Nexium contains the active ingredient esomeprazole magnesium in the form of a magnesium dihydrate. It is classified as a proton pump inhibitor (PPI). The medication is available as delayed-release capsules with strengths of 20 mg and 40 mg, intended for oral administration. Key inactive ingredients include diglycerin, hypromellose, and magnesium stearate.

How should I use this medication?

Take this medication by mouth. Take it as directed on the prescription label at the same time every day. Empty the contents of 1 packet into a container of water. The package your medication comes in will tell you how much water to use. Stir gently and allow 2 to 3 minutes to thicken. Stir again and drink the medication. Drink it within 30 minutes after mixing. If any medication remains after drinking, add more water, stir, and drink at once. Take this medication at least 1 hour before meals. Do not take it more often than directed. A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time. Talk to your care team about the use of this medication in children. While it may be prescribed for children as young as 1 month for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once. NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Where should I keep my medication?

Keep out of the reach of children. Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from light and moisture. Throw away any unused medication after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible: -Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat -Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet -Low magnesium level—muscle pain or cramps, unusual weakness or fatigue, fast or irregular heartbeat, tremors -Low vitamin B12 level—pain, tingling, or numbness in the hands or feet, muscle weakness, dizziness, confusion, difficulty concentrating -Rash on cheeks or arms that gets worse in the sun -Redness, blistering, peeling, or loosening of the skin, including inside the mouth -Severe diarrhea, fever -Unusual bruising or bleeding Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome): -Diarrhea -Dry mouth -Gas -Headache -Nausea

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions: -Liver disease -Low levels of calcium, magnesium, or potassium in the blood -Lupus -An unusual or allergic reaction to esomeprazole, other medications, foods, dyes, or preservatives -Pregnant or trying to get pregnant -Breast-feeding

What may interact with this medication?

Do not take this medication with any of the following: -Atazanavir -Clopidogrel -Nelfinavir -Rilpivirine This medication may also interact with the following: -Certain antivirals for HIV or hepatitis -Certain medications that treat or prevent blood clots, such as warfarin -Certain medications for fungal infections, such as itraconazole, ketoconazole, and voriconazole -Cilostazol -Citalopram -Dasatinib -Digoxin -Diuretics -Erlotinib -Iron supplements -Medications for anxiety, panic, and sleep, such as diazepam -Medications for seizures, such as carbamazepine, phenobarbital, phenytoin -Methotrexate -Mycophenolate mofetil -Nilotinib -Rifampin -St. John's wort -Tacrolimus

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

It can take several days before your stomach pain gets better. Check with your care team if your condition does not start to get better, or if it gets worse. Do not treat diarrhea with over the counter products. Contact your care team if you have diarrhea that lasts more than 2 days or if it is severe and watery. You may need blood work done while you are taking this medication. Using this medication for a long time may weaken your bones. The risk of bone fractures may be increased. Talk to your care team about your bone health. Using this medication for a long time may cause growths (polyps) in the stomach. They usually don't cause any symptoms. They are usually not cancerous. Contact your care team if you notice pain or tenderness when you press your stomach, have nausea, or see bloody or black, tar-like stools. This medication may cause a decrease in vitamin B12. You should make sure that you get enough vitamin B12 while you are taking this medication. Discuss the foods you eat and the vitamins you take with your care team.