Esomeprazole (patient information)

# Why this medication is prescribed
Esomeprazole is used to treat gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and injury of the esophagus (food pipe between the mouth and stomach). Esomeprazole is used to treat the symptoms of GERD, allow the esophagus to heal, and prevent further damage to the esophagus. It is also used with other medications to prevent stomach ulcers. Esomeprazole is in a class of medications called proton pump inhibitors. It works by decreasing the amount of acid made in the stomach.

# How this medication should be used
Esomeprazole comes as a delayed-release (long-acting) capsule to take by mouth. It is usually taken once a day at least one hour before a meal. To help you remember to take esomeprazole, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take esomeprazole exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow the capsules whole; do not split, chew, or crush them. If you cannot swallow the capsule, put one tablespoon of cool, soft applesauce in an empty bowl. Open one esomeprazole capsule and carefully sprinkle the pellets onto the applesauce. Mix the pellets with the applesauce, and swallow the entire tablespoonful of the applesauce and pellet mixture immediately. Do not chew the pellets in the applesauce. Do not save the pellets and applesauce for later use.
Your doctor will tell you how long you will need to take esomeprazole. If you are taking esomeprazole for GERD, you may take it for 4-8 weeks or longer. If you are taking esomeprazole to treat an ulcer, you may take it with other medications for 10 days.
Your doctor will tell you how long it will take to feel the full benefit of esomeprazole. Call your doctor if your symptoms worsen or do not improve during this time. Continue to take esomeprazole even if you feel well. Do not stop taking esomeprazole without talking to your doctor.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# Special precautions
Before taking esomeprazole:
- tell your doctor and pharmacist if you are allergic to esomeprazole, lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (AcipHex), or any other medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention anticoagulants ('blood thinners') such as warfarin (Coumadin). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- If you are taking digoxin (Lanoxin, Lanoxicaps), iron supplements, vitamins that contain iron, or ketoconazole (Nizoral), you should take these medications at least 2 hours before taking esomeprazole.
- tell your doctor if you have or have ever had liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking esomeprazole, call your doctor.
- You may take antacids with esomeprazole. If you feel you need an antacid, ask your doctor to recommend one and to tell you when and how to take it.

# Special dietary instructions
Talk to your doctor about your diet. Some foods and drinks can make your symptoms worse. Your doctor can tell you which foods and drinks you should avoid or eat/drink only in small quantities.

# What to do if you forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# Side effects

## Minor side effects
Esomeprazole may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- headache
- diarrhea
- upset stomach
- gas
- stomach pain
- constipation
- dry mouth

## Severe side effects
Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:
- hives
- skin rash
- itching
- difficulty breathing or swallowing
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- hoarseness
Esomeprazole may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
Some patients who took a medication similar to esomeprazole for a long time developed a condition in which the stomach muscles weaken and shrink. It is not known if taking esomeprazole increases your risk of developing this condition. Laboratory animals who were given esomeprazole developed stomach tumors. It is not known if esomeprazole increases the risk of tumors in humans. Talk to your doctor about the risks of taking esomeprazole.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online  or by phone .

# Storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
- confusion
- drowsiness
- blurred vision
- fast heartbeat
- upset stomach
- sweating
- flushing
- headache
- dry mouth

# Other information
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Nexium