The People's Perspective on Medicine

When Is It Best to Take Nexium?

To get the best absorption of prescription esomeprazole delayed release capsules, take Nexium at least one hour before any meal,
PPI esomeprazole heartburn

If you are a conscientious patient, you pay attention to the instructions you may be provided on how to take your medication. Should it be taken with food or on an empty stomach? At equally spaced intervals, or is there a little leeway? These details can be important in determining how well the drug works, but they aren’t always as clear as we’d like. That’s what we discovered from one reader’s question about how to take Nexium.

Rising Early to Take Nexium:

Q. I’ve been on Nexium for several years and it has “cured” Barrett’s esophagus and stomach ulcers. The directions say to take Nexium daily ONE HOUR before a meal. So I have to wake up earlier than I want to take it one hour before breakfast.

The PA at my doctor’s practice says she takes Nexium WITH breakfast. My question: If I eat breakfast (or lunch) two or more hours after taking Nexium, have I lost its benefit? What if I take it only 15 or 30 minutes before breakfast? How important is that ONE hour?

How Important Is That Hour?

A. We are not surprised that you are confused. The official labeling information on prescription esomeprazole  (Nexium) specifies that health professionals advise patients to take Nexium “at least one hour before a meal.”

Over-the-counter Nexium 24HR directs people to “swallow 1 tablet with a glass of water before eating in the morning.” The instructions are ambiguous about how long people should wait before eating.

Taking prescription Nexium with a meal could reduce the amount of medication that gets into your bloodstream by as much as 50 percent. Waiting at least an hour gets around that problem. You could avoid getting up early if you took your acid-suppressing drug an hour or two before lunch or supper. That way you still get the maximum absorption.

There may also be other approaches you could take to help control your ulcers. You’ll learn about some of them in our Guide to Digestive Disorders.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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When should I take my regular prescription meds while I am taking Nexium 24hr OTC?

You’ll get good advice on this from your pharmacist. You can call or go in person; it may work better if you have an appointment.

I have severe heartburn in the middle of the night. Does anybody take Nexium before dinner?

My doctor told me to take Nexium twice a day, one hour before meals. I take it an hour before breakfast and an hour before dinner and it definitely helps me sleep through the night.

I was told by the pharmacy that when taking Nexium that it should be taken 1 hour before meals or two hour after a meal. I take it when I first get up. Now I do have a QUESTION: DOES it cause memory issues over time and bone issues.

I am on Nexium 40 mg. I take it immediately before breakfast and about 20 hours later suffer severe stomach pain. Am now going to takei it one hiur before lunch and hope that stomach pain will not wake me up.

I am usually awake by 6am daily. That is when I take nexium. Thyroid medication I take around 7;30am and don’t eat breakfast until 8:30am. Is that enough time between medications?

My endocrinologist told me NOT to take Nexium before my thyroid meds. I changed it to later in the day. Sure enough, about 6 months later, I had to reduce one of the meds. She said the thyroid meds need a certain amount of stomach acid to break down properly.

Although I am not a pharmacist I have been a pharmacy technician for 37 years. I don’t know of any reason you could not take both medications at the same time and wait 1 hour to eat. When you get your prescriptions fill next ask to speak to your pharmacist about this so you will not have to interrupt your mornings any more than you must.

You are giving advice here on when to take PPI’s, but several days later you have an article on the danger of cognitive impairment from these drugs. I am confused as to the course of action I should take.

I totally agree with you, Colleen. I am completely confused about how to take PPIs as well as how to get off of them. I’ve been taking Dexilantm 60 mg, for several years.

I have had several “spontaneous” fractures of the spine and now have severe osteoporosis,

There doesn’t seem to be an alternative to PPIs.

PS: I’m sorry, I got off subject. My doctor agrees that you should take a PPI an hour before eating for the reasons mentioned above.

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