Nexium 24 hr (Esomeprazole) 20 mg – 14 Tablets
Once-daily proton pump inhibitor for rapid relief and maintenance of acid-related digestive disorders

Esomeprazole 20 mg (magnesium salt)

Also known as esomeprazole magnesium, S-isomer of omeprazole, or Nexium 24 hr delayed-release Tablet

Proton Pump Inhibitor (PPI)

OTC in many countries (Australia, UK, US) for 24-hour heartburn relief; prescription use for more serious acid-related conditions

Esomeprazole irreversibly blocks the H⁺/K⁺-ATPase pump in gastric parietal cells, reducing both basal and stimulated gastric acid secretion. Acid suppression lasts beyond 24 hours due to irreversible binding

OTC relief of frequent heartburn (≥2 times/week)

Prescriptions uses include GERD, erosive esophagitis, gastric and duodenal ulcers, NSAID-associated ulcers, H. pylori eradication (with antibiotics), Zollinger-Ellison syndrome
mayoclinic.org

20 mg once daily with or without food, preferably in the morning .

Higher doses (20–40 mg) may be prescribed for GERD or ulcer treatment for 4–8 weeks; maintenance therapy remains at 20 mg daily

For H. pylori eradication: 20 mg twice daily with amoxicillin and clarithromycin for 7 days

For Zollinger-Ellison: start at 40 mg twice daily; adjust as needed

Administration Tips: Swallow Tablets whole or disperse granules in ≥30 mL water taken shortly after reformulation; do not crush .

Common (>1%):

Headache, abdominal pain, diarrhea, nausea, flatulence, constipation, dry mouth

Serious/Long-term (>1 year use):

C. difficile–associated diarrhea; increased risk of bone fractures; low magnesium and vitamin B12 deficiency; fundic gland polyps; lupus-like symptoms, acute kidney injury, seizures

Severe allergic reactions, acute interstitial nephritis, angioedema
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Not for undiagnosed persistent dysphagia, bleeding, or severe abdominal symptoms

Long-term PPI use (>1 year) needs monitoring for mineral deficiencies and fracture risk

Stop 14 days before neuroendocrine tumor testing (CgA)

Caution with St. John's Wort, rifampin, methotrexate, digoxin due to altered metabolism or efficacy
accessdata.fda.gov

Affects CYP2C19 and CYP3A4 metabolisms, altering levels of warfarin, diazepam, clopidogrel (reduced activation), ketoconazole, atazanavir, benzodiazepines, methotrexate

May impair absorption of drugs needing acidic stomach (e.g., iron, B12, itraconazole) .

Feature Detail
Generic Name Esomeprazole magnesium 20 mg delayed-release Tablet
Form Film-coated Tablet
Class Proton Pump Inhibitor (PPI)
Regimen 14-day OTC pack; longer Rx courses available
Status OTC for heartburn; Rx for acid-related disorders

Frequently Asked Questions
Q1. How soon does Nexium 24 hr work?
A1. Provides substantial relief in 1–4 days; full effect may take 3–4 weeks for GERD/ulcers

Q2. Can I use it with antibiotics for ulcers?
A2. Yes, 20 mg twice daily with amoxicillin and clarithromycin is standard 7-day therapy

Q3. Is it safe for long-term use?
A3. Generally safe under supervision, but monitor calcium, magnesium, vit B12, bone health if >1 year .

Q4. What if I miss a dose?
A4. Take as soon as remembered, unless next dose is near; do not take double dose .

Q5. Is Nexium better than Prilosec?
A5. Both are effective PPIs, but Meta-analyses suggest esomeprazole may offer marginally faster healing in severe GERD

What is Nexium 24 hr used for?
Nexium 24 hr (Esomeprazole) 20 mg is a once-daily PPI that relieves frequent heartburn, treats GERD and ulcers, and can heal esophagitis. For H. pylori, it’s taken twice daily with antibiotics. Use is usually 14 days for OTC or longer with a physician.

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