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Aug 9, 2022

Gut Health

Most Commonly Asked Questions About Esomeprazole

How Does Esomeprazole Work?

Esomeprazole is a medication called a proton pump inhibitor (PPI). These medications work by inhibiting (stopping) the pump that usually releases acid into the stomach, thereby reducing the amount of acid in your stomach. This is different from something like an antacid, that works to neutralize the acid that has already been released. There are many medical conditions that are caused or exacerbated by stomach acid, so stopping this pump is often beneficial.

What Conditions does Esomeprazole Treat?

  1. GERD
  2. NSAID-induced stomach ulcer prevention
  3. H. pylori-induced duodenal ulcer treatment
  4. Hypersecretory conditions

GERD is a condition where the acidic contents of your stomach come back up and burn your throat. This is uncomfortable, damaging, and can even lead to another condition called “erosive esophagitis”. Erosive esophagitis is damage to the sensitive lining of your throat caused by recurrent exposure to the acid from your stomach.

Ulcers are another serious condition that esomeprazole is prescribed to prevent and/or treat. Ulcers are sores in your digestive system that can be very painful and dangerous. The two most common causes of ulcers are the continuous use of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, or an infection in your digestive system from the bacteria Helicobacter pylori. There is usually a thick lining of mucus covering the tissue in your stomach, so the tissue does not get damaged by the extremely acidic stomach acid. However, NSAIDs and H. pylori can chew away at this lining. Without this protective layer, the acid in the stomach reaches the tissue below and causes damage in the form of an ulcer.

PPIs, like esomeprazole, are prescribed to reduce the stomach acid and therefore, allow the ulcer to heal without being further irritated. Importantly, while reducing stomach acid production helps, the root cause must also be addressed when treating an ulcer. For an NSAID-related ulcer, the NSAID dose must be reduced or, preferably, stopped altogether and switched to another painkiller such as acetaminophen. Additionally, esomeprazole can be prescribed alongside a course of NSAIDs if a patient is at particular risk of developing an ulcer.

For an H. pylori-caused ulcer, you would be prescribed 2–3 antibiotics alongside a PPI, such as esomeprazole, to treat the underlying bacterial cause.

Hypersecretory conditions occur when your body makes too much stomach acid, leading to ulcers, GERD, or even bleeding in your digestive system. Esomeprazole decreases some of that acid production and therefore prevents some of this possible damage.

What are The Most Common Side Effects?

Side effects with esomeprazole are usually mild. Everyone reacts slightly differently when taking this medication, so you may experience none, some, or all side effects. The most common side effects you may experience while on esomeprazole are:

  • Nausea
  • Stomach upset
  • Diarrhea
  • Headache

This is not an exhaustive list, and if you experience anything abnormal while taking esomeprazole, be sure to discuss it with your healthcare provider.

Can I Take Esomeprazole While Pregnant or Breastfeeding?

This is something that your healthcare provider will decide. Some animal studies have shown toxicity to the fetus when esomeprazole was given at very high doses (much higher than would be prescribed to a human) throughout the pregnancy. Animal data isn’t always transferable to humans, so the actual dangers to a human fetus are unknown. However, because of this possible risk it’s usually recommended to avoid esomeprazole if pregnant.

Esomeprazole has been found to be present in breastmilk, and it’s difficult to know exactly how much of the medication the infant is getting. Because of this, it’s best to avoid taking esomeprazole while breastfeeding.

When pregnant, planning to become pregnant, or breastfeeding, speak with your healthcare provider and they will weigh the possible risks versus benefits of staying on esomeprazole.

What If I am Taking Other Medication?

There are many medications that require extra attention when taken alongside esomeprazole. Sometimes combining medications can change how our bodies process the medications and this can change the effectiveness of a medication, making it too weak, or too strong. If too weak the drug may not work, and if too strong, this can lead to adverse side-effects.

Some of the most common and potentially serious medications that interact with esomeprazole include:

  • HIV medications (rilpivirine, atazanavir, nelfinavir, saquinavir)
  • Digoxin
  • Clopidogrel
  • Methotrexate
  • St. John’s Wort (an herbal supplement)

Your healthcare provider can identify if any of the prescription medications, over-the-counter medications, vitamins, or supplements you take can interact with esomeprazole. Be sure to tell your healthcare provider about everything you take. They may need to adjust your medication routine to ensure your safety.

Is it Safe to Take Esomeprazole Long-term?

There are risks involved with taking esomeprazole for an extended period of time. Although it’s beneficial for conditions like GERD for the stomach acid to be suppressed, there are also benefits to having that acid. Therefore, when you’re reducing that acid for a very long period of time, there are potential risks to your health.

The most well-studied risk is the possibility of developing a vitamin or mineral deficiency. Some vitamins and minerals require the acidic environment of the stomach to be released from food and/or absorbed into the body. With long-term acid suppression, you can actually develop deficiencies in vitamin B12, calcium, and magnesium. This has dangers such as an increased likelihood of developing osteoporosis, irregular heartbeat, and eye damage.

Treating these conditions is relatively straightforward, with an increase in the amount of these vitamins and minerals you consume in the form of foods and/or supplements. However, it’s also an option to avoid these conditions by limiting the amount of time you remain on PPIs, if possible.

There are a number of other possible conditions linked the use of PPIs long-term. However, the link between these conditions and PPI use is not conclusive, and therefore the actual risk is somewhat unknown.

Learn more about the possible health risks involved with taking PPIs long-term.

How Should I Take Esomeprazole?

Take esomeprazole exactly as directed. You may take one or two doses per day, and it’s important to ensure you’re taking the medication at the same time(s) each day. You should take esomeprazole with plenty of water, and it can be taken with or without food.

If you miss a dose, take your missed medication as soon as you remember. However, if more than 12 hours have passed since your last dose (or 6 hours if you have twice daily dosing), skip the dose. Do not take double your dose at one time.

How Much Does Esomeprazole Cost?

At Marley Drug, you can get your esomeprazole prescription at $37 for a 6-month supply, or only $70 for a full 12-month supply. That’s less than $6 a month! We also provide free shipping with our 6- and 12- month supplies, so your medication gets delivered right to your door in 2–3 business days for no extra costs.

Why are our prices so low? We provide wholesale prices, which means our medications are priced based on what it costs us to buy them, not by the price decided by your insurance.

By purchasing our medications directly from accredited wholesalers, we cut out the insurance company middlemen who usually push up the costs of drugs with their unpredictable “service fees”. Because of this, our prices are competitive and often better than most insurance plans.

Learn more about how you can save money by buying more esomeprazole

  1. e-CPS: The Compendium of Pharmaceuticals and Specialties: The Canadian Drug Reference for Health Professionals (https://www-e-therapeutics-ca). Accessed 2022-07-04.
  2. Nexium (esomeprazole) – Access data FDA-Approved Drugs [Internet]. [amended 12/2014; accessed 06/2022].
  3. Koyyada, A. (2021). Long-term use of proton pump inhibitors as a risk factor for various adverse manifestations. Therapies, 76(1), 13-21. doi: 10.1016/j.therap.2020.06.019
  4. Nehra, A., Alexander, J., Loftus, C., & Nehra, V. (2018). Proton Pump Inhibitors: Review of Emerging Concerns. Mayo Clinic Proceedings, 93(2), 240-246. doi: 10.1016/j.mayocp.2017.10.022

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