Esomeprazole is a proton pump inhibitor (PPI) that reduces the amount of acid produced in the stomach. Brand names for this drug include Nexium, Essocam and Esomezel. Esomeprazole reduces gastric acid secretion by inhibiting an ion transport protein present in gastric parietal cells called H+/K+ ATPase.

One main use of esomeprazole is in the treatment of gastroesophageal reflux disease (GERD), when patients are unable to ingest oral medications due to inflammation and pain in the esophagus. GERD is caused by gastric acids coming into contact with and irritating the esophagus. One of the most common symptoms of this irritation is heartburn. Eventually, persistent contact between the esophagus and the digestive acid can cause permanent damage to the esophagus. The use of esomeprazole to minimize the secretion of these gastric acids can therefore help to alleviate the symptoms of GERD.

Another primary use of this drug is in the treatment of peptic and duodenal ulcers. Here, esomeprazole is used in conjunction with amoxicillin and clarithromycin, antibiotics used to eradicate the H.pylori infection that usually causes these ulcers.

Further examples where the use of esomeprazole may be indicated include the following:

• To prevent gastric ulcers caused by non-steroidal anti-inflammatory drugs
• To reduce the risk of an ulcer bleeding after an endoscopic procedure
• To treat the gastrointestinal ulcers associated with Chron’s disease

Side effects

As with other PPIs, the use of esomeprazole is not free from side effects. Some of the side effects associated with this drug are listed below.

Mild and more common side effects

• Drowsiness
• Headache
• Diarrhea
• Constipation
• Flatulence
• Nausea and vomiting
• Bloating and abdominal gas (there may be a general feeling of discomfort in the upper abdomen)
• Loss of appetite
• Dry mouth

Signs of allergy

In some cases, an individual may have an allergic reaction to the medication, and patients should seek urgent medical attention if any of the following symptoms occur:

• Difficulty breathing
• Tight chest or throat
• Severe stomach pain
• Swelling of the mouth, tongue, lips or face
• Skin rash
• Itching
• Hives

Other severe side effects

People should also seek medical attention if they experience any of these severe side effects:

• Blood or watery stools
• Chest pain
• Dark urine
• Fever
• Chills
• Persistent sore throat
• Fast heart rate
• Confusion
• Persistent nausea and vomiting
• Swollen hands, ankles or feet
• Unusual bleeding or bruising
• Yellowing of the skin or eyes
• Unusual fatigue or weakness

Drug interactions

Esomeprazole inhibits an enzyme called CYP2C19 and could therefore influence the effects of other drugs such as warfarin and diazepam that rely on this enzyme for their metabolism. If used in combination with esomeprazole, the concentration of these drugs in the blood may increase. Conversely, there may be a reduced effect of drugs that rely on the CYP2C19 enzyme for conversion to their active form. One example of a such a drug is clopidogrel.