Esomeprazole
- Class: Proton pump inhibitor
- Used for: heartburn
- Say it: es-oh-MEP-ruh-zole
- Forms: capsule, granules, injection
ESOMEPRAZOLE heals the ESOPHAGUS — the burnt tube that heartburn leaves behind.
The ESO is really the S-mirror-image of omeprazole, but the oesophagus is what it is reached for. Take it 30 to 60 minutes before breakfast: it only disables pumps that a meal has switched on.
It is the S-enantiomer of omeprazole — the same molecule, one mirror image isolated. It is cleared slightly more slowly, which gives modestly better acid control, though the clinical difference is small.
Side effects
Common: headache, diarrhea, stomach pain
Serious: low magnesium, bone fractures
Typical dose
20–40 mg once daily
Capsules may be opened into soft food, but the granules must never be crushed or chewed: crushing destroys the coat that carries them past the stomach.
Check yourself
When should a proton pump inhibitor be taken?
- 30-60 minutes before the first meal of the day
- At bedtime on an empty stomach
- With the largest meal of the day
- Any time — absorption is unaffected by food
Show answer
A. 30-60 minutes before the first meal of the day
PPIs bind only actively secreting pumps, and a meal is what activates them. Taking the dose before breakfast means the drug is present exactly when the pumps switch on — the single most useful piece of counselling for this class.
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