The Uses and Effects of Esomeprazole

Esomeprazole is a highly safe and effective drug for the treatment of gastric hypersecretion. Discover more about the uses and effects of Esomeprazole in the following article.
The Uses and Effects of Esomeprazole

Last update: 29 December, 2020

In this article, we’ll tell you everything you need to know about the uses and effects of esomeprazole.

Esomeprazole belongs to a group of medications called proton pump inhibitors, known by the acronym IBP. The mechanism of action of these drugs is to reduce the amount of acid that the stomach produces.

Proton pump inhibitors are probably the most widely prescribed medications in the world. Since the adverse effects of esomeprazole are minimal and not very serious, this S-isomer of omeprazole has a very favorable safety profile. Keep reading to discover the effects of esomeprazole.

Mechanism of action of esomeprazole

Chemically, esomeprazole is a weak base, which is concentrated and converted into its active form in the extremely acidic environment of the parietal cell secretory canaliculi – located in the stomach. There, it inhibits the enzyme H+K+-ATPase – the so-called proton pump – and thus inhibits acidic basal secretion and stimulated secretion.

When do doctors recommend treatment with esomeprazole?

Doctors prescribe esomeprazole for adults for the treatment of the following ailments:

  • Gastroesophageal reflux disease (GERD)
  • In combination with an appropriate antibacterial therapeutic regimen for the eradication of Helicobacter pylori
  • Scarring of duodenal ulcer in association with Helicobacter pylori
  • Prevention of relapses of peptic ulcers in patients with ulcers having to do with Helicobacter pylori

You may be interested: Gastric and Duodenal Ulcers

  • Patients who need continuous treatment with non-steroidal anti-inflammatory drugs (NSAIDs), which is a risk factor for the appearance of peptic ulcers.
  • Scarring of gastric ulcers having to do with treatment involving NSAIDs.
  • Continuing treatment for the prevention of intravenous induced peptic ulcer bleeding.
  • Treatment of Zollinger Ellison syndrome. This is a rare condition in which one or more tumors form in the pancreas or duodenum. These tumors are gastrinomas and secrete large amounts of the hormone gastrin which causes our stomach to produce excess acid.

Doctors may prescribe treatment with esomeprazole for adolescents from the age of 12 in case of:

  • Gastroesophageal reflux disease (GERD)
  • In combination with antibiotics in the treatment of duodenal ulcer as a result of Helicobacter pylori
A woman with chest pain.


Dosage and form of administration

It’s important to note that the dosage of esomeprazole depends on the type of condition. However, its usual administration is in tablet form at a dose of 20 or 40 mg, depending on the doctor’s prescription.

Furthermore, patients should swallow the tablet whole with the help of liquid, without chewing or crushing it. However, patients with swallowing difficulties can dissolve the tablet in half a glass of non-carbonated water. It’s important not to use any other liquids, since they could dissolve the enteric coating that prevents the disintegration of the tablet in the gastric environment.

As for patients who can’t swallow, it’s also possible to dissolve the tablets in still water and administer them through a gastric tube. If necessary, doctors may also assess the intravenous route.

Most frequent adverse effects

The most frequently common adverse side effects of esomeprazole are:

  • Headache
  • Skin rash
  • Dyspepsia
  • Abdominal pain
  • Diarrhea and nausea

In short, the safety profile is similar for the different formulations, treatment indications, age groups, and patient populations. To date, research has revealed no dose-related adverse reactions.

A colorful array of pills.


Interactions with other medications

Drug-to-drug interactions can occur through several mechanisms. Either malabsorption of the drug due to changes in gastric pH, or competition from cytochrome P450 enzymes.

The most significant drug interactions of esomeprazole with other drugs are the following:

  • Atazanavir
  • Clopidogrel
  • Cyclosporine
  • Warfarin
  • Acenocoumarol
  • Carbamazepine
  • Antifungal agents

Contraindications

The main contraindication to the administration of this drug is the hypersensitivity to the active principle. In other words, to benzimidazoles or to the excipients it contains, for example sucrose.

It’s important to note that specialists don’t recommend concomitant administration of esomeprazole with atazanavir – an antiretroviral used in the prevention and treatment of HIV.

However, if it’s deemed strictly necessary, then close clinical monitoring is essential, along with an increase in the dose of atazanavir to 400 mg with 100 mg of ritonavir. However, doctors shouldn’t recommend exceeding the 20 mg dose of esomeprazole.

Responsible use of proton pump inhibitors

Once again, esomeprazole belongs to the most widely used group of medicines in the world. Although we’ve already seen that it’s a very safe drug with very mild adverse effects, they tend to be considered simple gastric protectors without side effects and are often available without a prescription.

Unfortunately, however, this fact may lead to the erroneous use of esomeprazole for the treatment of symptoms that have nothing to do with gastric hypersecretion, which is its main indication.

According to some studies, prolonged and inappropriate use of esomeprazole may result in the following:

  • Complications in at-risk or polymedicated patients

However, esomeprazole is a highly safe and effective drug for the treatment of gastric hypersecretion.

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  • Agencia Española de Medicamentos y Productos Sanitarios (AEMPS). Centro de información del medicamento (CIMA). Ficha técnica de Nexium Mups 20 mg: https://cima.aemps.es/cima/dochtml/ft/63436/FT_63436.html
  • Earp JC, Mehrotra N, Peters KE, et al. Esomeprazole FDA Approval in Children With GERD: Exposure-Matching and Exposure-Response. J Pediatr Gastroenterol Nutr, 2017. 65:272-277.
  • de la Coba Ortiz C, Argüelles Arias F, Martín de Argila de Prados C. Proton-pump inhibitors adverse effects: a review of the evidence and position statement by the Sociedad Española de Patología Digestiva. Rev Esp Enferm Dig, 2016. 108:207-24.