What is Nexium?
Nexium mups contains the active ingredient esomeprazole, a newer-generation proton pump inhibitor (PPI). Esomeprazole is the S-enantiomer (mirror-image molecule) of omeprazole and has slightly better bioavailability.
MUPS technology (Multiple Unit Pellet System) consists of many small gastro-resistant pellets in one tablet. These can be dissolved in water, which makes the medication easier to take if you have difficulty swallowing.
Nexium is manufactured by AstraZeneca and is approved for the treatment of acid-related disorders. Generics containing esomeprazole are also available.
Active Ingredients & Mechanism of Action
Active ingredient: Esomeprazol
Esomeprazole inhibits the proton pump of the parietal cells in the stomach:
Mechanism of action:
- Identical to other PPIs: irreversible inhibition of H+/K+-ATPase
- Blocks gastric acid production at the final step
Advantages of esomeprazole:
- Higher bioavailability than omeprazole
- More consistent metabolism (less dependent on CYP2C19 genetics)
Clinical relevance: The difference from other PPIs is small.
Who is it suitable for?
Nexium is suitable for:
- Gastroesophageal reflux disease (GERD)
- Reflux esophagitis (healing and prevention of relapse)
- Gastric and duodenal ulcers
- Helicobacter pylori eradication
- Stomach protection during NSAID use
- Zollinger-Ellison syndrome
Particularly suitable for:
- Difficulty swallowing (MUPS can be dissolved in water)
Available Dosages
Available strengths:
- 20 mg MUPS tablets
- 40 mg MUPS tablets
Usual dosages:
- Heartburn: 20 mg 1x daily
- Reflux esophagitis: 40 mg 1x daily for 4-8 weeks
- Maintenance therapy: 20 mg 1x daily
- Stomach protection with NSAIDs: 20 mg 1x daily
- Helicobacter eradication: 20 mg 2x daily (with antibiotics)
Dosage form and pack sizes
The medicines catalogue lists 2 pack variants: 2 strengths in one pack size.
- Dosage form
- Magensaftresistente Tablette
- Strengths
- 20 mg, 40 mg
- Pack sizes
- 30 units
| Strength | Pack | PZN | Duration |
|---|---|---|---|
| 20 mg | 30 units | 01340086 | 30 days |
| 40 mg | 30 units | 01340175 | 30 days |
Packs listed in the German medicines catalogue. Which of them are currently available and what they cost is shown in the price overview.
The Pharmazentralnummer (PZN) is the nationwide unique identifier of a pack in Germany.
Duration is the catalogue value for the usual dosage. How long a pack actually lasts depends on the dose your doctor prescribes.
How to Take
How to take:
- Swallow the tablet whole with water
- Do not chew or crush
If you have difficulty swallowing:
- Dissolve the tablet in half a glass of noncarbonated water
- Stir until the pellets separate (the tablet does not disintegrate completely)
- Drink within 30 minutes
- Rinse the glass and drink what remains
Via gastric tube: Nexium mups can be dissolved in water and given via a gastric tube.
Contraindications
Nexium must not be taken in cases of:
- Hypersensitivity to esomeprazole or other PPIs
- Concomitant use of nelfinavir
Use with caution in cases of:
- Severe liver impairment (max. 20 mg)
- Long-term use (risks as with all PPIs)
- Suspected stomach cancer
Pregnancy/breastfeeding: Limited data. Use only if clearly indicated. There is more experience data for omeprazole in pregnancy.
Possible Side Effects
Common (1-10%):
- Headache
- Abdominal pain
- Diarrhea
- Flatulence
- Nausea
- Vomiting
- Constipation
Uncommon:
- Dry mouth
- Dizziness
- Sleep disturbances
- Elevated liver enzymes
Long-term risks (class effect of all PPIs):
- Magnesium deficiency
- Vitamin B12 deficiency
- Increased risk of fractures
- Possible risk of kidney disease
Interactions
Contraindicated:
- Nelfinavir (HIV medication)
Not recommended:
- Atazanavir (HIV medication)
Esomeprazole inhibits CYP2C19 (moderately):
- Clopidogrel: possible reduction in effect (consider preferring pantoprazole)
- Diazepam: slower breakdown
- Phenytoin: increased levels
Reduced absorption:
- Ketoconazole, itraconazole
- Iron supplements
- Erlotinib
Frequently Asked Questions
Esomeprazole has slightly higher bioavailability than omeprazole. In practice, the difference is small. For most patients, both are equivalent.
MUPS stands for Multiple Unit Pellet System. The tablet consists of many small gastro-resistant pellets. Advantage: the tablet can be dissolved in water, which is helpful in cases of difficulty swallowing or tube feeding.
Yes, esomeprazole generics contain the same active ingredient. Omeprazole and pantoprazole are also effective alternatives. Talk to your doctor about the best option for you.
Similar Medications
Is Nexium right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor or pharmacist.
Important Safety Information
This service operates under German pharmaceutical law (HWG). For risks and side effects, read the package leaflet and consult your doctor or pharmacist. All medications are dispensed from a licensed pharmacy in Germany.