EsomeprazoleEsomeprazole Magnesium

About Esomeprazole

Esomeprazole, the S-isomer of omeprazole, shuts down the acid pumps in the stomach lining. It heals erosive esophagitis and keeps it healed, treats reflux in adults and teenagers, lowers stomach ulcer risk in at-risk people taking NSAIDs, helps clear H. pylori alongside two antibiotics, and controls Zollinger-Ellison syndrome. Packets are used for children from one month old.

Headache, diarrhea, nausea, gas and stomach pain are common. Long-term use is linked to low magnesium and vitamin B12 and to hip, wrist and spine fractures; C. difficile diarrhea, kidney inflammation, lupus and severe skin reactions are less common, so prescribers use the lowest dose for the shortest time that works. It must not be taken with the HIV drug rilpivirine.

Over the counter, esomeprazole 20 mg is sold as Nexium 24HR and store brands for adults with heartburn on two or more days a week, taken each morning for 14 days and repeated no more than once every four months unless a doctor says otherwise. Prescription esomeprazole adds 40 mg, the packets and longer treatment of diagnosed conditions. If you are prescribed 20 mg daily, the over-the-counter product is the same medicine and strength without a dispensing fee; whether it can replace the prescription, and for how long, is your prescriber’s decision.

Taking Esomeprazole

How to take it

Usually once a day, at least 1 hour before a meal. Swallow capsules whole, or open one onto a tablespoon of applesauce and swallow it at once without chewing the granules. Empty a 2.5 or 5 mg packet into 5 mL of water, or a larger packet into 15 mL, wait 2 to 3 minutes, stir and drink within 30 minutes.

If you miss a dose

Take it as soon as you remember, unless it is nearly time for the next dose; then skip it and carry on as usual. Never take a double dose.

Storage

At room temperature in the original container, tightly closed, away from heat and moisture, out of reach of children.

Interactions to know about

It must not be taken with rilpivirine. Clopidogrel, whose effect it weakens, St. John’s wort and rifampin are avoided. It can raise levels of methotrexate (mainly at high doses), citalopram, digoxin and tacrolimus, and the INR on warfarin, and can reduce absorption of iron. Antacids can be used with it.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Esomeprazole differs from pharmacy to pharmacy

Generic capsules have many makers and cost pharmacies little, so a fill is priced mostly on each pharmacy’s dispensing fee and markup, which vary widely. A prescription that names Nexium and blocks substitution is quoted at a brand price.

The packets have few generic makers and usually cost far more than capsules. Over the counter there is no dispensing fee, and store brands usually cost less than Nexium 24HR.

Ways to pay less for Esomeprazole without insurance

• If you take 20 mg once a day, ask your prescriber whether the over-the-counter product fits your treatment, and for how long.
• Ask for the prescription to allow generic substitution.
• If packets were prescribed only for swallowing trouble, ask whether an opened capsule on applesauce would do.
• For long-term treatment, ask for a ninety-day supply.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Esomeprazole

1. 1.Is the over-the-counter 20 mg product the same as my prescription?
2. 2.How long before a meal should I take it?
3. 3.Does it interact with clopidogrel, methotrexate or my other medicines?
4. 4.How long should I stay on it?
5. 5.Can I open the capsule if swallowing is hard?

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