Nexium, a potent proton inhibitor that reduces levels of gastric acid in the stomach, is generally safe for long-term use. However, consult your doctor to ensure that you are not suffering from an underlying medical condition or taking another medication that could make Nexium use unwise.
Nexium is a drug that people take to decrease the levels of acid produced by the stomach. It’s usually prescribed to treat gastroesophageal reflux disease (GERD) and to help the esophagus heal after having been damaged by stomach acid.
Nexium belongs to a class of drugs called proton pump inhibitors (PPIs). The cells lining the stomach contain proton pumps that produce stomach acid. Esomeprazole, the active ingredient in Nexium, inhibits proton pump action, causing less stomach acid to be produced.
Stomach acid is necessary for digestion, but in people with GERD, too much acid is produced, and it can flow back up from the stomach into the esophagus, causing painful heartburn. This acid can also irritate and damage the lining of the esophagus over time. Nexium, by addressing excess stomach acid production, can allow the lining of the esophagus to heal after it’s been damaged over time by acid reflux.
Nexium is generally safe for long-term use, but there are a few risks that people who take Nexium long term should be aware of.
Long Term Use and Magnesium Levels
People who take Nexium or other PPIs for longer than three months may experience lower levels of magnesium in the blood. This is particularly true of people who take Nexium and who also take diuretics or digoxin. When magnesium levels are low, symptoms can occur, like twitching or muscle spasms, increased heart rate, dizziness, and disorientation. If you have been taking Nexium and experience these symptoms, you should tell your doctor, who may want to test your magnesium levels. If magnesium levels are low, you may have to take a magnesium supplement and you may need to discontinue taking Nexium. If your doctor prescribes Nexium and you already take digoxin or diuretics, be sure to tell him or her. Your doctor may want to monitor your magnesium levels to prevent deficiencies.
Risk of Bone Fractures
When taken in higher doses for longer than a year, PPIs like Nexium are associated with a slight increase in bone fracture risk, particularly in the hip, spine, or wrist. That’s because long-term PPI use can reduce the amount of calcium and vitamin D absorbed by the digestive system. The people most likely to experience this higher risk of bone fracture are older, have osteoporosis, or have risk factors for osteoporosis. If you are in one of these higher risk groups, your doctor may advise you to take calcium and vitamin D supplements, particularly if your diet has inadequate levels of these essential nutrients.
Vitamin B12 is used to make red blood cells and DNA and to carry out many other bodily functions. Since it isn’t produced naturally by the body, it has to be obtained from food or supplements. Long-term use of Nexium can cause less B12 to be absorbed from foods, which can result in B12 deficiency. Vegetarians, older people, and those who have undergone weight loss surgery are at particular risk of B12 deficiency. Deficiency of vitamin B12 causes gradually increasing symptoms like tingling or pins-and-needles feelings in the extremities, anemia, jaundice, and weakness. Many physicians overlook the possibility of B12 deficiency, so if you’re taking Nexium long term and experience symptoms of B12 deficiency, you should bring up the subject with your doctor. Deficiencies can be treated with shots or high-dose tablets of B12. Mild deficiencies can be treated with regular multivitamins containing B12.
Other Drug Interactions
There are a few drugs with which Nexium should not be taken. People who take the anti-HIV drugs rilpivirine, nelfinavir, and atazanavir should not take Nexium because Nexium decreases blood levels of these drugs and could make them less effective at treating HIV. There are other drugs that may show increased blood levels when Nexium is taken at the same time, including benzodiazepines, digoxin, and citalopram. If you take any of these drugs, tell your doctor when he or she prescribes Nexium. Dosages of these other drugs may need to be altered. Likewise, some drugs, like the antidepressant fluvoxamine, can increase the amount of Nexium in the blood, so your Nexium dosage may need to be adjusted. In general, your physician should know which prescription and over-the-counter drugs you take to minimize the chances of harmful drug interactions.
Most of the time, taking Nexium long term is safe, particularly in people who consume a well-balanced diet. However, it’s important to be aware of possible long term side effects of Nexium use. With regular health check-ups and honesty with your doctor about your lifestyle and the other medications you take, you can minimize the chances of Nexium causing other health problems.
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