Common questions about esomeprazole

Esomeprazole is a type of medicine called a proton pump inhibitor (PPI). Proton pumps are enzymes in the lining of your stomach that help it make acid to digest food.

Esomeprazole prevents proton pumps from working properly. This reduces the amount of acid the stomach makes.

You should start to feel better within 2 to 3 days, but it may take up to 4 weeks for esomeprazole to work fully. You may still have some acid symptoms during this time.

If you bought esomeprazole without a prescription to treat your symptoms and your symptoms are no better after 2 weeks, tell your doctor. They may want to do tests or put you on a different medicine.

If you take esomeprazole for more than 3 months, the levels of magnesium in your blood may fall.

Low magnesium can make you feel tired, confused and dizzy and cause muscle twitches, shakiness and an irregular heartbeat. If you get any of these symptoms, tell your doctor.

Taking esomeprazole for more than a year may increase your chances of certain side effects, including:

• bone fractures
• gut infections
• vitamin B12 deficiency – symptoms include feeling very tired, a sore and red tongue, mouth ulcers and pins and needles

If you take esomeprazole for longer than 1 year, your doctor will regularly check your health to see if you should carry on taking it.

It's not known if esomeprazole works less well the longer you take it. If you feel like it is not working any more, talk to your doctor.

There is some research to suggest that taking medicines to reduce stomach acid, like PPIs and H2 blockers, may slightly increase the chance of developing stomach cancer. It also suggested that it could be more likely in people taking them for longer than 3 years.

However, studies involving more people need to be done to be sure that PPIs and H2 blockers cause stomach cancer, rather than something else causing it.

PPIs, like most medicines, have side effects so it's best to take them for the shortest time possible.

And it's important to speak to your doctor if you notice any of these symptoms which can be signs of stomach cancer:

• having problems swallowing (dysphagia)
• feeling sick or being sick
• feeling full very quickly when eating
• losing weight without trying to

Speak to your doctor or pharmacist if you are concerned.

Usually, you can stop taking esomeprazole without reducing your dose first.

But if you've been taking esomeprazole for a long time speak to your doctor before you stop taking it. Stopping suddenly could make your stomach produce a lot more acid, and make your symptoms come back.

Reducing the dose gradually before stopping completely will prevent this happening.

Sometimes, if esomeprazole is not working or does not agree with you, your doctor may suggest that you try taking another proton pump inhibitor.

There are other prescription medicines and ones you can buy that treat indigestion and heartburn.

Antacids, like calcium carbonate (Tums), sodium bicarbonate, Maalox and Milk of Magnesia, relieve indigestion and heartburn by reducing the damage that acid can do to your stomach. They give quick relief that lasts for a few hours. They're ideal for occasional stomach acid symptoms.

Some antacids, such as Gaviscon, have an extra ingredient called alginic acid. They work by making a lining so juices from your stomach do not splash up into your food pipe. They're especially good for relieving acid reflux.

Antacids are available from pharmacies and supermarkets.

Histamine antagonists (also known as H2 blockers) reduce the amount of acid made in your stomach, but they do this in a different way to proton pump inhibitors. They include famotidine (Pepcid), cimetidine (Tagamet) and nizatidine.

You can buy famotidine and nizatidine without a prescription from pharmacies.

In general, proton pump inhibitors (PPIs) like esomeprazole are used first because they are better than H2 blockers at reducing stomach acid. But if a PPI does not work or causes side effects, your doctor may prescribe a H2 blocker.

Other proton pump inhibitors are:

• lansoprazole
• omeprazole
• pantoprazole
• rabeprazole

They all work in the same way as esomeprazole by reducing acid in your stomach. They generally work as well as esomeprazole and have similar side effects, but may be given in different doses.

You can take esomeprazole with an antacid such as Gaviscon if you need to.

Esomeprazole does not affect any type of regular contraception including the combined pill and the progestogen-only pill. It may reduce the effectiveness of one type of emergency contraception called ellaOne (ulipristal), so a different emergency contraceptive may be recommended instead.

If using esomeprazole makes you vomit or have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Check the pill packet to find out what to do.

Find out more:

• What to do if you're sick or have diarrhoea when taking the combined pill
• What to do if you're sick or have diarrhoea when taking the progestogen-only pill

Occasionally, esomeprazole can make you feel dizzy, sleepy, or cause blurred vision. If this happens to you, do not drive, cycle or use machinery or tools until you feel better.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking esomeprazole. GOV.UK has more information on the law on drugs and driving.

Alcohol does not affect the way esomeprazole works, but it makes your stomach produce more acid than normal. This can irritate your stomach lining and make your symptoms worse.

You can eat and drink normally while taking esomeprazole. However, it's best to avoid foods that seem to make your indigestion worse – things like rich, spicy and fatty foods.

Try to cut down on caffeinated drinks, such as tea, coffee and cola. Reduce or try to avoid alcohol.

It may be possible to ease symptoms caused by too much stomach acid by making a few changes to your diet and lifestyle:

• maintain a healthy weight by eating healthily
• do not eat foods that can make your symptoms worse, such as rich, spicy and fatty foods, and acidic foods like tomatoes, citrus fruits, salad dressings and fizzy drinks
• try to cut down on caffeinated drinks, such as tea, coffee and cola, as well as alcohol and smoking
• if you have symptoms at night, try not to eat for at least 3 hours before you go to bed
• prop your head and shoulders up when you go to bed. This can stop stomach acid coming up while you sleep