Esomeprazole - oral

Esomeprazole is a gastric medicine.

It is used to treat conditions caused by excessive acidity in your stomach, such as ulcers in the stomach or duodenum (upper portion of the small intestine), reflux disease (also known as "heartburn", a condition described as a burning pain in your chest caused by food or acid from your stomach that backs up into your mouth), and Zollinger-Ellison syndrome (tumour growth in the pancreas or duodenum which causes the secretion of too much stomach acid).

This medicine is also used in the treatment or prevention of stomach or duodenum ulcers associated with nonsteroidal anti-inflammatory drugs (medicines for pain and inflammation).

Esomeprazole treats these conditions by reducing the amount of acid your stomach makes.

This medicine may also be used together with other medicines to treat a specific type of stomach problem caused by the Helicobacter pylori bacteria.

Esomeprazole may be used to treat other conditions as decided by your doctor.

Take Esomeprazole exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

Ask your doctor or pharmacist about whether you should take this medicine with or without food. Different brands of this medicine may be taken differently.

Try to take it at the same time each day.

This medicine is available as a gastro-resistant or delayed-release capsule or tablet and granules for oral suspension.

If you are taking the gastro-resistant capsule or tablet, swallow it whole with a glass of water. Do not chew or crush the capsule or tablet. If you have trouble swallowing, you may disperse the capsule or tablet in half a glass of non-carbonated ("non-fizzy") water and stir until the capsule or tablet disintegrates, then drink the liquid with the granules or pellets immediately or within 30 minutes. The granules or pellets must also not be chewed or crushed.

If you are taking the delayed-release capsule, swallow it whole. Do not chew or crush the capsule. If you have trouble swallowing, you may open the capsule and mix the contents with applesauce, then swallow the mixture immediately. The mixture must also not be chewed, crushed, or warmed.

If you are taking the granules for oral suspension, empty the contents of the packet into a container containing the appropriate amount of water indicated on the label. Stir the mixture and leave it for 2-3 minutes to thicken, then stir and drink within 30 minutes. If any contents remain after consuming, add more water and drink immediately.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the type and severity of your condition.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Do not take Esomeprazole with medicines for HIV infection, such as nelfinavir and rilpivirine.

Inform your doctor if you have the following conditions:

• cobalamin (vitamin B₁₂) deficiency
• at risk of osteoporosis (thinning and weakening of bones)
• liver disease
• severe kidney disease

Let your doctor know if you are pregnant or breastfeeding.

Be sure to check with your doctor or pharmacist before giving Esomeprazole to a child. Children may be more sensitive to the side effects.

If your gastric problem seems to be getting worse, let your doctor know.

If you are going to have certain laboratory tests (e.g. chromogranin A), inform your doctor that you are taking this medicine.

For as long as you are taking this medicine, you may need to have regular blood tests to check your body's response to the medicine. Your doctor will advise you about how often you need to have blood tests.

Esomeprazole may cause any of the following side effects: headache, nausea, vomiting, dry mouth, diarrhoea, constipation, stomach pain and wind, and dizziness with or without sensations of spinning.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• rashes with peeling of the skin or blistering of the lips, mouth or eyes accompanied by fever
• mood changes, confusion, muscle pain, cramps, or spasms, weakness, fits or seizures
• unable to pass urine, change in how much urine is passed, blood in the urine
• bone pain
• severe stomach pain or cramps, very loose or watery stools, bloody stools
• rashes, breathlessness, swelling of the face, eyes, or mouth

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Do not take Esomeprazole with nelfinavir or rilpivirine (medicines for HIV infection).

Inform your doctor and pharmacist if you are taking any of these medicines:

• other medicines for HIV infection e.g. saquinavir, atazanavir
• blood-thinning medicines e.g. warfarin, clopidogrel, cilostazol
• medicines for fungal infection e.g. ketoconazole, itraconazole, voriconazole
• medicines to treat depression e.g. citalopram, imipramine
• medicines for cancer e.g. methotrexate, erlotinib
• water pills or medicines for water retention
• tacrolimus (medicine used in organ transplant or certain immune disorders)
• digoxin (medicine for irregular heartbeat)
• diazepam (medicine for sleep disorder or anxiety)
• phenytoin (medicine for fits or seizures)
• rifampicin (medicine to treat TB, a lung infection known as tuberculosis)
• St. John's wort (herbal medicine)

This list does not include all medicines that may interact with Esomeprazole.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicine, supplements and medicines that you buy without a prescription.

Avoid alcohol.

Do not take unpasteurised whole milk, cheese, or fruit juices. Spicy food and carbonated "fizzy" drinks like soft drinks should also be avoided.

Avoid caffeine-containing beverages such as coffee, tea, and certain soft drinks.

Eat small but frequent meals as large single meals may increase the pressure in your stomach leading to reflux.

You should try to avoid lying down soon after eating as this may worsen reflux symptoms.

It may be helpful to discuss your diet with your doctor or dietitian as a change in diet may help improve your symptoms.

Store in a cool, dry place away from the reach of children.

Protect from light and moisture.

Medicines must not be used past the expiry date.