Can you Take Nexium (Esomeprazole) After a Meal? Gastroenterologist Explains.
Our content is not intended nor recommended as a substitute for medical advice by your doctor. Use for informational purposes only.
What you need to know:
- Don’t take Nexium (esomeprazole) directly after or before meals. Only you can take it at least 2-3 hours after your meal.
- Generally, we don’t recommend taking Nexium regularly after meals unless you’ve missed your premeal dose.
- Nexium works best when your stomach is empty or near empty.
Why taking Nexium with food is a bad idea?
Nexium is sensitive to acid. So, it is manufactured to be protected from stomach acid.
The active ingredient of Nexium is coated in an acid-resistant capsule. This coat opens only in an alkaline medium.
We all know that the stomach is acidic (due to HCL secretion), and the duodenum is alkaline (due to pancreatic and bile secretions).
Taking Nexium directly after meals leads to a decrease in its effects. You won’t be able to obtain the desired effect of Nexium if taken after eating.
Food triggers stomach acid secretion, which in turn worsens your acid reflux or gastritis symptoms.
Nexium decreases food-induced gastric acid secretion if you take it one hour before a meal.
You will lose the pre-meal inhibitory effect of Nexium when you take it after meals.
When should you take Nexium after meals?
We don’t advise our patients to take Nexium after meals (whether directly or one hour after meals).
The default timing is one hour before your meals. However, you can take Nexium for at least 2 hours after meals under certain circumstances:
- Missed dose: if you forgot your premeal Nexium dose.
- Twice-daily Nexium for nighttime GERD: We advise patients with GERD not to eat 2-3 hours before bedtime. In such a case, it is allowed to take Nexium 2-3 hours after your last meal (before bedtime). However, you can take Nexium one hour before your last meal and still getting the same efficacy.
What is the best time to take Nexium after meals?
If you’re planning to take Nexium after meals, You have to wait for your stomach to empty its contents.
The stomach usually takes 2-3 hours to empty its contents. Here are how much food is still inside your stomach according to gastric emptying studies:
- One hour after your meal: 37-90% of food is still in your stomach.
- Two hours after your meal: 30-60% of food is still in your stomach.
- Four hours after your meal: only about 10% is still in your stomach.
The more you separate Nexium from your meal, the more efficacy you will get.
So, Our advice is to wait for at least two to three hours after eating before you take Nexium.
Gastric emptying can be affected by stomach diseases. You may have conditions that cause a delay in stomach emptying (called delayed gastric emptying or gastroparesis).
Causes of gastroparesis include:
- Diabetes mellitus.
- Idiopathic gastroparesis (unknown cause) in 50% of cases.
- Viral gastroenteritis (as rotavirus or norvirus infections).
- Medications such as blood pressure medications, antidepressants, clonidine, and some anti-diabetes drugs (reference).
- Injury to the vagus nerve (which is responsible for your stomach motility): usually during surgery.
- Some neurological diseases as Multiple Sclerosis (MS), stroke, Parkinson’s disease, and others.
- Some autoimmune diseases as Scleroderma.
So, You may experience delayed gastric emptying if you have any of the conditions listed above. Moreover, delayed gastric emptying (gastroparesis) may have no symptoms if it is mild or in an early stage.
Nexium after meals in patients with gastroparesis is not a good idea. Nexium will be ineffective because your stomach may take several hours to empty its contents.
What happens if you take Nexium after a meal?
Taking Nexium shortly after your meal may result in:
- Less Nexium is absorbed from your digestive system.
- Consequently, it leads to less acid suppression and less control of your symptoms.
- No suppression of meal-induced stomach acid secretion.