NexIUM 24HR is used to treat symptoms of gastroesophageal reflux disease (GERD) and other conditions involving excessive stomach acid such as Zollinger-Ellison syndrome. This medicine is also used to promote healing of erosive esophagitis (damage to your esophagus caused by stomach acid).

NexIUM 24HR may also be given to prevent gastric ulcer caused by infection with Helicobacter pylori (H. pylori), or by the use of nonsteroidal anti-inflammatory drugs (NSAIDs).

NexIUM 24HR is not for immediate relief of heartburn symptoms.

NexIUM 24HR may also be used for purposes not listed in this medication guide.

NexIUM 24HR can cause kidney problems. Tell your doctor if you are urinating less than usual, or if you have blood in your urine.

Diarrhea may be a sign of a new infection. Call your doctor if you have diarrhea that is watery or has blood in it.

NexIUM 24HR may cause new or worsening symptoms of lupus. Tell your doctor if you have joint pain and a skin rash on your cheeks or arms that worsens in sunlight.

You may be more likely to have a broken bone while taking NexIUM 24HR long term or more than once per day.

Use exactly as directed on the label, or as prescribed by your doctor.

Take each dose with a full glass (8 ounces) of water.

NexIUM 24HR should be taken at least one hour before a meal.

Swallow the pill whole and do not crush, chew, break, or open it.

If you cannot swallow a capsule whole, open it and sprinkle the medicine into a spoonful of pudding or applesauce. Swallow the mixture right away without chewing. Do not save it for later use.

The NexIUM 24HR capsule can be given through a nasogastric (NG) feeding tube. Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

NexIUM 24HR is usually given for 4 to 8 weeks only. Your doctor may recommend a second course of treatment if you need additional healing time.

Use NexIUM 24HR for the full prescribed length of time, even if your symptoms quickly improve.

Call your doctor if your symptoms do not improve or if they get worse while you are taking this medicine.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using NexIUM 24HR.

Some conditions are treated with a combination of esomeprazole and antibiotics. Use all medications as directed.

Store at room temperature away from moisture and heat.

Heartburn can mimic early symptoms of a heart attack. Get emergency medical help if you have chest pain that spreads to your jaw or shoulder and you feel anxious or light-headed.

You should not use this medicine if:

• you had breathing problems, kidney problems, or a severe allergic reaction after taking NexIUM 24HR in the past; or

• you are allergic to NexIUM 24HR or to similar medicines such as lansoprazole, omeprazole, pantoprazole, rabeprazole, Dexilant, Nexium, Prevacid, Protonix, and others.

Tell your doctor if you have ever had:

• severe liver disease;

• lupus;

• osteoporosis or low bone mineral density (osteopenia); or

• low levels of magnesium in your blood.

You may be more likely to have a broken bone in your hip, wrist, or spine while taking a proton pump inhibitor long-term or more than once per day. Talk with your doctor about ways to keep your bones healthy.

Ask a doctor before using this medicine if you are pregnant or breastfeeding.

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

NexIUM 24HR can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor before using anti-diarrhea medicine.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

NexIUM 24HR may cause serious side effects. Call your doctor at once if you have:

• severe stomach pain, diarrhea that is watery or bloody;

• seizure (convulsions);

• kidney problems-- fever, rash, nausea, loss of appetite, joint pain, urinating less than usual, blood in your urine, weight gain;

• low magnesium--dizziness, fast or irregular heart rate, tremors (shaking) or jerking muscle movements, feeling jittery, muscle cramps, muscle spasms in your hands and feet, cough or choking feeling; or

• new or worsening symptoms of lupus--joint pain, and a skin rash on your cheeks or arms that worsens in sunlight.

Taking NexIUM 24HR long-term may cause you to develop stomach growths called fundic gland polyps. Talk with your doctor about this risk.

If you use NexIUM 24HR for longer than 3 years, you could develop a vitamin B-12 deficiency. Talk to your doctor about how to manage this condition if you develop it.

Common side effects of NexIUM 24HR may include:

• headache;

• diarrhea;

• nausea, stomach pain, gas, constipation; or

• dry mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your current medicines. Many drugs can affect NexIUM 24HR, especially:

• cilostazol;

• clopidogrel;

• diazepam;

• digoxin;

• erlotinib;

• iron-containing medicines (ferrous fumarate, ferrous gluconate, ferrous sulfate, and others);

• methotrexate;

• mycophenolate mofetil;

• rifampin;

• St. John's wort;

• tacrolimus;

• warfarin (Coumadin, Jantoven);

• antifungal medication--ketoconazole, voriconazole; or

• HIV/AIDS medication--atazanavir, nelfinavir, saquinavir.

This list is not complete and many other drugs may affect NexIUM 24HR. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.