Generic Nexium (Esomeprazole) from Canada: Uses, Action, Side Effects

Nexium is a brand-name pharmaceutical that belongs to the class of medications known as proton pump inhibitors (PPIs). Its generic version is called esomeprazole after the chief active substance used in both drugs. This PPI medicine is designed to decrease the excessive production of gastric acid and relieve the symptoms of gastroesophageal reflux disease (GERD).

Which versions of Nexium in Canada are available?

Nexium in Canada is available in several generic and branded versions. All of them have the same active drug substance – esomeprazole – and are chemically identical to one another. They all are designed to work in pretty much the same way and only differ in price and ease of purchase.

Prescription Nexium is a brand-name prescription-only medicine approved in 2001 for the treatment of acid-related gastric diseases such as heartburn, ulcers, gastric reflux, etc. AstraZeneca manufactures this version of prescription Nexium in the form of sachets and tablets.

Generic Nexium is the first generic version of the branded medication, which was FDA-approved for production by Teva Pharmaceuticals in 2015. Today, at least eight different generic manufacturers produce the drug. The generic esomeprazole contained here is only available on a medical prescription.

OTC Nexium 24HR has been available without a prescription since 2015. This OTC medication is used to treat frequent heartburn that lasts for over two days a week. The Nexium 24HR capsules by Pfizer can be found in physical and online pharmacies, as well as in regular grocery stores that have a pharmaceutical department.

Store brand Nexium 24HR is an over-the-counter medication that appeared in 2017. The Perrigo Company PLC introduced it as a cheaper equivalent of the brand-name Nexium 24HR. The drug contains esomeprazole magnesium and comes boxed as the own label of the shop. Patients do not need to have a valid prescription from their doctor to purchase this medication but are advised to consult a licensed physician first to make sure the drug meets their treatment needs in full.

Usage and mechanism of action

Nexium is an oral drug prescribed to treat the symptoms of gastroesophageal reflux disease and other health conditions that are associated with excessive gastric acid production, such as Zollinger-Ellison syndrome (ZES). This medication facilitates the healing of erosive esophagitis and prevents the development of stomach ulcers caused by the H. Pylori infection or the long-term use of NSAIDs.

This proton pump inhibitor (PPI) drug is designed to bind to a particular type of cells in the stomach wall lining and inhibit their acid-production action. It causes the gastric acidity levels to drop and helps heal the esophageal erosions and stomach and duodenal ulcers.

Recommended dosages

Branded and generic versions of Nexium come as oral capsules, tablets, sachets, and also as a liquid. The available dosage strengths range from 10mg sachets to 20mg and 40mg tablets and capsules. The average recommended dose of the medication depends on the condition it is prescribed to treat.

The usual dose for patients with frequent heartburn and acid reflux is 20mg a day. The same daily amount of medicine is recommended for treating stomach ulcers.

The treatment of gastroesophageal reflux disease (GERD) requires taking 20mg to 40mg of Nexium per day, either in one go or split into two separate morning/evening intakes.

Patients who are diagnosed with the Zollinger-Ellison syndrome are advised to take at least 80mg of esomeprazole a day. This amount of medication can be increased to 160mg a day if the lower dose does not prove helpful enough.

The treatment course with Nexium can last from a few weeks to a few months.

Side effects

Nexium is known to cause several side effects that can range from mild to more serious. The most common of them include constipation, loose stool, gas production, stomach sickness, mouth dryness, giddiness, headache, and sleep disorders.

Serious side effects from taking Nexium are less likely but may sometimes manifest themselves by the following symptoms:

  • visual disturbance
  • yellowish skin and dark pee
  • uncontrolled jerky muscle movements
  • muscular weakness and limpness
  • seizures
  • heartbeat irregularities

Overdose with Nexium is a rare event. If you suspect you might have taken too much of esomeprazole and start noticing the following symptoms – blurriness of the vision, excessive sleeplessness, rapid heartbeat, profuse sweating, confusion or agitation, contact your physician and get medical help right away.


Possible contraindications for Nexium include:

  • hepatic disorders
  • inadequate levels of vitamin B12
  • low magnesium levels
  • interstitial nephritis
  • diarrhea caused by Clostridium difficile bacteria
  • autoimmune diseases
  • brittle bone disease
  • CYP2C19 PM

Warnings and drug interactions

People who are hypersensitive to esomeprazole or who cannot tolerate benzimidazoles should avoid taking Nexium. The medicine is known to interact unsafely with some prescription and OTC drugs, as well as herbal and dietary additives. Taking them together may decrease the effectiveness of the treatment or trigger some unpleasant and dangerous side effects.

Always inform your prescribing physician about all medicinal products you are currently taking, in particular, about:

  • PDE3 inhibitors like cilostazol
  • antiplatelet medications such as clopidogrel
  • immunosuppressants like high-dose methotrexate
  • omeprazole
  • rifampin
  • John’s wort

Also, be careful when you co-take esomeprazole with any medications that require gastric acid for proper absorption. Since Nexium works to decrease the production of this acid, the effectiveness of these may be reduced significantly. Such medicines include rilpivirine, atazanavir, azole antifungals, pazopanib, and some others.

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