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Esomeprazole Precautions and Warnings

When it comes to esomeprazole, precautions and warnings to be aware of include things such as limiting your daily dose of the medication if you have severe liver disease and avoiding breastfeeding while taking the drug. Other precautions and warnings for esomeprazole users involve potential drug interactions. People who are allergic to substituted benzimidazoles should not take esomeprazole.

Esomeprazole Precautions and Warnings: What to Tell Your Doctor

Before taking esomeprazole (marketed under the brand name Nexium®), you should let your healthcare provider know if you:
  • Have liver disease or liver failure
  • Have low blood magnesium (hypomagnesemia) 
  • Are pregnant or breastfeeding
  • Have any allergies.
Also, tell your healthcare provider about all the medicines you are currently taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Some Esomeprazole Precautions and Warnings

Some precautions and warnings to be aware of concerning esomeprazole include the following:
  • Studies indicate that people who take proton pump inhibitor medications (such as esomeprazole) may be at an increased risk for broken bones. The risk appears to be highest for people who take such medications at high doses or for long periods (over a year). You and your healthcare provider should take this into account when deciding if the benefits of this medication outweigh the risks for your particular situation.


  • The use of proton pump inhibitors (including this medication) may increase the risk of a potentially serious condition known as Clostridium difficile-associated diarrhea (CDAD). If you develop diarrhea that does not seem to improve (especially if it is watery and accompanied by a fever and abdominal pain), seek immediate medical attention. 


  • Esomeprazole can interact with certain medications (see Esomeprazole Drug Interactions).
  • Esomeprazole is considered a pregnancy category B drug. This means that it has not been studied in pregnant women. However, when studied in animals, it showed no negative effects on unborn babies. If you are pregnant, discuss the safety of taking esomeprazole with your healthcare provider before starting the medication.
  • People with severe liver disease should not exceed a daily dose of 20 mg.


  • Proton pump inhibitors (PPIs), including esomeprazole, may cause low blood magnesium levels (hypomagnesemia). Seek immediate medical attention if you develop any symptoms of hypomagnesemia, such as muscle spasms, an irregular heart rhythm (arrhythmia), or seizures. Your healthcare provider may want to check your magnesium levels periodically using a simple blood test.
  • Based on information about omeprazole (Prilosec®), a similar drug, it is likely that esomeprazole passes through breast milk. Talk with your doctor before taking this drug while breastfeeding.


Esomeprazole Magnesium

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