{"title":"Acid Reflux \u0026 Heartburn Clinic","description":"\u003cp\u003ePrescription treatments for acid reflux, heartburn and GORD from the Stock My Medicine Online Clinic.\u003c\/p\u003e","products":[{"product_id":"esomeprazole-20mg-28-gastro-resistant-tablets","title":"Esomeprazole 20mg - 28 Gastro-Resistant Tablets","description":"\u003ch2\u003eAbout Esomeprazole 20mg Tablets\u003c\/h2\u003e\u003cp\u003eEsomeprazole is a proton pump inhibitor (PPI), the strongest class of acid-reducing medicine available, and the one most GPs reach for when heartburn is frequent, severe or has started to damage the oesophagus. Esomeprazole 20mg is the standard dose for day-to-day acid reflux: it treats the heartburn and regurgitation of gastro-oesophageal reflux disease (GORD), keeps healed oesophagitis from coming back, and protects the stomach from ulcers in people who need to stay on anti-inflammatory painkillers. One tablet a day switches off most of the acid pumps in the stomach lining for around 24 hours, so acid that would otherwise rise into the throat is reduced at source.\u003c\/p\u003e\u003cp\u003eThis is a generic, prescription-only medicine (the same active ingredient as the brand Nexium) supplied through our \u003ca href=\"\/pages\/acid-reflux-heartburn\"\u003eAcid Reflux \u0026amp; Heartburn online clinic\u003c\/a\u003e. You answer a short consultation, a UK prescriber reviews it, and if it is suitable a private prescription is issued and the pack is dispensed by our pharmacy. Pack of 28 gastro-resistant tablets; the manufacturer may vary.\u003c\/p\u003e\u003ch2\u003eWhat's in Esomeprazole 20mg Tablets?\u003c\/h2\u003e\u003ctable\u003e\n\u003cthead\u003e\u003ctr\u003e\n\u003cth\u003eComponent\u003c\/th\u003e\n\u003cth\u003eType\u003c\/th\u003e\n\u003cth\u003eRole\u003c\/th\u003e\n\u003c\/tr\u003e\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003eEsomeprazole 20mg (as magnesium)\u003c\/td\u003e\n\u003ctd\u003eActive ingredient\u003c\/td\u003e\n\u003ctd\u003eBlocks the proton pumps that make stomach acid\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eGastro-resistant coating on the tablet\u003c\/td\u003e\n\u003ctd\u003eProtective layer\u003c\/td\u003e\n\u003ctd\u003eStops stomach acid destroying the medicine before it is absorbed\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eSugar spheres, cellulose, talc and other excipients\u003c\/td\u003e\n\u003ctd\u003eInactive\u003c\/td\u003e\n\u003ctd\u003eForm the tablet; check the leaflet if you have a sucrose intolerance\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\u003cp\u003eEsomeprazole is the active half (the S-isomer) of omeprazole. Because the body clears it more slowly, it keeps acid lower for longer at the same dose, which is why it is often chosen when omeprazole hasn't fully controlled symptoms. The tablets contain the same esomeprazole as the \u003ca href=\"\/products\/esomeprazole-20mg-28-gastro-resistant-capsules\"\u003e20mg gastro-resistant capsules\u003c\/a\u003e; which you receive is simply a matter of preference and availability.\u003c\/p\u003e\u003ch2\u003eWhat is esomeprazole 20mg used for?\u003c\/h2\u003e\u003cp\u003eEsomeprazole treats conditions caused by too much stomach acid, or acid in the wrong place:\u003c\/p\u003e\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003eGastro-oesophageal reflux disease (GORD)\u003c\/strong\u003e: heartburn and acid regurgitation that happen more than twice a week, or that keep returning after antacids and alginates such as Gaviscon.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eReflux oesophagitis\u003c\/strong\u003e: inflammation or erosions in the lower oesophagus caused by reflux, usually diagnosed at an endoscopy. Healing uses 40mg; 20mg keeps it healed.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eStomach protection with anti-inflammatory painkillers\u003c\/strong\u003e: people who need regular ibuprofen, naproxen or diclofenac and are at risk of ulcers.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eHelicobacter pylori\u003c\/strong\u003e: as part of a seven-day triple therapy with two antibiotics, prescribed by a GP after a positive test.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eZollinger-Ellison syndrome\u003c\/strong\u003e: a rare condition in which a tumour drives acid overproduction; managed by specialists.\u003c\/li\u003e\n\u003c\/ul\u003e\u003cp\u003e20mg is the maintenance and symptom-control strength. If your reflux has damaged the lining of the oesophagus (erosive oesophagitis, usually found at an endoscopy) the healing course is \u003ca href=\"\/products\/esomeprazole-40mg-28-gastro-resistant-tablets\"\u003eesomeprazole 40mg\u003c\/a\u003e for four to eight weeks, after which most people step down to 20mg.\u003c\/p\u003e\u003ch2\u003eWhich symptoms does it relieve?\u003c\/h2\u003e\u003cp\u003eBy cutting acid production, esomeprazole relieves the burning pain behind the breastbone that rises after meals or when lying down, the sour or acidic taste of regurgitation, belching and bloating after food, the night-time cough or hoarseness that acid can cause, and the gnawing upper-stomach pain of an ulcer. It is a treatment for the cause, so it takes a little longer to work than an antacid: expect a clear improvement within two to three days and full effect within a week. It does not treat the sudden, occasional heartburn after a big meal as quickly as an alginate does; the two can be used together while the PPI gets going.\u003c\/p\u003e\u003ch2\u003eHow do I take esomeprazole 20mg tablets?\u003c\/h2\u003e\u003ctable\u003e\n\u003cthead\u003e\u003ctr\u003e\n\u003cth\u003eStep\u003c\/th\u003e\n\u003cth\u003eWhat to do\u003c\/th\u003e\n\u003c\/tr\u003e\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003eWhen\u003c\/td\u003e\n\u003ctd\u003eOnce a day, at the same time each day, at least an hour before a meal; most people take it before breakfast. Food reduces how much is absorbed.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eHow\u003c\/td\u003e\n\u003ctd\u003eSwallow the tablet whole with a glass of water. Don't chew or crush it: the gastro-resistant coating protects esomeprazole from stomach acid so it can be absorbed further down. If you can't swallow tablets, drop one into half a glass of still (not fizzy) water, stir until it breaks up, drink it within 30 minutes, then rinse the glass with more water and drink that too.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eMissed dose\u003c\/td\u003e\n\u003ctd\u003eTake it as soon as you remember unless the next dose is due, then skip it. Never take two doses together.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eAntacids\u003c\/td\u003e\n\u003ctd\u003eFine to take alongside esomeprazole if you need quick relief in the first few days.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eLifestyle\u003c\/td\u003e\n\u003ctd\u003eSmaller meals, not eating in the three hours before bed, raising the head of the bed, cutting down on alcohol, coffee, fatty and spicy food and losing excess weight all reduce reflux and may let you stop the medicine sooner.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\u003ch2\u003eHow much and for how long?\u003c\/h2\u003e\u003ctable\u003e\n\u003cthead\u003e\u003ctr\u003e\n\u003cth\u003eCondition\u003c\/th\u003e\n\u003cth\u003eAdult dose\u003c\/th\u003e\n\u003cth\u003eCourse\u003c\/th\u003e\n\u003c\/tr\u003e\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003eHeartburn and reflux without oesophagitis\u003c\/td\u003e\n\u003ctd\u003eOne 20mg tablet once a day for 4 weeks\u003c\/td\u003e\n\u003ctd\u003eThen 20mg only on the days you need it\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eKeeping healed oesophagitis healed\u003c\/td\u003e\n\u003ctd\u003eOne 20mg tablet once a day\u003c\/td\u003e\n\u003ctd\u003eLong-term, reviewed every 3 months\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eHealing an ulcer caused by anti-inflammatories\u003c\/td\u003e\n\u003ctd\u003eOne 20mg tablet once a day\u003c\/td\u003e\n\u003ctd\u003e4 to 8 weeks\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003ePreventing ulcers while on anti-inflammatories\u003c\/td\u003e\n\u003ctd\u003eOne 20mg tablet once a day\u003c\/td\u003e\n\u003ctd\u003eFor as long as the painkiller continues\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eHelicobacter pylori eradication (with two antibiotics)\u003c\/td\u003e\n\u003ctd\u003eOne 20mg tablet twice a day\u003c\/td\u003e\n\u003ctd\u003e7 days\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\u003cp\u003eEach pack contains 28 tablets, which is a four-week course at one a day. Our prescriber approves one pack per order; if you need ongoing treatment you can reorder, and after three months of continuous use we will ask you to review your symptoms with your GP, as the NHS recommends.\u003c\/p\u003e\u003ch2\u003eWho can and can't take esomeprazole?\u003c\/h2\u003e\u003cp\u003eEsomeprazole is licensed for adults and children from 12; this clinic prescribes for adults only. It can't be taken with the HIV medicine nelfinavir, or by anyone allergic to esomeprazole, omeprazole or other PPIs (lansoprazole, pantoprazole, rabeprazole).\u003c\/p\u003e\u003cp\u003eThe consultation will ask about other medicines because esomeprazole changes how several are handled: it reduces the effect of \u003cstrong\u003eclopidogrel\u003c\/strong\u003e, raises levels of \u003cstrong\u003emethotrexate\u003c\/strong\u003e, \u003cstrong\u003edigoxin\u003c\/strong\u003e and \u003cstrong\u003etacrolimus\u003c\/strong\u003e, needs extra INR checks with \u003cstrong\u003ewarfarin\u003c\/strong\u003e, lowers the absorption of \u003cstrong\u003eketoconazole, itraconazole, erlotinib\u003c\/strong\u003e and some \u003cstrong\u003eHIV medicines\u003c\/strong\u003e, and is itself weakened by \u003cstrong\u003eSt John's wort\u003c\/strong\u003e and \u003cstrong\u003erifampicin\u003c\/strong\u003e. It will also ask about liver disease (the dose is capped at 20mg in severe liver impairment) and about low magnesium, osteoporosis and vitamin B12 deficiency, which matter for longer courses.\u003c\/p\u003e\u003cp\u003eIt is not prescribed through this clinic in pregnancy, when planning a pregnancy or while breastfeeding. Most importantly, anyone with difficulty swallowing, unexplained weight loss, repeated vomiting, blood in vomit or black stools, or new symptoms over 55 needs to see a GP before taking an acid suppressant, because these medicines can mask something more serious.\u003c\/p\u003e\u003ch2\u003eWhat are the side effects of esomeprazole?\u003c\/h2\u003e\u003cp\u003eMost people take esomeprazole without any problems. Common side effects (up to 1 in 10 people) are headache, stomach pain, constipation, diarrhoea, wind and feeling sick; these usually settle in the first week. Benign polyps in the stomach lining are also common with long-term use and need no treatment. Uncommon effects include dizziness, dry mouth, difficulty sleeping, pins and needles and skin rash.\u003c\/p\u003e\u003cp\u003eWith courses longer than a year, or high doses, there is a small increase in the risk of hip, wrist and spine fractures, low magnesium (muscle cramps, palpitations) and low vitamin B12, which is why the prescriber keeps the dose as low as possible and asks for a GP review after three months. Stop and seek urgent help for a severe skin rash, especially with blistering or mouth ulcers, for swelling of the face or throat, or for a rash on sun-exposed skin with joint pain. Report any suspected side effect through the MHRA Yellow Card scheme.\u003c\/p\u003e\u003ch2\u003eEsomeprazole or omeprazole?\u003c\/h2\u003e\u003cp\u003eThey are close relatives: omeprazole is a mixture of two mirror-image forms, and esomeprazole is the one of the two that does the work. Milligram for milligram esomeprazole suppresses acid a little more and more consistently, and studies in erosive oesophagitis show slightly higher healing rates with esomeprazole 40mg than omeprazole 20mg. For simple heartburn the difference is small, so if omeprazole already controls your symptoms there is no need to switch; if it doesn't, esomeprazole is a reasonable next step before stronger measures. Lansoprazole and pantoprazole sit in the same class and are equally valid choices. The prescriber will choose between them based on what you've already tried.\u003c\/p\u003e\u003ch2\u003eHow does the online clinic work?\u003c\/h2\u003e\u003cp\u003eStart from the \u003ca href=\"\/pages\/acid-reflux-heartburn\"\u003eAcid Reflux \u0026amp; Heartburn clinic page\u003c\/a\u003e and complete the consultation first; you are not asked to choose a medicine until the questions are done. A UK-registered prescriber then reviews your answers and either approves the treatment you requested, suggests a more suitable one, or declines and refunds you with an explanation. Every prescription is checked by our pharmacist before it leaves the dispensary. Stock My Medicine is a GPhC-registered UK pharmacy; orders go by Royal Mail Tracked, usually within three to five working days. If you are unsure whether this clinic is right for you, \u003ca href=\"\/pages\/talk-to-a-pharmacist\"\u003etalk to our pharmacist\u003c\/a\u003e first.\u003c\/p\u003e","brand":"StockMyMedicine","offers":[{"title":"Default Title","offer_id":62978626781571,"sku":"1165612","price":12.99,"currency_code":"GBP","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/1006\/9282\/0355\/files\/1_68b63e19-31c6-4607-9adc-8d602d8c53e8.jpg?v=1792769128"},{"product_id":"esomeprazole-40mg-28-gastro-resistant-tablets","title":"Esomeprazole 40mg - 28 Gastro-Resistant Tablets","description":"\u003ch2\u003eAbout Esomeprazole 40mg Tablets\u003c\/h2\u003e\u003cp\u003eEsomeprazole is a proton pump inhibitor (PPI), the strongest class of acid-reducing medicine available, and the one most GPs reach for when heartburn is frequent, severe or has started to damage the oesophagus. Esomeprazole 40mg is the full healing dose: it is prescribed for four to eight weeks when acid reflux has inflamed or ulcerated the lining of the oesophagus (erosive reflux oesophagitis), and in the rare acid-overproducing condition Zollinger-Ellison syndrome. One tablet a day switches off most of the acid pumps in the stomach lining for around 24 hours, so acid that would otherwise rise into the throat is reduced at source.\u003c\/p\u003e\u003cp\u003eThis is a generic, prescription-only medicine (the same active ingredient as the brand Nexium) supplied through our \u003ca href=\"\/pages\/acid-reflux-heartburn\"\u003eAcid Reflux \u0026amp; Heartburn online clinic\u003c\/a\u003e. You answer a short consultation, a UK prescriber reviews it, and if it is suitable a private prescription is issued and the pack is dispensed by our pharmacy. Pack of 28 gastro-resistant tablets; the manufacturer may vary.\u003c\/p\u003e\u003ch2\u003eWhat's in Esomeprazole 40mg Tablets?\u003c\/h2\u003e\u003ctable\u003e\n\u003cthead\u003e\u003ctr\u003e\n\u003cth\u003eComponent\u003c\/th\u003e\n\u003cth\u003eType\u003c\/th\u003e\n\u003cth\u003eRole\u003c\/th\u003e\n\u003c\/tr\u003e\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003eEsomeprazole 40mg (as magnesium)\u003c\/td\u003e\n\u003ctd\u003eActive ingredient\u003c\/td\u003e\n\u003ctd\u003eBlocks the proton pumps that make stomach acid\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eGastro-resistant coating on the tablet\u003c\/td\u003e\n\u003ctd\u003eProtective layer\u003c\/td\u003e\n\u003ctd\u003eStops stomach acid destroying the medicine before it is absorbed\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eSugar spheres, cellulose, talc and other excipients\u003c\/td\u003e\n\u003ctd\u003eInactive\u003c\/td\u003e\n\u003ctd\u003eForm the tablet; check the leaflet if you have a sucrose intolerance\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\u003cp\u003eEsomeprazole is the active half (the S-isomer) of omeprazole. Because the body clears it more slowly, it keeps acid lower for longer at the same dose, which is why it is often chosen when omeprazole hasn't fully controlled symptoms. The tablets contain the same esomeprazole as the \u003ca href=\"\/products\/esomeprazole-40mg-28-gastro-resistant-capsules\"\u003e40mg gastro-resistant capsules\u003c\/a\u003e; which you receive is simply a matter of preference and availability.\u003c\/p\u003e\u003ch2\u003eWhat is esomeprazole 40mg used for?\u003c\/h2\u003e\u003cp\u003eEsomeprazole treats conditions caused by too much stomach acid, or acid in the wrong place:\u003c\/p\u003e\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003eGastro-oesophageal reflux disease (GORD)\u003c\/strong\u003e: heartburn and acid regurgitation that happen more than twice a week, or that keep returning after antacids and alginates such as Gaviscon.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eReflux oesophagitis\u003c\/strong\u003e: inflammation or erosions in the lower oesophagus caused by reflux, usually diagnosed at an endoscopy. Healing uses 40mg; 20mg keeps it healed.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eStomach protection with anti-inflammatory painkillers\u003c\/strong\u003e: people who need regular ibuprofen, naproxen or diclofenac and are at risk of ulcers.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eHelicobacter pylori\u003c\/strong\u003e: as part of a seven-day triple therapy with two antibiotics, prescribed by a GP after a positive test.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eZollinger-Ellison syndrome\u003c\/strong\u003e: a rare condition in which a tumour drives acid overproduction; managed by specialists.\u003c\/li\u003e\n\u003c\/ul\u003e\u003cp\u003e40mg is the healing strength, not the everyday one. Once the oesophagus has healed, or if you have reflux symptoms without any damage to the lining, the usual dose is \u003ca href=\"\/products\/esomeprazole-20mg-28-gastro-resistant-tablets\"\u003eesomeprazole 20mg\u003c\/a\u003e once a day, and many people need it only on the days their symptoms flare.\u003c\/p\u003e\u003ch2\u003eWhich symptoms does it relieve?\u003c\/h2\u003e\u003cp\u003eBy cutting acid production, esomeprazole relieves the burning pain behind the breastbone that rises after meals or when lying down, the sour or acidic taste of regurgitation, belching and bloating after food, the night-time cough or hoarseness that acid can cause, and the gnawing upper-stomach pain of an ulcer. It is a treatment for the cause, so it takes a little longer to work than an antacid: expect a clear improvement within two to three days and full effect within a week. It does not treat the sudden, occasional heartburn after a big meal as quickly as an alginate does; the two can be used together while the PPI gets going.\u003c\/p\u003e\u003ch2\u003eHow do I take esomeprazole 40mg tablets?\u003c\/h2\u003e\u003ctable\u003e\n\u003cthead\u003e\u003ctr\u003e\n\u003cth\u003eStep\u003c\/th\u003e\n\u003cth\u003eWhat to do\u003c\/th\u003e\n\u003c\/tr\u003e\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003eWhen\u003c\/td\u003e\n\u003ctd\u003eOnce a day, at the same time each day, at least an hour before a meal; most people take it before breakfast. Food reduces how much is absorbed.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eHow\u003c\/td\u003e\n\u003ctd\u003eSwallow the tablet whole with a glass of water. Don't chew or crush it: the gastro-resistant coating protects esomeprazole from stomach acid so it can be absorbed further down. If you can't swallow tablets, drop one into half a glass of still (not fizzy) water, stir until it breaks up, drink it within 30 minutes, then rinse the glass with more water and drink that too.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eMissed dose\u003c\/td\u003e\n\u003ctd\u003eTake it as soon as you remember unless the next dose is due, then skip it. Never take two doses together.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eAntacids\u003c\/td\u003e\n\u003ctd\u003eFine to take alongside esomeprazole if you need quick relief in the first few days.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eLifestyle\u003c\/td\u003e\n\u003ctd\u003eSmaller meals, not eating in the three hours before bed, raising the head of the bed, cutting down on alcohol, coffee, fatty and spicy food and losing excess weight all reduce reflux and may let you stop the medicine sooner.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\u003ch2\u003eHow much and for how long?\u003c\/h2\u003e\u003ctable\u003e\n\u003cthead\u003e\u003ctr\u003e\n\u003cth\u003eCondition\u003c\/th\u003e\n\u003cth\u003eAdult dose\u003c\/th\u003e\n\u003cth\u003eCourse\u003c\/th\u003e\n\u003c\/tr\u003e\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003eHealing erosive reflux oesophagitis\u003c\/td\u003e\n\u003ctd\u003eOne 40mg tablet once a day\u003c\/td\u003e\n\u003ctd\u003e4 weeks; a further 4 weeks if not fully healed\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eSevere or persistent reflux symptoms\u003c\/td\u003e\n\u003ctd\u003eOne 40mg tablet once a day\u003c\/td\u003e\n\u003ctd\u003eShort course, then step down to 20mg\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eZollinger-Ellison syndrome\u003c\/td\u003e\n\u003ctd\u003eOne 40mg tablet twice a day to start\u003c\/td\u003e\n\u003ctd\u003eAdjusted by the prescriber\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eAfter healing\u003c\/td\u003e\n\u003ctd\u003eStep down to 20mg once a day\u003c\/td\u003e\n\u003ctd\u003eLong-term, reviewed every 3 months\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\u003cp\u003eEach pack contains 28 tablets, which is a four-week course at one a day. Our prescriber approves one pack per order; if you need ongoing treatment you can reorder, and after three months of continuous use we will ask you to review your symptoms with your GP, as the NHS recommends.\u003c\/p\u003e\u003ch2\u003eWho can and can't take esomeprazole?\u003c\/h2\u003e\u003cp\u003eEsomeprazole is licensed for adults and children from 12; this clinic prescribes for adults only. It can't be taken with the HIV medicine nelfinavir, or by anyone allergic to esomeprazole, omeprazole or other PPIs (lansoprazole, pantoprazole, rabeprazole).\u003c\/p\u003e\u003cp\u003eThe consultation will ask about other medicines because esomeprazole changes how several are handled: it reduces the effect of \u003cstrong\u003eclopidogrel\u003c\/strong\u003e, raises levels of \u003cstrong\u003emethotrexate\u003c\/strong\u003e, \u003cstrong\u003edigoxin\u003c\/strong\u003e and \u003cstrong\u003etacrolimus\u003c\/strong\u003e, needs extra INR checks with \u003cstrong\u003ewarfarin\u003c\/strong\u003e, lowers the absorption of \u003cstrong\u003eketoconazole, itraconazole, erlotinib\u003c\/strong\u003e and some \u003cstrong\u003eHIV medicines\u003c\/strong\u003e, and is itself weakened by \u003cstrong\u003eSt John's wort\u003c\/strong\u003e and \u003cstrong\u003erifampicin\u003c\/strong\u003e. It will also ask about liver disease (the dose is capped at 20mg in severe liver impairment) and about low magnesium, osteoporosis and vitamin B12 deficiency, which matter for longer courses.\u003c\/p\u003e\u003cp\u003eIt is not prescribed through this clinic in pregnancy, when planning a pregnancy or while breastfeeding. Most importantly, anyone with difficulty swallowing, unexplained weight loss, repeated vomiting, blood in vomit or black stools, or new symptoms over 55 needs to see a GP before taking an acid suppressant, because these medicines can mask something more serious.\u003c\/p\u003e\u003ch2\u003eWhat are the side effects of esomeprazole?\u003c\/h2\u003e\u003cp\u003eMost people take esomeprazole without any problems. Common side effects (up to 1 in 10 people) are headache, stomach pain, constipation, diarrhoea, wind and feeling sick; these usually settle in the first week. Benign polyps in the stomach lining are also common with long-term use and need no treatment. Uncommon effects include dizziness, dry mouth, difficulty sleeping, pins and needles and skin rash.\u003c\/p\u003e\u003cp\u003eWith courses longer than a year, or high doses, there is a small increase in the risk of hip, wrist and spine fractures, low magnesium (muscle cramps, palpitations) and low vitamin B12, which is why the prescriber keeps the dose as low as possible and asks for a GP review after three months. Stop and seek urgent help for a severe skin rash, especially with blistering or mouth ulcers, for swelling of the face or throat, or for a rash on sun-exposed skin with joint pain. Report any suspected side effect through the MHRA Yellow Card scheme.\u003c\/p\u003e\u003ch2\u003eEsomeprazole or omeprazole?\u003c\/h2\u003e\u003cp\u003eThey are close relatives: omeprazole is a mixture of two mirror-image forms, and esomeprazole is the one of the two that does the work. Milligram for milligram esomeprazole suppresses acid a little more and more consistently, and studies in erosive oesophagitis show slightly higher healing rates with esomeprazole 40mg than omeprazole 20mg. For simple heartburn the difference is small, so if omeprazole already controls your symptoms there is no need to switch; if it doesn't, esomeprazole is a reasonable next step before stronger measures. Lansoprazole and pantoprazole sit in the same class and are equally valid choices. The prescriber will choose between them based on what you've already tried.\u003c\/p\u003e\u003ch2\u003eHow does the online clinic work?\u003c\/h2\u003e\u003cp\u003eStart from the \u003ca href=\"\/pages\/acid-reflux-heartburn\"\u003eAcid Reflux \u0026amp; Heartburn clinic page\u003c\/a\u003e and complete the consultation first; you are not asked to choose a medicine until the questions are done. A UK-registered prescriber then reviews your answers and either approves the treatment you requested, suggests a more suitable one, or declines and refunds you with an explanation. Every prescription is checked by our pharmacist before it leaves the dispensary. Stock My Medicine is a GPhC-registered UK pharmacy; orders go by Royal Mail Tracked, usually within three to five working days. If you are unsure whether this clinic is right for you, \u003ca href=\"\/pages\/talk-to-a-pharmacist\"\u003etalk to our pharmacist\u003c\/a\u003e first.\u003c\/p\u003e","brand":"StockMyMedicine","offers":[{"title":"Default Title","offer_id":62978639430019,"sku":"1165620","price":13.99,"currency_code":"GBP","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/1006\/9282\/0355\/files\/1_8e74cf2a-4956-4bdb-a8e7-28afced810f7.jpg?v=1792768899"},{"product_id":"esomeprazole-20mg-28-gastro-resistant-capsules","title":"Esomeprazole 20mg - 28 Gastro-Resistant Capsules","description":"\u003ch2\u003eAbout Esomeprazole 20mg Capsules\u003c\/h2\u003e\u003cp\u003eEsomeprazole is a proton pump inhibitor (PPI), the strongest class of acid-reducing medicine available, and the one most GPs reach for when heartburn is frequent, severe or has started to damage the oesophagus. Esomeprazole 20mg is the standard dose for day-to-day acid reflux: it treats the heartburn and regurgitation of gastro-oesophageal reflux disease (GORD), keeps healed oesophagitis from coming back, and protects the stomach from ulcers in people who need to stay on anti-inflammatory painkillers. One capsule a day switches off most of the acid pumps in the stomach lining for around 24 hours, so acid that would otherwise rise into the throat is reduced at source.\u003c\/p\u003e\u003cp\u003eThis is a generic, prescription-only medicine (the same active ingredient as the brand Nexium) supplied through our \u003ca href=\"\/pages\/acid-reflux-heartburn\"\u003eAcid Reflux \u0026amp; Heartburn online clinic\u003c\/a\u003e. You answer a short consultation, a UK prescriber reviews it, and if it is suitable a private prescription is issued and the pack is dispensed by our pharmacy. Pack of 28 gastro-resistant capsules; the manufacturer may vary.\u003c\/p\u003e\u003ch2\u003eWhat's in Esomeprazole 20mg Capsules?\u003c\/h2\u003e\u003ctable\u003e\n\u003cthead\u003e\u003ctr\u003e\n\u003cth\u003eComponent\u003c\/th\u003e\n\u003cth\u003eType\u003c\/th\u003e\n\u003cth\u003eRole\u003c\/th\u003e\n\u003c\/tr\u003e\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003eEsomeprazole 20mg (as magnesium)\u003c\/td\u003e\n\u003ctd\u003eActive ingredient\u003c\/td\u003e\n\u003ctd\u003eBlocks the proton pumps that make stomach acid\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eGastro-resistant coating on the pellets\u003c\/td\u003e\n\u003ctd\u003eProtective layer\u003c\/td\u003e\n\u003ctd\u003eStops stomach acid destroying the medicine before it is absorbed\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eSugar spheres, cellulose, talc and other excipients\u003c\/td\u003e\n\u003ctd\u003eInactive\u003c\/td\u003e\n\u003ctd\u003eForm the capsule; check the leaflet if you have a sucrose intolerance\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\u003cp\u003eEsomeprazole is the active half (the S-isomer) of omeprazole. Because the body clears it more slowly, it keeps acid lower for longer at the same dose, which is why it is often chosen when omeprazole hasn't fully controlled symptoms. The capsules contain the same esomeprazole as the \u003ca href=\"\/products\/esomeprazole-20mg-28-gastro-resistant-tablets\"\u003e20mg gastro-resistant tablets\u003c\/a\u003e; they can be opened and the pellets taken in water, which some people find easier than dispersing a tablet.\u003c\/p\u003e\u003ch2\u003eWhat is esomeprazole 20mg used for?\u003c\/h2\u003e\u003cp\u003eEsomeprazole treats conditions caused by too much stomach acid, or acid in the wrong place:\u003c\/p\u003e\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003eGastro-oesophageal reflux disease (GORD)\u003c\/strong\u003e: heartburn and acid regurgitation that happen more than twice a week, or that keep returning after antacids and alginates such as Gaviscon.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eReflux oesophagitis\u003c\/strong\u003e: inflammation or erosions in the lower oesophagus caused by reflux, usually diagnosed at an endoscopy. Healing uses 40mg; 20mg keeps it healed.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eStomach protection with anti-inflammatory painkillers\u003c\/strong\u003e: people who need regular ibuprofen, naproxen or diclofenac and are at risk of ulcers.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eHelicobacter pylori\u003c\/strong\u003e: as part of a seven-day triple therapy with two antibiotics, prescribed by a GP after a positive test.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eZollinger-Ellison syndrome\u003c\/strong\u003e: a rare condition in which a tumour drives acid overproduction; managed by specialists.\u003c\/li\u003e\n\u003c\/ul\u003e\u003cp\u003e20mg is the maintenance and symptom-control strength. If your reflux has damaged the lining of the oesophagus (erosive oesophagitis, usually found at an endoscopy) the healing course is \u003ca href=\"\/products\/esomeprazole-40mg-28-gastro-resistant-capsules\"\u003eesomeprazole 40mg\u003c\/a\u003e for four to eight weeks, after which most people step down to 20mg.\u003c\/p\u003e\u003ch2\u003eWhich symptoms does it relieve?\u003c\/h2\u003e\u003cp\u003eBy cutting acid production, esomeprazole relieves the burning pain behind the breastbone that rises after meals or when lying down, the sour or acidic taste of regurgitation, belching and bloating after food, the night-time cough or hoarseness that acid can cause, and the gnawing upper-stomach pain of an ulcer. It is a treatment for the cause, so it takes a little longer to work than an antacid: expect a clear improvement within two to three days and full effect within a week. It does not treat the sudden, occasional heartburn after a big meal as quickly as an alginate does; the two can be used together while the PPI gets going.\u003c\/p\u003e\u003ch2\u003eHow do I take esomeprazole 20mg capsules?\u003c\/h2\u003e\u003ctable\u003e\n\u003cthead\u003e\u003ctr\u003e\n\u003cth\u003eStep\u003c\/th\u003e\n\u003cth\u003eWhat to do\u003c\/th\u003e\n\u003c\/tr\u003e\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003eWhen\u003c\/td\u003e\n\u003ctd\u003eOnce a day, at the same time each day, at least an hour before a meal; most people take it before breakfast. Food reduces how much is absorbed.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eHow\u003c\/td\u003e\n\u003ctd\u003eSwallow the capsule whole with a glass of water. Don't chew or crush it: the pellets inside have a coating that protects esomeprazole from stomach acid. If you can't swallow capsules, open one and stir the pellets into half a glass of still (not fizzy) water, drink it within 30 minutes, then rinse the glass with more water and drink that too, without chewing the pellets.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eMissed dose\u003c\/td\u003e\n\u003ctd\u003eTake it as soon as you remember unless the next dose is due, then skip it. Never take two doses together.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eAntacids\u003c\/td\u003e\n\u003ctd\u003eFine to take alongside esomeprazole if you need quick relief in the first few days.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eLifestyle\u003c\/td\u003e\n\u003ctd\u003eSmaller meals, not eating in the three hours before bed, raising the head of the bed, cutting down on alcohol, coffee, fatty and spicy food and losing excess weight all reduce reflux and may let you stop the medicine sooner.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\u003ch2\u003eHow much and for how long?\u003c\/h2\u003e\u003ctable\u003e\n\u003cthead\u003e\u003ctr\u003e\n\u003cth\u003eCondition\u003c\/th\u003e\n\u003cth\u003eAdult dose\u003c\/th\u003e\n\u003cth\u003eCourse\u003c\/th\u003e\n\u003c\/tr\u003e\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003eHeartburn and reflux without oesophagitis\u003c\/td\u003e\n\u003ctd\u003eOne 20mg capsule once a day for 4 weeks\u003c\/td\u003e\n\u003ctd\u003eThen 20mg only on the days you need it\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eKeeping healed oesophagitis healed\u003c\/td\u003e\n\u003ctd\u003eOne 20mg capsule once a day\u003c\/td\u003e\n\u003ctd\u003eLong-term, reviewed every 3 months\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eHealing an ulcer caused by anti-inflammatories\u003c\/td\u003e\n\u003ctd\u003eOne 20mg capsule once a day\u003c\/td\u003e\n\u003ctd\u003e4 to 8 weeks\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003ePreventing ulcers while on anti-inflammatories\u003c\/td\u003e\n\u003ctd\u003eOne 20mg capsule once a day\u003c\/td\u003e\n\u003ctd\u003eFor as long as the painkiller continues\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eHelicobacter pylori eradication (with two antibiotics)\u003c\/td\u003e\n\u003ctd\u003eOne 20mg capsule twice a day\u003c\/td\u003e\n\u003ctd\u003e7 days\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\u003cp\u003eEach pack contains 28 capsules, which is a four-week course at one a day. Our prescriber approves one pack per order; if you need ongoing treatment you can reorder, and after three months of continuous use we will ask you to review your symptoms with your GP, as the NHS recommends.\u003c\/p\u003e\u003ch2\u003eWho can and can't take esomeprazole?\u003c\/h2\u003e\u003cp\u003eEsomeprazole is licensed for adults and children from 12; this clinic prescribes for adults only. It can't be taken with the HIV medicine nelfinavir, or by anyone allergic to esomeprazole, omeprazole or other PPIs (lansoprazole, pantoprazole, rabeprazole).\u003c\/p\u003e\u003cp\u003eThe consultation will ask about other medicines because esomeprazole changes how several are handled: it reduces the effect of \u003cstrong\u003eclopidogrel\u003c\/strong\u003e, raises levels of \u003cstrong\u003emethotrexate\u003c\/strong\u003e, \u003cstrong\u003edigoxin\u003c\/strong\u003e and \u003cstrong\u003etacrolimus\u003c\/strong\u003e, needs extra INR checks with \u003cstrong\u003ewarfarin\u003c\/strong\u003e, lowers the absorption of \u003cstrong\u003eketoconazole, itraconazole, erlotinib\u003c\/strong\u003e and some \u003cstrong\u003eHIV medicines\u003c\/strong\u003e, and is itself weakened by \u003cstrong\u003eSt John's wort\u003c\/strong\u003e and \u003cstrong\u003erifampicin\u003c\/strong\u003e. It will also ask about liver disease (the dose is capped at 20mg in severe liver impairment) and about low magnesium, osteoporosis and vitamin B12 deficiency, which matter for longer courses.\u003c\/p\u003e\u003cp\u003eIt is not prescribed through this clinic in pregnancy, when planning a pregnancy or while breastfeeding. Most importantly, anyone with difficulty swallowing, unexplained weight loss, repeated vomiting, blood in vomit or black stools, or new symptoms over 55 needs to see a GP before taking an acid suppressant, because these medicines can mask something more serious.\u003c\/p\u003e\u003ch2\u003eWhat are the side effects of esomeprazole?\u003c\/h2\u003e\u003cp\u003eMost people take esomeprazole without any problems. Common side effects (up to 1 in 10 people) are headache, stomach pain, constipation, diarrhoea, wind and feeling sick; these usually settle in the first week. Benign polyps in the stomach lining are also common with long-term use and need no treatment. Uncommon effects include dizziness, dry mouth, difficulty sleeping, pins and needles and skin rash.\u003c\/p\u003e\u003cp\u003eWith courses longer than a year, or high doses, there is a small increase in the risk of hip, wrist and spine fractures, low magnesium (muscle cramps, palpitations) and low vitamin B12, which is why the prescriber keeps the dose as low as possible and asks for a GP review after three months. Stop and seek urgent help for a severe skin rash, especially with blistering or mouth ulcers, for swelling of the face or throat, or for a rash on sun-exposed skin with joint pain. Report any suspected side effect through the MHRA Yellow Card scheme.\u003c\/p\u003e\u003ch2\u003eEsomeprazole or omeprazole?\u003c\/h2\u003e\u003cp\u003eThey are close relatives: omeprazole is a mixture of two mirror-image forms, and esomeprazole is the one of the two that does the work. Milligram for milligram esomeprazole suppresses acid a little more and more consistently, and studies in erosive oesophagitis show slightly higher healing rates with esomeprazole 40mg than omeprazole 20mg. For simple heartburn the difference is small, so if omeprazole already controls your symptoms there is no need to switch; if it doesn't, esomeprazole is a reasonable next step before stronger measures. Lansoprazole and pantoprazole sit in the same class and are equally valid choices. The prescriber will choose between them based on what you've already tried.\u003c\/p\u003e\u003ch2\u003eHow does the online clinic work?\u003c\/h2\u003e\u003cp\u003eStart from the \u003ca href=\"\/pages\/acid-reflux-heartburn\"\u003eAcid Reflux \u0026amp; Heartburn clinic page\u003c\/a\u003e and complete the consultation first; you are not asked to choose a medicine until the questions are done. A UK-registered prescriber then reviews your answers and either approves the treatment you requested, suggests a more suitable one, or declines and refunds you with an explanation. Every prescription is checked by our pharmacist before it leaves the dispensary. Stock My Medicine is a GPhC-registered UK pharmacy; orders go by Royal Mail Tracked, usually within three to five working days. If you are unsure whether this clinic is right for you, \u003ca href=\"\/pages\/talk-to-a-pharmacist\"\u003etalk to our pharmacist\u003c\/a\u003e first.\u003c\/p\u003e","brand":"StockMyMedicine","offers":[{"title":"Default Title","offer_id":62978645754243,"sku":"3564838","price":12.99,"currency_code":"GBP","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/1006\/9282\/0355\/files\/1_59704805-6942-4ff7-ab92-10702dc1b890.jpg?v=1792769213"},{"product_id":"esomeprazole-40mg-28-gastro-resistant-capsules","title":"Esomeprazole 40mg - 28 Gastro-Resistant Capsules","description":"\u003ch2\u003eAbout Esomeprazole 40mg Capsules\u003c\/h2\u003e\u003cp\u003eEsomeprazole is a proton pump inhibitor (PPI), the strongest class of acid-reducing medicine available, and the one most GPs reach for when heartburn is frequent, severe or has started to damage the oesophagus. Esomeprazole 40mg is the full healing dose: it is prescribed for four to eight weeks when acid reflux has inflamed or ulcerated the lining of the oesophagus (erosive reflux oesophagitis), and in the rare acid-overproducing condition Zollinger-Ellison syndrome. One capsule a day switches off most of the acid pumps in the stomach lining for around 24 hours, so acid that would otherwise rise into the throat is reduced at source.\u003c\/p\u003e\u003cp\u003eThis is a generic, prescription-only medicine (the same active ingredient as the brand Nexium) supplied through our \u003ca href=\"\/pages\/acid-reflux-heartburn\"\u003eAcid Reflux \u0026amp; Heartburn online clinic\u003c\/a\u003e. You answer a short consultation, a UK prescriber reviews it, and if it is suitable a private prescription is issued and the pack is dispensed by our pharmacy. Pack of 28 gastro-resistant capsules; the manufacturer may vary.\u003c\/p\u003e\u003ch2\u003eWhat's in Esomeprazole 40mg Capsules?\u003c\/h2\u003e\u003ctable\u003e\n\u003cthead\u003e\u003ctr\u003e\n\u003cth\u003eComponent\u003c\/th\u003e\n\u003cth\u003eType\u003c\/th\u003e\n\u003cth\u003eRole\u003c\/th\u003e\n\u003c\/tr\u003e\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003eEsomeprazole 40mg (as magnesium)\u003c\/td\u003e\n\u003ctd\u003eActive ingredient\u003c\/td\u003e\n\u003ctd\u003eBlocks the proton pumps that make stomach acid\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eGastro-resistant coating on the pellets\u003c\/td\u003e\n\u003ctd\u003eProtective layer\u003c\/td\u003e\n\u003ctd\u003eStops stomach acid destroying the medicine before it is absorbed\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eSugar spheres, cellulose, talc and other excipients\u003c\/td\u003e\n\u003ctd\u003eInactive\u003c\/td\u003e\n\u003ctd\u003eForm the capsule; check the leaflet if you have a sucrose intolerance\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\u003cp\u003eEsomeprazole is the active half (the S-isomer) of omeprazole. Because the body clears it more slowly, it keeps acid lower for longer at the same dose, which is why it is often chosen when omeprazole hasn't fully controlled symptoms. The capsules contain the same esomeprazole as the \u003ca href=\"\/products\/esomeprazole-40mg-28-gastro-resistant-tablets\"\u003e40mg gastro-resistant tablets\u003c\/a\u003e; they can be opened and the pellets taken in water, which some people find easier than dispersing a tablet.\u003c\/p\u003e\u003ch2\u003eWhat is esomeprazole 40mg used for?\u003c\/h2\u003e\u003cp\u003eEsomeprazole treats conditions caused by too much stomach acid, or acid in the wrong place:\u003c\/p\u003e\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003eGastro-oesophageal reflux disease (GORD)\u003c\/strong\u003e: heartburn and acid regurgitation that happen more than twice a week, or that keep returning after antacids and alginates such as Gaviscon.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eReflux oesophagitis\u003c\/strong\u003e: inflammation or erosions in the lower oesophagus caused by reflux, usually diagnosed at an endoscopy. Healing uses 40mg; 20mg keeps it healed.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eStomach protection with anti-inflammatory painkillers\u003c\/strong\u003e: people who need regular ibuprofen, naproxen or diclofenac and are at risk of ulcers.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eHelicobacter pylori\u003c\/strong\u003e: as part of a seven-day triple therapy with two antibiotics, prescribed by a GP after a positive test.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eZollinger-Ellison syndrome\u003c\/strong\u003e: a rare condition in which a tumour drives acid overproduction; managed by specialists.\u003c\/li\u003e\n\u003c\/ul\u003e\u003cp\u003e40mg is the healing strength, not the everyday one. Once the oesophagus has healed, or if you have reflux symptoms without any damage to the lining, the usual dose is \u003ca href=\"\/products\/esomeprazole-20mg-28-gastro-resistant-capsules\"\u003eesomeprazole 20mg\u003c\/a\u003e once a day, and many people need it only on the days their symptoms flare.\u003c\/p\u003e\u003ch2\u003eWhich symptoms does it relieve?\u003c\/h2\u003e\u003cp\u003eBy cutting acid production, esomeprazole relieves the burning pain behind the breastbone that rises after meals or when lying down, the sour or acidic taste of regurgitation, belching and bloating after food, the night-time cough or hoarseness that acid can cause, and the gnawing upper-stomach pain of an ulcer. It is a treatment for the cause, so it takes a little longer to work than an antacid: expect a clear improvement within two to three days and full effect within a week. It does not treat the sudden, occasional heartburn after a big meal as quickly as an alginate does; the two can be used together while the PPI gets going.\u003c\/p\u003e\u003ch2\u003eHow do I take esomeprazole 40mg capsules?\u003c\/h2\u003e\u003ctable\u003e\n\u003cthead\u003e\u003ctr\u003e\n\u003cth\u003eStep\u003c\/th\u003e\n\u003cth\u003eWhat to do\u003c\/th\u003e\n\u003c\/tr\u003e\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003eWhen\u003c\/td\u003e\n\u003ctd\u003eOnce a day, at the same time each day, at least an hour before a meal; most people take it before breakfast. Food reduces how much is absorbed.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eHow\u003c\/td\u003e\n\u003ctd\u003eSwallow the capsule whole with a glass of water. Don't chew or crush it: the pellets inside have a coating that protects esomeprazole from stomach acid. If you can't swallow capsules, open one and stir the pellets into half a glass of still (not fizzy) water, drink it within 30 minutes, then rinse the glass with more water and drink that too, without chewing the pellets.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eMissed dose\u003c\/td\u003e\n\u003ctd\u003eTake it as soon as you remember unless the next dose is due, then skip it. Never take two doses together.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eAntacids\u003c\/td\u003e\n\u003ctd\u003eFine to take alongside esomeprazole if you need quick relief in the first few days.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eLifestyle\u003c\/td\u003e\n\u003ctd\u003eSmaller meals, not eating in the three hours before bed, raising the head of the bed, cutting down on alcohol, coffee, fatty and spicy food and losing excess weight all reduce reflux and may let you stop the medicine sooner.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\u003ch2\u003eHow much and for how long?\u003c\/h2\u003e\u003ctable\u003e\n\u003cthead\u003e\u003ctr\u003e\n\u003cth\u003eCondition\u003c\/th\u003e\n\u003cth\u003eAdult dose\u003c\/th\u003e\n\u003cth\u003eCourse\u003c\/th\u003e\n\u003c\/tr\u003e\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003eHealing erosive reflux oesophagitis\u003c\/td\u003e\n\u003ctd\u003eOne 40mg capsule once a day\u003c\/td\u003e\n\u003ctd\u003e4 weeks; a further 4 weeks if not fully healed\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eSevere or persistent reflux symptoms\u003c\/td\u003e\n\u003ctd\u003eOne 40mg capsule once a day\u003c\/td\u003e\n\u003ctd\u003eShort course, then step down to 20mg\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eZollinger-Ellison syndrome\u003c\/td\u003e\n\u003ctd\u003eOne 40mg capsule twice a day to start\u003c\/td\u003e\n\u003ctd\u003eAdjusted by the prescriber\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eAfter healing\u003c\/td\u003e\n\u003ctd\u003eStep down to 20mg once a day\u003c\/td\u003e\n\u003ctd\u003eLong-term, reviewed every 3 months\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\u003cp\u003eEach pack contains 28 capsules, which is a four-week course at one a day. Our prescriber approves one pack per order; if you need ongoing treatment you can reorder, and after three months of continuous use we will ask you to review your symptoms with your GP, as the NHS recommends.\u003c\/p\u003e\u003ch2\u003eWho can and can't take esomeprazole?\u003c\/h2\u003e\u003cp\u003eEsomeprazole is licensed for adults and children from 12; this clinic prescribes for adults only. It can't be taken with the HIV medicine nelfinavir, or by anyone allergic to esomeprazole, omeprazole or other PPIs (lansoprazole, pantoprazole, rabeprazole).\u003c\/p\u003e\u003cp\u003eThe consultation will ask about other medicines because esomeprazole changes how several are handled: it reduces the effect of \u003cstrong\u003eclopidogrel\u003c\/strong\u003e, raises levels of \u003cstrong\u003emethotrexate\u003c\/strong\u003e, \u003cstrong\u003edigoxin\u003c\/strong\u003e and \u003cstrong\u003etacrolimus\u003c\/strong\u003e, needs extra INR checks with \u003cstrong\u003ewarfarin\u003c\/strong\u003e, lowers the absorption of \u003cstrong\u003eketoconazole, itraconazole, erlotinib\u003c\/strong\u003e and some \u003cstrong\u003eHIV medicines\u003c\/strong\u003e, and is itself weakened by \u003cstrong\u003eSt John's wort\u003c\/strong\u003e and \u003cstrong\u003erifampicin\u003c\/strong\u003e. It will also ask about liver disease (the dose is capped at 20mg in severe liver impairment) and about low magnesium, osteoporosis and vitamin B12 deficiency, which matter for longer courses.\u003c\/p\u003e\u003cp\u003eIt is not prescribed through this clinic in pregnancy, when planning a pregnancy or while breastfeeding. Most importantly, anyone with difficulty swallowing, unexplained weight loss, repeated vomiting, blood in vomit or black stools, or new symptoms over 55 needs to see a GP before taking an acid suppressant, because these medicines can mask something more serious.\u003c\/p\u003e\u003ch2\u003eWhat are the side effects of esomeprazole?\u003c\/h2\u003e\u003cp\u003eMost people take esomeprazole without any problems. Common side effects (up to 1 in 10 people) are headache, stomach pain, constipation, diarrhoea, wind and feeling sick; these usually settle in the first week. Benign polyps in the stomach lining are also common with long-term use and need no treatment. Uncommon effects include dizziness, dry mouth, difficulty sleeping, pins and needles and skin rash.\u003c\/p\u003e\u003cp\u003eWith courses longer than a year, or high doses, there is a small increase in the risk of hip, wrist and spine fractures, low magnesium (muscle cramps, palpitations) and low vitamin B12, which is why the prescriber keeps the dose as low as possible and asks for a GP review after three months. Stop and seek urgent help for a severe skin rash, especially with blistering or mouth ulcers, for swelling of the face or throat, or for a rash on sun-exposed skin with joint pain. Report any suspected side effect through the MHRA Yellow Card scheme.\u003c\/p\u003e\u003ch2\u003eEsomeprazole or omeprazole?\u003c\/h2\u003e\u003cp\u003eThey are close relatives: omeprazole is a mixture of two mirror-image forms, and esomeprazole is the one of the two that does the work. Milligram for milligram esomeprazole suppresses acid a little more and more consistently, and studies in erosive oesophagitis show slightly higher healing rates with esomeprazole 40mg than omeprazole 20mg. For simple heartburn the difference is small, so if omeprazole already controls your symptoms there is no need to switch; if it doesn't, esomeprazole is a reasonable next step before stronger measures. Lansoprazole and pantoprazole sit in the same class and are equally valid choices. The prescriber will choose between them based on what you've already tried.\u003c\/p\u003e\u003ch2\u003eHow does the online clinic work?\u003c\/h2\u003e\u003cp\u003eStart from the \u003ca href=\"\/pages\/acid-reflux-heartburn\"\u003eAcid Reflux \u0026amp; Heartburn clinic page\u003c\/a\u003e and complete the consultation first; you are not asked to choose a medicine until the questions are done. A UK-registered prescriber then reviews your answers and either approves the treatment you requested, suggests a more suitable one, or declines and refunds you with an explanation. Every prescription is checked by our pharmacist before it leaves the dispensary. Stock My Medicine is a GPhC-registered UK pharmacy; orders go by Royal Mail Tracked, usually within three to five working days. If you are unsure whether this clinic is right for you, \u003ca href=\"\/pages\/talk-to-a-pharmacist\"\u003etalk to our pharmacist\u003c\/a\u003e first.\u003c\/p\u003e","brand":"StockMyMedicine","offers":[{"title":"Default Title","offer_id":62978658369923,"sku":"3564820","price":12.99,"currency_code":"GBP","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/1006\/9282\/0355\/files\/1_df2b3688-6a91-4e37-b523-93f3c0152842.jpg?v=1792769017"},{"product_id":"famotidine-20mg-28-tablets","title":"Famotidine 20mg - 28 Tablets","description":"\u003ch2\u003eAbout Famotidine 20mg Tablets\u003c\/h2\u003e\u003cp\u003eFamotidine is an H2 blocker (histamine H2-receptor antagonist): it stops histamine from telling the stomach to make acid. It is the medicine many people knew as Pepcid, and it has become the usual choice when a proton pump inhibitor isn't suitable or when acid breaks through at night. Famotidine 20mg tablets treat acid reflux and reflux oesophagitis, heal stomach and duodenal ulcers and stop them coming back, and are used by specialists for Zollinger-Ellison syndrome.\u003c\/p\u003e\u003cp\u003eIt works faster than a PPI (within an hour) but less powerfully, and because it is cleared by the kidneys rather than the liver it has far fewer interactions with other medicines. Prescription-only in the UK, supplied through our \u003ca href=\"\/pages\/acid-reflux-heartburn\"\u003eAcid Reflux \u0026amp; Heartburn online clinic\u003c\/a\u003e after a short consultation reviewed by a UK prescriber. Pack of 28 film-coated tablets; the manufacturer may vary.\u003c\/p\u003e\u003ch2\u003eWhat's in Famotidine 20mg Tablets?\u003c\/h2\u003e\u003ctable\u003e\n\u003cthead\u003e\u003ctr\u003e\n\u003cth\u003eComponent\u003c\/th\u003e\n\u003cth\u003eType\u003c\/th\u003e\n\u003cth\u003eRole\u003c\/th\u003e\n\u003c\/tr\u003e\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003eFamotidine 20mg\u003c\/td\u003e\n\u003ctd\u003eActive ingredient\u003c\/td\u003e\n\u003ctd\u003eBlocks histamine H2 receptors on acid-producing cells, cutting acid output by around 70%\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eFilm coating\u003c\/td\u003e\n\u003ctd\u003eProtective layer\u003c\/td\u003e\n\u003ctd\u003eMakes the tablet easy to swallow and masks the taste\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eMicrocrystalline cellulose, starch, magnesium stearate and other excipients\u003c\/td\u003e\n\u003ctd\u003eInactive\u003c\/td\u003e\n\u003ctd\u003eForm the tablet; check the leaflet for any you're sensitive to\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\u003cp\u003eFamotidine is the most potent of the H2 blockers: 20mg suppresses acid for 10 to 12 hours, roughly eight times the effect of an equivalent dose of ranitidine, which was withdrawn in the UK in 2020. Unlike a PPI it doesn't need a protective coating, so there is nothing to worry about if the tablet is cut or crushed.\u003c\/p\u003e\u003ch2\u003eWhat is famotidine 20mg used for?\u003c\/h2\u003e\u003cp\u003eFamotidine is licensed for:\u003c\/p\u003e\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003eReflux oesophagitis and GORD\u003c\/strong\u003e: 20mg twice a day (40mg twice a day if the oesophagus is eroded) for six to twelve weeks, then 20mg twice a day to prevent recurrence.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eDuodenal ulcer\u003c\/strong\u003e: 40mg at bedtime for four to eight weeks, then 20mg at bedtime to prevent relapse.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eBenign stomach ulcer\u003c\/strong\u003e: 40mg at bedtime for four to eight weeks, once a GP has ruled out anything more serious.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eZollinger-Ellison syndrome\u003c\/strong\u003e: higher, specialist-adjusted doses.\u003c\/li\u003e\n\u003c\/ul\u003e\u003cp\u003eIn practice it is also prescribed as a bedtime add-on for people whose daytime PPI leaves them with night-time heartburn, and as the main acid suppressant for people who can't take a PPI because of interactions (clopidogrel, for example), low magnesium or side effects. If you have never been treated for reflux before, a PPI such as \u003ca href=\"\/products\/esomeprazole-20mg-28-gastro-resistant-tablets\"\u003eesomeprazole 20mg\u003c\/a\u003e is usually the first choice; the prescriber will tell you if famotidine suits you better.\u003c\/p\u003e\u003ch2\u003eWhich symptoms does it relieve?\u003c\/h2\u003e\u003cp\u003eFamotidine eases the burning behind the breastbone after meals, acid rising into the throat when you lie down, a sour taste in the mouth, belching and a bloated, uncomfortable stomach, and the gnawing hunger-like pain of an ulcer that wakes you in the early hours. Because it starts working within an hour, it suits symptoms with an obvious pattern, such as heartburn every night, as well as regular courses. It will not instantly neutralise acid the way an antacid does, but relief lasts far longer.\u003c\/p\u003e\u003ch2\u003eHow do I take famotidine 20mg tablets?\u003c\/h2\u003e\u003ctable\u003e\n\u003cthead\u003e\u003ctr\u003e\n\u003cth\u003eStep\u003c\/th\u003e\n\u003cth\u003eWhat to do\u003c\/th\u003e\n\u003c\/tr\u003e\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003eWhen\u003c\/td\u003e\n\u003ctd\u003eTwice a day for reflux (morning and bedtime), or once at bedtime for ulcers and prevention. Night-time dosing matters because acid secretion peaks in the early hours.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eFood\u003c\/td\u003e\n\u003ctd\u003eWith or without food; it makes no difference to how well it works.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eHow\u003c\/td\u003e\n\u003ctd\u003eSwallow with a glass of water. The tablet can be halved or crushed if you find it hard to swallow.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eAntacids\u003c\/td\u003e\n\u003ctd\u003eLeave one to two hours between famotidine and any antacid, which can reduce its absorption.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eMissed dose\u003c\/td\u003e\n\u003ctd\u003eTake it when you remember unless the next dose is nearly due; never double up.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eLifestyle\u003c\/td\u003e\n\u003ctd\u003eSmaller meals, nothing to eat in the three hours before bed, less alcohol, coffee and fatty food, and raising the head of the bed all reduce reflux.\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\u003ch2\u003eHow much and for how long?\u003c\/h2\u003e\u003ctable\u003e\n\u003cthead\u003e\u003ctr\u003e\n\u003cth\u003eCondition\u003c\/th\u003e\n\u003cth\u003eAdult dose\u003c\/th\u003e\n\u003cth\u003eCourse\u003c\/th\u003e\n\u003c\/tr\u003e\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003eReflux and heartburn (GORD)\u003c\/td\u003e\n\u003ctd\u003eOne 20mg tablet twice a day\u003c\/td\u003e\n\u003ctd\u003e6 to 12 weeks, then 20mg twice a day to prevent recurrence\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eErosive reflux oesophagitis\u003c\/td\u003e\n\u003ctd\u003eTwo 20mg tablets (40mg) twice a day\u003c\/td\u003e\n\u003ctd\u003e6 to 12 weeks\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eDuodenal or stomach ulcer\u003c\/td\u003e\n\u003ctd\u003eTwo 20mg tablets (40mg) at bedtime\u003c\/td\u003e\n\u003ctd\u003e4 to 8 weeks\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003ePreventing ulcer relapse\u003c\/td\u003e\n\u003ctd\u003eOne 20mg tablet at bedtime\u003c\/td\u003e\n\u003ctd\u003eLong-term, reviewed by the prescriber\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003eKidney impairment (creatinine clearance under 30)\u003c\/td\u003e\n\u003ctd\u003eHalf the usual dose\u003c\/td\u003e\n\u003ctd\u003eAs above\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\u003cp\u003eA pack of 28 tablets is two weeks at twice a day or four weeks at bedtime only. Our prescriber approves one pack per order; reorder as needed, and after three months of continuous use please review your symptoms with your GP.\u003c\/p\u003e\u003ch2\u003eWho can and can't take famotidine?\u003c\/h2\u003e\u003cp\u003eFamotidine is for adults. It can't be taken by anyone who has reacted to famotidine or another H2 blocker (ranitidine, cimetidine, nizatidine). The dose is halved in moderate to severe kidney disease, so the consultation asks about your kidneys. It is not prescribed through this clinic in pregnancy, when planning a pregnancy or while breastfeeding, as the manufacturer advises against both.\u003c\/p\u003e\u003cp\u003eIt has few drug interactions, which is one of its advantages, but it reduces the absorption of medicines that need stomach acid: take \u003cstrong\u003eketoconazole, itraconazole\u003c\/strong\u003e or the HIV medicine \u003cstrong\u003eatazanavir\u003c\/strong\u003e at least two hours before famotidine, and keep \u003cstrong\u003eantacids\u003c\/strong\u003e one to two hours apart. It should not be combined with \u003cstrong\u003eprobenecid\u003c\/strong\u003e, which raises famotidine levels. Anyone with difficulty swallowing, unexplained weight loss, repeated vomiting, blood in vomit or black stools, anaemia, or new symptoms over 55 needs a GP assessment first, because acid suppressants can mask a stomach cancer.\u003c\/p\u003e\u003ch2\u003eWhat are the side effects of famotidine?\u003c\/h2\u003e\u003cp\u003eFamotidine is well tolerated. The common side effects (up to 1 in 10 people) are headache, dizziness, constipation and diarrhoea; dry mouth, nausea, loss of appetite, tiredness and skin rash are uncommon. Confusion has been reported in elderly people and those with kidney impairment, usually at higher doses, and settles when the medicine is stopped. Rarely, liver enzyme changes, low blood counts or allergic reactions occur. Unlike proton pump inhibitors it is not associated with low magnesium, fractures or vitamin B12 deficiency, although very long courses should still be reviewed. Stop and seek urgent help for swelling of the face or throat, difficulty breathing or a severe rash, and report suspected side effects through the MHRA Yellow Card scheme.\u003c\/p\u003e\u003ch2\u003eFamotidine or omeprazole?\u003c\/h2\u003e\u003cp\u003eOmeprazole and esomeprazole are proton pump inhibitors: slower to start (two to three days) but stronger, switching off acid production almost completely, so they are the first choice for erosive oesophagitis and for reflux that happens most days. Famotidine works within an hour and for 10 to 12 hours, suppresses acid by about 70%, and is kinder on interactions and on long-term bone and magnesium effects. It is the better option for intermittent or night-time symptoms, for people on clopidogrel or with low magnesium, and for those who had side effects from a PPI. Some people take both, a PPI in the morning and famotidine at night, under a prescriber's direction. The prescriber reviewing your consultation will choose based on your history.\u003c\/p\u003e\u003ch2\u003eHow does the online clinic work?\u003c\/h2\u003e\u003cp\u003eStart from the \u003ca href=\"\/pages\/acid-reflux-heartburn\"\u003eAcid Reflux \u0026amp; Heartburn clinic page\u003c\/a\u003e and complete the consultation first; you are not asked to choose a medicine until the questions are done. A UK-registered prescriber then reviews your answers and either approves the treatment you requested, suggests a more suitable one, or declines and refunds you with an explanation. Every prescription is checked by our pharmacist before dispatch. Stock My Medicine is a GPhC-registered UK pharmacy; orders go by Royal Mail Tracked, usually within three to five working days. Unsure whether this clinic is right for you? \u003ca href=\"\/pages\/talk-to-a-pharmacist\"\u003eTalk to our pharmacist\u003c\/a\u003e first.\u003c\/p\u003e","brand":"StockMyMedicine","offers":[{"title":"Default Title","offer_id":62978689958275,"sku":"1058890","price":9.99,"currency_code":"GBP","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/1006\/9282\/0355\/files\/1_3c8573ae-d8ad-41b6-87e2-12b5d2db9b4b.jpg?v=1792768529"}],"url":"https:\/\/www.stockmymedicine.co.uk\/collections\/clinic-acid-reflux-heartburn.oembed","provider":"StockMyMedicine","version":"1.0","type":"link"}