Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Nexium (Esomeprazole). If you are concerned about side effects, discuss the risks and benefits of Nexium (Esomeprazole) with your doctor.

The following side effects have been reported by at least 1% of people taking Nexium (Esomeprazole). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• changed sense of taste
• Diarrhea
• dizziness
• drowsiness
• Dry Mouth
• hair loss
• headache
• increased sweating
• muscle pain or weakness
• nausea
• nervousness
• sensitivity to the sun
• sore mouth
• spinning sensation
• swelling ankles, feet, and hands
• trouble sleeping

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• blurred vision
• confusion
• diarrhea (watery and severe; may also be bloody)
• feeling of burning or tingling
• hallucinations (seeing or hearing things that aren’t there)
• rash on cheeks or the arms that worsens in the sun
• shortness of breath
• signs of Depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• signs of electrolyte imbalance (e.g., muscle pain or cramps, weakness, irregular heart beat)
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• skin reactions (such as rash, itching, or Hives)
• sore joints

Stop taking the medication and seek immediate medical attention if any of the following occur:

• severe skin problems (blisters, ulcers, or lesions)
• signs of a Anaphylaxis (severe allergic reaction) such as hives; difficulty breathing; or swelling of the tongue, face, mouth, or throat

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Nexium (Esomeprazole).

Tablets 

20 mg
Each light pink, oblong, and biconvex, delayed-release tablet, engraved with "20 mg" on one side and "A" over "EH" on the other side, contains 20 mg of Nexium (Esomeprazole). Nonmedicinal ingredients: cellulose microcrystalline, crospovidone, glyceryl monostearate, hydroxypropyl cellulose, hypromellose, iron oxide, magnesium stearate, methacrylic acid ethylacrylate copolymer, polyethylene glycol, polysorbate, sodium stearyl fumarate, sugar spheres, synthetic paraffin, talc, titanium dioxide, and triethyl citrate.

40 mg
Each pink, oblong, and biconvex, delayed-release tablet, engraved with "40 mg" on one side and "A" over "EI" on the other side, contains 40 mg of Nexium (Esomeprazole). Nonmedicinal ingredients: cellulose microcrystalline, crospovidone, glyceryl monostearate, hydroxypropyl cellulose, hypromellose, iron oxide, magnesium stearate, methacrylic acid ethylacrylate copolymer, polyethylene glycol, polysorbate, sodium stearyl fumarate, sugar spheres, synthetic paraffin, talc, titanium dioxide, and triethyl citrate.

Do not take Nexium (Esomeprazole) if you:

• are allergic to Nexium (Esomeprazole) or any ingredients of the medication
• are taking the medication rilpivirine

There may be an interaction between Nexium (Esomeprazole) and any of the following:

• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• Apalutamide
• "azole" antifungals (e.g., fluconazole, itraconazole, ketoconazole, Voriconazole)
• bisphosphonates (e.g., Alendronate, etidronate, Risedronate)
• Capecitabine
• cefuroxime
• Citalopram
• Clopidogrel
• delavirdine
• dexmethylphenidate
• Digoxin
• Domperidone
• doxycycline
• Enzalutamide
• Escitalopram
• Hepatitis C antiviral medications (e.g., ledipasvir, sofosbuvir, velpatasvir)
• HIV protease inhibitors (e.g., atazanavir, indinavir, lopinavir, ritonavir, saquinavir)
• iron supplements (e.g., ferrous sulfate, ferrous fumarate)
• lumacaftor
• Mesalamine
• methotrexate
• Methylphenidate
• multiple vitamins with minerals
• other proton pump inhibitors (e.g., Omeprazole, Lansoprazole, Pantoprazole)
• certain protein kinase inhibitors (e.g., Bosutinib, Dabrafenib, Dasatinib, Erlotinib, Pazopanib)
• raltegravir
• rifampin
• rilpivirine
• Riociguat
• St. John's wort
• Tacrolimus
• Warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Nexium (Esomeprazole). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Nexium (Esomeprazole).

Bone health:  Studies suggest that the use of Nexium (Esomeprazole), like other PPIs, may be related to an increase risk of fractures, particularly for people who take Nexium (Esomeprazole) for a year or longer. The lowest dose of Nexium (Esomeprazole) to control the symptoms, taken for the shortest period of time, is less likely to cause these problems.

Diarrhea: When gastric acid is decreased, the number of bacteria normally in the digestive system increases. Occasionally, this can cause serious infection in the digestive tract. If you experience watery, foul-smelling bowel movements after starting to take Nexium (Esomeprazole), contact your doctor as soon as possible.

Fluid and electrolyte balance: Nexium (Esomeprazole) may cause the levels of electrolytes such as potassium, magnesium, and calcium in the blood to change while taking Nexium (Esomeprazole). If you experience symptoms of fluid and electrolyte imbalance such as muscle pains or cramps; dry mouth; numb hands, feet, or lips; or racing heartbeat, contact your doctor as soon as possible.

Liver function: The liver is partially responsible for removing Nexium (Esomeprazole) from the body. Liver disease or reduced liver function may cause Nexium (Esomeprazole) to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Nexium (Esomeprazole) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Nexium (Esomeprazole), and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Nexium (Esomeprazole).

Methotrexate interaction: Nexium (Esomeprazole), like other medications in this group, may interact with methotrexate when the two medications are used at the same time. This combination may lead to higher than expected amounts of methotrexate in the body and can cause serious side effects, including kidney damage, irregular heartbeat, Anemia, or infection. If you take Nexium (Esomeprazole) and are also going to receive a dose of methotrexate, discuss with your doctor how Nexium (Esomeprazole) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Nexium (Esomeprazole), and whether any special monitoring is needed.

More serious conditions of the stomach and intestines: If you experience symptoms of a more serious condition of the stomach and intestines (e.g., trouble swallowing, unplanned weight loss, persistent vomiting, vomiting blood, or black stools) while taking Nexium (Esomeprazole), contact your doctor immediately.

Subacute cutaneous Lupus erythematosus (SCLE): Nexium (Esomeprazole), like other PPIs, has been rarely associated with SCLE, an autoimmune disease. If you develop any skin lesions, especially in sun-exposed skin areas, and if accompanied by muscle aches or pains, contact your doctor immediately.

Vitamin B12: Long-term use of Nexium (Esomeprazole) may lead to vitamin B12 deficiency. If you are a vegetarian or have low vitamin B12 levels, discuss with your doctor whether any special monitoring is required.

Pregnancy: Nexium (Esomeprazole) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Nexium (Esomeprazole), contact your doctor immediately.

Breast-feeding: It is not known if Nexium (Esomeprazole) passes into breast milk. If you are a breast-feeding mother and are taking Nexium (Esomeprazole), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Nexium (Esomeprazole) have not been established for children less than 1 year of age.