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Treatment > Medications

Nexium – Quick remedy for heartburn, acid regurgitation and the treatment of stomach ulcers

Dr. med. André Sommer

Dr. med. André Sommer

Heartburn and acid regurgitation are often very uncomfortable for those affected. Nexium, a drug used to treat these symptoms, can help. It reduces the acidity of the gastric juice. That is why it is also used in the treatment of stomach ulcers. Nexium is also often used in combination with other medications as stomach protection to prevent complications in the stomach.

What is Nexium?

Nexium is a medicine that contains the active substance esomeprazole. It is a prescription drug that is available from various manufacturers in the form of tablets containing 10 mg, 20 mg and 40 mg of the active ingredient. Like pantoprazole or omeprazole, esomeprazole is a proton pump inhibitor (PPI). Proton pump inhibitors reduce the acidity of the gastric juice. This can help relieve the symptoms of heartburn, a reflux disease, and stomach ulcers.

How does Nexium work?

The mucous membrane of the stomach consists of various highly specialized cells. Parietal cells are responsible for acid production and its delivery to the gastric juice. Using a specific transporter, acidic protons (H +) are released into the gastric juice in exchange with potassium ions (K +) (proton pump). Nexium binds specifically to this transporter and irrevocably blocks it. This reduces the acidity of the gastric juice.

Interesting: Structure of the gastric mucosa The gastric mucosa consists of different, highly specialized cells Main cells form enzymes (pepsinogens), which are important for the breakdown and digestion of proteins that we ingest through food Side cells form a slimy protective shield (mucine) for the gastric mucosa, so that it is protected from the digestive enzymes and the acidic gastric juice Parietal cells release acidic protons into the gastric juice and are therefore responsible for the acidity of the gastric juice. They also produce the protein intrinsic factor, which is necessary for the absorption of vitamin B12 from food

Overview: What is Nexium and how does it work?

  • Nexium is a proton pump inhibitor (PPI)
  • It reduces the acidity of the gastric juice
  • The drug irrevocably blocks the proton pump of the gastric parietal cells

How quickly and for how long does Nexium work?

If you have acute reflux, of course you want to get better as soon as possible. After taking a tablet, the effects of Nexium begin within one to two hours. However, the full effect can only be expected after regular intake over several days. Since proton pump inhibitors irreversibly impair the function of the proton pump of the parietal cells, Nexium works until replaced by the parietal cell. This usually takes two to three days.

What are the side effects of Nexium?

Since Nexium blocks the proton pump of the parietal cells very specifically, it has relatively few side effects. The most common side effects affect the gastrointestinal tract. Taking Nexium can cause abdominal pain, nausea, vomiting, constipation, diarrhea and gas. In addition, frequent headache and dizziness have been reported with Nexium therapy.

If you use the medication for more than three months, the risk increases that your body can absorb less vitamin B12 and magnesium. Especially in high doses or when taken daily for over a year, the risk of hip fractures increases.

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Where can I get Nexium?

Nexium is available only with a prescription. With a valid till prescription, you pay the patient co-pay of 5 euros in Germany at the pharmacy. You can buy other proton pump inhibitors such as pantoprazole 20mg or omeprazole 20mg in small pharmacy sizes without a prescription.

When should I not use Nexium?

Nexium contains both lactose and sucrose. If you are intolerant to lactose or fructose, the use of Nexium is not recommended. The drug also has an impact on the uptake of many drugs into the bloodstream. For example, taking Nexium and the immunosuppressive drugs methotrexate or tacrolimus at the same time can increase serum levels. The use of Nexium in children under the age of 12 is also not recommended.

Did you know that you can get many stomach disorders under control by changing your diet? We have developed a therapy specifically for this, in which your certified nutritionist supports you on the way to better health. Find out in a free initial consultation whether the therapy is suitable for you.

I am pregnant or breastfeeding - can I use Nexium?

As there is insufficient data on the use of Nexium during pregnancy, it should not be used for safety reasons. If there is a need to use a proton pump inhibitor during pregnancy, you should use omeprazole. If you are breastfeeding your child at the moment, you should also avoid Nexium, as it is not known whether the drug can pass into breast milk and whether it affects your child's development.

Overview: Who should not use Nexium?

  • People with hypersensitive reaction to components of Nexium (lactose, sucrose)
  • Children under the age of twelve
  • Pregnant woman
  • Breastfeeding women

How do I take Nexium?

You should swallow the tablets with water. The tablets should not be chewed. Concomitant use of Nexium with food delays and reduces the absorption of the active substance esomeprazole. However, a negative effect on the acidity of the gastric juice has not been demonstrated.

What diseases does Nexium help with?

If you have an inflammation of the mucous membrane of the esophagus caused by reflux disease, which has been diagnosed by gastroscopy, Nexium 40mg is used once a day for four weeks. This should improve your symptoms. Nexium 20mg is used once a day thereafter. This prevents the inflammation from occurring again. It may be the case that inflammation of the esophagus has not been demonstrated, but there are similar symptoms. Then you can use Nexium 20mg once a day to control the symptoms of the reflux disease. The drug is usually administered for four weeks in this case.

Nexium 20mg is also used once a day to prevent stomach ulcers from occurring due to long-term use of anti-inflammatory drugs such as diclofenac, ibuprofen, naproxen, or aspirin. If long-term treatment with anti-inflammatory drugs has already caused a stomach ulcer, this is also treated with Nexium 20mg once a day for a period of 4-8 weeks. If you have a diagnosed stomach ulcer with the presence of Helicobacter pylori (H. pylori) bacterium, Nexium 20mg in combination with several antibiotics is used twice a day for seven to 14 days.

With relatively rare Zollinger-Ellison syndrome, a tumor leads to increased acidity in the gastric juice. The symptoms of the disease can be controlled by taking 40 mg of Nexium twice a day or using an individually adjusted dose.

Overview: What diseases is Nexium used for?

  • Reflux disease with inflammation of the esophagus, which was secured by gastroscopy
  • Reflux disease to control the symptoms
  • Stomach protection during long-term therapy with anti-inflammatory drugs such as, diclofenac, ibuprofen, naproxen or aspirin
  • Gastric ulcer caused by long-term therapy with anti-inflammatory drugs
  • Peptic ulcer caused by Helicobacter pylori
  • Zollinger-Ellison syndrome

FDA U.S. Food & Drug Administration (2011): FDA Drug Safety Communication: Low magnesium levels can be associated with long-term use of Proton Pump Inhibitor drugs (PPIs). Last update 04.08.2017. Downloaded on 08.11.2018 from:

Yang, Y. X., Lewis, J. D., Epstein, S., & Metz, D. C. (2006). Long-term proton pump inhibitor therapy and risk of hip fracture. Jama, 296(24), 2947-2953.

Baker, D. E. (2001). Esomeprazole magnesium (Nexium). Reviews in gastroenterological disorders, 1(1), 32-41.

Dr. med. André Sommer

Dr. med. André Sommer

I’m André, a medical doctor from Berlin. Together with a team of medical doctors, nutritionists and data scientists we empower people to understand digestive issues with our app Cara Care.

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