For the patient with mild to a moderate liver problem, the infusion of Esomeprazole should not exceed with 6mg per hour. 

Drug Interaction

When you have received direct instruction from your doctor before using Nexium, he may have discussed the possible drug interaction of this medication. Your doctor will closely monitor your condition. It is not recommended to start or stop taking Nexium or change your medication dosage without consulting your doctor.

Nexium has severe interactions with the following:

  • erlotinib
  • nelfinavir
  • rilpivirine

Nexium has serious interactions with the following:

  • secretin
  • acalabrutinib
  • capecitabine
  • ledipasvir/velpatasvir
  • clobazam
  • methotrexate
  • citalopram (>20mg)
  • clopidogrel
  • posaconazole suspension
  • selected kinase inhibitors

Nexium has moderate interactions with the following:’

  • select CYP2C19 AND CYP3A4 inducers
  • omeprazole/carbamazepine
  • cilostazol (<=50mg)
  • escitalopram (<= 15 mg)
  • saquinavir
  • escitalopram (> 15 mg)
  • selected cephalosporins
  • citalopram (<= 20 mg)
  • tacrolimus
  • mycophenolate mofetil
  • methotrexate(low strength injection, oral)
  • raltegravir
  • amphetamines
  • itraconazole; ketoconazole

Warnings and Precautions

Right here are some warnings and precautions that you need to remember when taking Nexium:

  1. Bone Fracture – some studies showed that taking Nexium can increase your risk with hip, wrist, or spine fracture. The risk is even higher for those who are taking high-dose of this medication, patient who takes multiple doses in a day, and those who are taking the medication for long-term (more than a year therapy). 
  2. Clostridium Difficile-Associated Diarrhea – many PPI therapy such as Nexium can develop a higher risk of Clostridium difficile-associated diarrhea. This is most common for patients who are staying in the hospital. 
  3. Gastric Malignancy – for adults, early symptoms as a response to the NEXIUM I.V. therapy does not conclude the gastric malignancy condition. A patient must undergo follow-up checkups and medical examinations to confirm the case.
  4. Clopidogrel Interaction – when a patient is taking Nexium, it is not recommended to take it with clopidogrel because Nexium can impair the active metabolite of clopidogrel. 
  5. Hypomagnesemia – though this condition rarely happens for patients who had been treated with PPI, it is possible to develop Hypomagnesemia for those who are taking Nexium. For many patients, the treatment for Hypomagnesemia must be done with magnesium replacement, and the use of PPI must be stopped.
  6. Acute Interstitial Nephritis – this condition has been observed in patients who are taking PPIs, including NEXIUM I.V. The Acute interstitial nephritis can happen to a patient at any point while undergoing PPI therapy. It is commonly related to an idiopathic hypersensitivity reaction. When acute interstitial nephritis has been diagnosed, the administration of NEXIUM I.V. must be stopped immediately. 

There are other health problems and complications that could be developed when a person is taking Nexium. That’s why it is recommended that you have close monitoring together with your doctor to ensure that your medication is working well.

Overdose and Contraindications

A patient who is overdosed with Nexium will show the following conditions:

  • confusion
  • drowsiness
  • vision problems
  • nausea
  • sweating and flushing
  • headache
  • dry mouth
  • rapid heartbeat

If you experience one or more of this condition after taking Nexium, you have to call your doctor and seek emergency medical attention. 

The contraindication of Nexium is hypersensitivity to Esomeprazole or any other proton type inhibitors (PPI).

Clinical Pharmacology

Nexium, or often referred to as Esomeprazole, is a PPI that is used to suppress the secretion of gastric acid by particular inhibition of the H+/K+- ATPase. This medication blocks the end step in acid production by acting on the proton pump. This will reduce gastric acidity. 

Medication Guide

A patient who is taking Nexium is advised to contact his doctor and discuss his condition if he experiences one or more of these signs and symptoms consistently:

  • Hypersensitivity Reactions 
  • Acute Interstitial Nephritis
  • Clostridium difficile-Associated Diarrhea 
  • Bone Fracture
  • Cutaneous and Systemic Lupus Erythematosus
  • Hypomagnesemia 

As part of every patient’s responsibility, you must inform your doctor of any medical professional if you will take other medication aside from Nexium because this medicine can change the effect of other drugs in your body. Or worse, it can cause other complications that you are not aware of. Here are the other administration guides about Nexium:

  • The patient must know that antacids can be administered while using Nexium.
  • When the patient experiences diarrhea that doesn’t improve for days, he must report to his doctor immediately and seek the needed medical help. It can be a sign of Clostridium difficile-associated diarrhea.
  • When the patient experiences any neurological or cardiovascular symptoms such as seizures, dizziness, palpitations, and tetany, he must report to his doctor immediately and seek the needed medical help. These are the possible signs of Hypomagnesemia and must be addressed immediately.