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The safety information provided here outlines potential risks and necessary precautions when using this medication. Please read it carefully and consult your healthcare provider if you have any questions or concerns.

• Masking Serious Conditions: Frequent heartburn may indicate a more serious issue, such as stomach cancer. If your heartburn worsens or recurs after using esomeprazole (Nexium), or if accompanied by poor appetite, unexplained weight loss, or weakness, contact your healthcare provider immediately to rule out other medical problems.

• Kidney Issues: Some users of proton pump inhibitors (PPIs) like esomeprazole (Nexium) have experienced sudden kidney issues. If you notice changes in urination, nausea, weakness, fever, rash, or joint pain, seek medical advice promptly.

• Risk of Severe Diarrhea: PPIs, including esomeprazole (Nexium), may increase the risk of a bacterial infection known as Clostridioides difficile (C. diff), which can lead to severe diarrhea. This risk is higher for individuals over 65, those recently hospitalized or in nursing homes, and those with weakened immune systems. To reduce this risk, use the lowest effective dose for the shortest duration. Report any severe diarrhea, fever, abdominal pain, loss of appetite, or nausea to your provider immediately.

• Bone Fractures: There is an increased risk of fractures in the hip, wrist, or spine with PPIs usage, especially if taken in high doses or for more than a year. If you have a history of fractures or osteoporosis, consult your provider before starting this medication.

• Serious Skin Reactions: Rare but serious skin reactions such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) have been reported with PPIs. Symptoms include fever, body aches, rash, peeling skin, painful blisters, and facial swelling. Seek immediate medical attention if these occur.

• Lupus Symptoms: Some individuals have developed new or worsening lupus symptoms while on PPIs, which can manifest as joint pain or a rash. These symptoms typically improve within 1 to 3 months after stopping the medication. If you experience such symptoms, discontinue use and contact your provider.

• Vitamin B12 and Magnesium Deficiency: Long-term use of esomeprazole (Nexium) can lead to deficiencies in vitamin B12 and magnesium. If you've been using the medication for more than a year and notice symptoms like dizziness, muscle weakness, pale skin, fatigue, or tingling in the extremities, consult your healthcare provider.

• Drug Interactions: Certain medications, such as St. John’s Wort and rifampin (Rifadin), can alter the effectiveness of esomeprazole (Nexium) by affecting its concentration in the body. Avoid these medications while using esomeprazole (Nexium).

Contraindications:

• Do not use this medication if you have an allergy to PPIs.
• Avoid if you are taking Edurant (rilpivirine) or rilpivirine-containing medications like Complera, as it may pose serious health risks.

Always consult with your healthcare provider to ensure this medication is appropriate for you, especially if you have existing health conditions or are taking other medications.

When using this medication, some individuals may experience common side effects such as headaches, abdominal pain, diarrhea, nausea, passing gas, constipation, and dry mouth. These effects are usually mild, but if they persist or worsen, it's advisable to consult with a healthcare provider.

There are other side effects that have been reported, including a large abdomen, weakness, back pain, chest pain, swelling, hot flushes, fatigue, flu-like symptoms such as a stuffy nose and cough, rapid heartbeat, acid reflux, ear ringing or pain, weight changes, trouble sleeping, migraines, and loss of taste. While these are generally non-severe, contacting a healthcare provider is recommended if they cause concern.

Certain side effects are rare but severe, requiring immediate medical attention. These include severe stomach pain or persistent diarrhea, signs of kidney problems such as changes in urination and fever, symptoms of lupus like joint pain and skin rashes that worsen with sun exposure, and serious skin reactions such as blistering or peeling. Additionally, the medication may rarely cause vitamin B-12 deficiency if used long-term, with symptoms such as unusual weakness or numbness in the extremities, and a very serious allergic reaction is possible, marked by symptoms like fever, swollen lymph nodes, rash, and difficulty breathing.

If you notice any other effects not mentioned, or if you experience any of the severe symptoms listed, seeking medical advice promptly is crucial. Remember, most people do not experience serious side effects from this medication, but staying informed and vigilant is important for your health and safety.

Esomeprazole, also known as Nexium, can interact with various medications and supplements. It's important to inform your doctor and pharmacist of all the medications, supplements, and vitamins you're currently taking. Here are some key interactions to be aware of:

1. Avoid Combining: Do not use esomeprazole with rilpivirine, as using them together is not recommended.

2. Use with Caution: Some medications might require careful monitoring or dosage adjustments if used with esomeprazole. These include acalabrutinib, amphetamine, Atazanavir, Benzphetamine, bosutinib, Capecitabine, Cilostazol, Citalopram, Clopidogrel, dacomitinib, dasatinib, Dextroamphetamine, Erlotinib, Escitalopram, eslicarbazepine acetate, gefitinib, Ketoconazole, ledipasvir, Lisdexamfetamine, Methamphetamine, Methotrexate, mycophenolate mofetil, nelfinavir, neratinib, nilotinib, Octreotide, pazopanib, pexidartinib, Posaconazole, saquinavir, secretin human, selpercatinib, sunitinib, Tacrolimus, thiopental, velpatasvir, and vismodegib.

3. Increased Side Effects: Using esomeprazole with Levothyroxine, Risedronate, Voriconazole, or Warfarin may heighten the risk of side effects. Your doctor may need to adjust the dosage or frequency of these medications.

Additionally, esomeprazole reduces stomach acid, which can affect the absorption of certain medications like atazanavir, erlotinib, levoketoconazole, nelfinavir, pazopanib, rilpivirine, sparsentan, and some azole antifungals (such as Itraconazole, ketoconazole, and posaconazole).

Lastly, do not take esomeprazole together with any medications containing Omeprazole, as they are very similar. Inform all your healthcare providers, including lab personnel, that you are taking this medication, as it may interfere with certain laboratory tests, potentially leading to inaccurate results.