What makes Nexium perfect for heartburn treatment?
Heartburn is caused by "washing back" (also known by term “reflux’) of unprocessed food and acids from the stomach into the food pipe (known as “oesophagus”) touching the unprotected lining of oesophagus, and resulting in discomfort and pain.
Heartburn manifests through a burning sensation and feeling of discomfort behind the breastbone. Some people additionally experience an unpleasant taste or bitter-tasting fluid at the back of the esophagus. Less common symptoms of heartburn include bad breath, persistent cough, and chest pain that can prevent or disturb sleep – heartburn is usually worse when you are in horizontal position.
Acid reflux is a highly unpleasant condition. Not only is it painful, but suffering chronic acid reflux (also known as “gastroesophageal reflux disease” or “GERD”) may cause esophageal cancer down the road.
Old-style heartburn treatments are designed to deliver temporary relief from the pain of heartburn but do not address the original problem of acid production. Antacids, for instance work reactively by neutralizing the acid whilst alginates inhibit acids in the stomach from flowing back to the esophagus by forming a raft. H2 blockers reduce the amount of acid produced by your stomach and typically last for 12 hours.
Drugs called Proton pump inhibitors (PPI, view full list on Drugs.com: drugs.com/drug-class/proton-pump-inhibitors.html) are different as they confront heartburn at its source by blocking acid production inside the stomach. Typically, patients find that proton-pump inhibitors are very effective as a first line treatment of acid reflux. PPIs also have the added benefit that just one capsule or tablet a day can provide up to 24-hour relief from recurrent heartburn.
Nexium delayed-release capsules, tablets, injection, as well as packets for preparation of the delayed-release oral suspensions contain the active component esomeprazole, which is a type of PPI. Esomeprazole is also obtainable as the generic medicine.
Proton pumps are enzymes found on cells lining up the stomach and are used by these stomach cells to produce stomach acid. Nexium works by inhibiting the action of the proton pumps, thus reducing the production of stomach acid, and allowing the stomach, as well as esophagus, to heal.
Possible side effects and how to avoid them
Many patients using Nexium do not develop any serious side effects. Some side effects of Nexium do not need medical attention and may disappear over the first few days or weeks of the treatment as your body adapts to the drug.
Tell your healthcare practitioner right away if you develop: allergic reactions, persistent diarrhea, fever, stomach pain, blood or mucus in your stool, as well as low magnesium blood level (characterized by persistent muscle spasms, unusually fast or slow or irregular heartbeat, seizures).
Inform your doctor in any case when the following side effects do not disappear within reasonable time or are worrisome:
Very common side effects (10% or more):
- Headache (up to 10.9%)
- Flatulence (up to 10.3%)
Common side effects (1% to 10%):
- Dizziness, vertigo, drowsiness
- Abdominal pain, constipation, diarrhea, dry mouth, epigastric pain, duodenal ulcer hemorrhage, tooth disorder, gastritis, regurgitation, nausea, vomiting
- Hypertension or aggravated hypertension
- Back pain
- Skin itching
- Accident or injury, fever
- Cough, respiratory infection, sinusitis.
Uncommon side effects (0.1% to 1%):
- "Pins and needles" sensation in limbs, feet or fingers
- Bleeding from the nose
- Dermatitis, hives, rash
- Peripheral edema
- Fracture of the wrist, hip, or spine
- Blurred vision
Rare side effects (0.01% to 0.1%):
- Taste disturbance
- Vitamin B-12 deficiency (characterized by unusual weakness, numbness of the hands and feet, sore tongue)
- Visual field defect
- Increased sweating
- Agitation, confusion, depression
- Tiredness, weakness, shortness of breath, spontaneous bruising
- Anaphylactic reaction, swelling or puffiness of the eyelids or around the eyes, lips, face or tongue, hypersensitivity reactions
- Joint or muscle pains
- Hair loss
- Bronchospasm (coughing, difficulty with breathing, chest pain)
Very rare side effects (less than 0.01%):
- Liver encephalopathy, liver failure
- Hallucinations, aggression,
- Agranulocytosis (acute condition of reduced white blood cell count)
- Pancytopenia (shortage of all categories of blood cells)
- Magnesium deficiency with or without calcium deficiency and/or potassium deficiency
- Kidney inflammation with or without kidney failure
- Gynecomastia (enlarged breasts in men)
- Erythema multiforme (inflammatory skin rash characterized by red spots sometimes with blistered or purple areas in the center)
If you already have osteoporosis or you are disposed to getting osteoporosis, it is essential to ensure that you have a sufficient intake of vitamin D and calcium to avoid any bone density problems. Your physician might recommend you take vitamin D calcium and supplements if you don't get adequate amounts of those nutrients in your diet.
Ask your doctor for further advice about ways to compensate for shortage of magnesium and potassium, should you have developed respective side effects.
This is not a comprehensive list of potential side effects. Speak to your physician or pharmacist if you experience any side effects not mentioned above.
Who cannot take Nexium
You should avoid taking Nexium if you:
- Have allergy to esomeprazole or to any other ingredient of Nexium
- Have allergy to any other PPI drug
Avoid Nexium if you are also taking cilostazol, a drug used for improvement of the symptoms of some blood flow problems in the legs. Cilostazol will be affected by Nexium.
Nexium should not be taken by patients taking the anti-HIV / AIDS medicines atazanavir, rilpivirine or nelfinavir. This is because esomeprazole reduces the blood level of these medications and might make them less effective at treating the HIV infection.
Nexium is not appropriate for infants under 12 months of age. There are no definite guidelines about using Nexium in young children of this age group, so Nexium is not suggested for these patients.
The safety of Nexium for use during the pregnancy has not been fully proven. Nexium should be used with caution by women who are pregnant, and only in those cases when the benefits to the mother compensate for any risks to the developing fetus. Request medical advice from your physician.
It is not entirely known whether this medication passes into the breast milk. For this reason, the manufacturers of esomeprazole warn that it should not be taken by women who are breastfeeding. Request medical advice from your physician.
Nexium tablets include sucrose and therefore are not suitable for individuals with rare hereditary problems of glucose-galactose malabsorption, fructose intolerance, or sucrase-isomaltase insufficiency.
Tell your physician about all the drugs you take including prescription and non-prescription drugs, as well as herbal supplements and vitamins. Nexium may affect the way how other drugs work, and other drugs may affect how Nexium works.
Especially inform your doctor if you are taking:
- Clopidogrel and warfarin – used in prevention of blood clots
- ketoconazole, voriconazole and itraconazole – used in treatment of fungal infections
- rifampin – used in treatment of several types of bacterial infections, such as tuberculosis, Legionnaire's disease and leprosy,
- rifampicin and clarithromycin – used in treatment of some bacterial infections
- products that contain iron
- digoxin – used in treatment of some heart conditions
- St. John’s Wort (Hypericum perforatum) – used in treatment of some mood disorders
- diazepam – used in treatment of anxiety and some other conditions
- citalopram, imipramine and clomipramine – used in treatment of depression
- mycophenolate and tacrolimus – used for assistance in organ transplants
- phenytoin – used in treatment of fits or epilepsy
- erlotinib – used in treatment of some types of cancer
- methotrexate – used in treatment of arthritis and some types of cancer
This is not a comprehensive list of esomeprazole drug interactions. Ask your physician or pharmacist for more details.
Long-term use of Nexium
Patients who have chronic problems with acid reflux tend to take Nexium for a very long time. This increasingly looks like a double-edged sword. While Nexium might remove the need for stomach surgery down the road and reduce the risk of esophageal cancer, the long-term usage of Nexium has been associated with some severe side effects.
By thwarting high acidity in the stomach, Nexium – when used over the long period – could lead to a higher rate of infections in the gastrointestinal tract since not enough acid is present to destroy harmful germs in the gastrointestinal area. For instance, Nexium might increase the risk of Clostridium difficile infection that manifests through watery diarrhea, abdominal pain, nausea, and fever. Clostridium is among top three types of infectious diarrhea in individuals aged 75 and older.
Prolonged use (one year or longer) reduces absorption of vitamin B12. Higher doses and long-term use (longer than one year) of Nexium might increase the risk of fractures related to osteoporosis, particularly in the hip, spine or wrist areas.
Medium-term administration of Nexium and other PPIs (3 month or longer) is also associated with hypomagnesemia (low levels of magnesium). Analysis of individuals taking PPIs for long periods of time revealed an added risk of cardiovascular events such as heart attacks.
Therefore, it is essential to use Nexium in the lowest effective doses and over the shortest duration of time necessary for the treatment of acid reflux.Related news: