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Side effects of esomeprazole - Brand names: Nexium, Nexium Control, Emozul, Guardium Acid Reflux Control

The side effects of esomeprazole, if you get them, are usually mild and often go away when you stop taking it.

Common side effects

These common side effects of esomeprazole happen in more than 1 in 100 people. There are things you can do to help cope with them:

Headaches

Make sure you rest and drink plenty of fluids. It's best not to drink too much alcohol. Ask your pharmacist to recommend a painkiller, or talk to your doctor if they do not go away or are severe.

Feeling sick

Try taking esomeprazole with or after a meal or snack. It may also help if you do not eat rich or spicy food while you're taking this medicine.

Being sick

Take small, frequent sips of water to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee.

If you take the combined pill or the progestogen-only pill and you're being sick your contraception may not protect you from pregnancy. Check the pill packet for advice.

Diarrhoea

Drink plenty of fluids, such as water or squash, to prevent dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee.

If the diarrhoea does not get better, talk to your doctor.

If you take the combined pill or the progestogen-only pill and you have severe, watery diarrhoea, or any diarrhoea that lasts for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Constipation

Get more fibre into your diet such as fresh fruit and vegetables and cereals, and drink plenty of water. Try to exercise regularly, for example, by going for a daily walk or run. If this does not help, talk to your pharmacist or doctor.

Stomach pain

Try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help. If you are in a lot of pain, speak to your pharmacist or doctor.

Farting (flatulence)

Try to avoid foods that cause farting, like pulses, lentils, beans and onions. It might help to eat smaller meals more frequently, eat and drink slowly, and exercise regularly. Some pharmacy remedies, such as simeticone, may improve the problem.

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Serious side effects

Serious side effects happen in less than 1 in 1,000 people.

Call a doctor or call 111 straight away if:

  • your skin becomes yellow (although this may be less obvious on brown or black skin), you have pale coloured poo, your pee becomes darker and you feel more tired than usual – these can be signs of liver problems
  • you get joint pain and a red skin rash, especially on parts of your body exposed to the sun, such as your arms, cheeks and nose – these can be signs of a rare condition called subacute cutaneous lupus erythematosus. This can happen even if you have been taking esomeprazole for a long time
  • you have diarrhoea that is severe or does not go away – this can be a sign of an inflamed bowel

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to esomeprazole.

Immediate action required: Call 999 now if:

  • your lips, mouth, throat or tongue suddenly become swollen
  • you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
  • your throat feels tight or you're struggling to swallow
  • your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
  • you suddenly become very confused, drowsy or dizzy
  • someone faints and cannot be woken up
  • a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

Information:

Do not drive yourself to A&E.

The person you speak to at 999 will give you advice about what to do.

Long-term side effects

If you take esomeprazole for more than 3 months, the levels of magnesium in your blood may fall.

Low magnesium can make you feel tired, confused, dizzy and cause muscle twitches, shakiness and an irregular heartbeat. If you get any of these symptoms, tell your doctor straight away.

Taking esomeprazole for more than a year may increase your chances of certain side effects, including:

  • bone fractures
  • gut infections
  • vitamin B12 deficiency – symptoms include feeling very tired, a sore and red tongue, mouth ulcers and pins and needles

Speak to your doctor straight away if you're worried or have any questions.

If you take esomeprazole for longer than 1 year, they will regularly check your health to see if you should carry on taking it.

Esomeprazole can sometimes make it harder to notice the symptoms of stomach cancer. It's important to contact your doctor if you have any new symptoms, if your symptoms change, or if anything does not feel normal for you.

Other side effects

These are not all the side effects of esomeprazole. For a full list, see the leaflet inside your medicine packet.

Information:

Reporting side effects

You can report any suspected side effect using the Yellow Card safety scheme.

Visit the Yellow Card website for more information about reporting side effects.

Page last reviewed: 26 November 2025
Next review due: 26 November 2028