Nexium 40 mg 28 tablets

• Esomeprazole belongs to a group of medicines called 'proton pump inhibitors'. They work by decreasing the amount of acid your stomach produces.
• This medication is used for adults for the short-term treatment of reflux symptoms (eg, heartburn and acid regurgitation).
• Reflux is the backflow of acid from the stomach into the esophagus (the "food pipe") which may become inflamed and painful. This may cause symptoms such as pain in the chest that radiates to the throat (heartburn) and a sour taste in the mouth (acid regurgitation).
• Esomeprazole is not intended to provide immediate relief.
• You may need to take the capsules for 2-3 days in a row before you feel an improvement. You should speak to your doctor if you do not feel better or if you feel worse after 14 days.

What you need to know before using esomeprazole:
Do not use esomeprazole
• If you are allergic to esomeprazole or any of the other ingredients in this medicine
• If you are allergic to other proton pump inhibitor medicines (such as pantoprazole, lansoprazole, rabeprazole or omeprazole).
• If you are taking a medicine containing nelfinavir (used to treat HIV infection).

Cautions and precautions:
You should tell your doctor:
• You have had a stomach ulcer or stomach surgery in the past.
• You have been taking continuous medication for reflux or heartburn for 4 weeks or longer.
• You suffer from jaundice (yellowing of the skin or eyes) or severe liver problems.
• You have serious kidney problems.
• If you are over 55 and have new or recently changed reflux symptoms or need to take a daily over-the-counter indigestion or heartburn remedy.
• You have had a skin reaction before after treatment with a medicine similar to esomeprazole that reduces stomach acid.
• You are due to have an endoscopy or a urea breath test.
• You are due to have a specific blood test (chromogranin A).

Other medicines and esomeprazole:
• Do not take this medicine if you are taking a medicine that contains nelfinavir (used to treat HIV infection).
• You must tell your doctor or pharmacist specifically if you are taking clopidogrel (used to prevent blood clots).
• Do not take this medicine with other medicines that reduce the amount of acid produced in your stomach such as a proton pump inhibitor (such as pantoprazole, lansoprazole, rabeprazole, or omeprazole) or an H2 antagonist (such as ranitidine or famotidine)

Tell your doctor about the medicines you are taking, and especially mention to your doctor if you are taking:
• Ketoconazole and Itraconazole (used to treat infections caused by fungi).
• voriconazole (used to treat infections caused by fungi) and clarithromycin (used to treat infections). Your doctor may adjust your dose of esomeprazole if you also have severe liver problems and have been treated for a long period of time.
• Erlotinib (used to treat cancer).
• Methotrexate (for the treatment of cancer and rheumatic disorders).
• Digoxin (used for heart problems).
• Atazanavir, saquinavir (used to treat HIV infection).
• Citalopram, imipramine or clomipramine (for depression).
• Diazepam (used to treat anxiety, relax muscles, or epilepsy).
• Phenytoin (used in the treatment of epilepsy).
• Medications that are used to thin the blood, such as warfarin. Your doctor may need to monitor you when you start or stop taking esomeprazole.
• Cilostazol (used to treat intermittent claudication - a condition in which lack of blood flow to the leg muscles causes pain and difficulty walking).
• Cisapride (used for indigestion and heartburn).
• Rifampicin (used to treat tuberculosis).
• Tacrolimus (in cases of organ transplantation).
• St. John's Wort (Hypericum perforatum) (used to treat depression). Low threshold risk for seizures.

Children and adolescents:
Esomeprazole should not usually be used in children and adolescents younger than 18 years old.

How to use esomeprazole:
Always take this medicine exactly as described in this leaflet or as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

• The recommended dose is one capsule per day.
• Do not take more than this recommended dose of one capsule (20 mg) per day, even if you do not feel better right away.
• You may need to take the capsules for two or three days in a row before your reflux symptoms (eg, heartburn and acid regurgitation) improve.
• The duration of treatment is up to 14 days.
• When reflux symptoms completely disappear, you should stop taking this medicine.
• If your reflux symptoms worsen or do not improve after taking this medicine for 14 days in a row, you should consult your doctor. If you have symptoms that persist or are long lasting and recurring even after treatment with this medicine, you should contact your doctor. take this medicine
• You can take the capsule at any time of the day either with food or on an empty stomach.
• Swallow the capsule whole with half a glass of water. Do not chew, crush, or open the capsule. This is because the capsule contains coated globules, which prevent the medicine from being broken down by the acid in your stomach.
• It is important not to damage the pellets.

Possible side effects:
Stop using the product and seek immediate medical attention if:
• Swelling of the face, lips, tongue or throat, which may cause difficulty in breathing or swallowing

How to store esomeprazole:
• Keep this medicine out of the sight and reach of children.
• Do not use this medicine after the expiry date which is stated on the carton and bottle after EXP. The expiration date refers to the last day of the same month.
• It is not allowed to store above 30°C.
• Keep this medicine in the original package to protect it from moisture.
• Do not dispose of medicines in sewage or household waste. Ask your pharmacist how to dispose of medicines you no longer use. These measures will help protect the environment.