Esomeprazole Tablet: Uses, Dose, Side Effects and Top Brands in India (2026)

• Updated 23 October 2026
• Reviewed by Sudhanshu Singhal
• 21 min read
• 41 sources

These Maximum Retail Prices are the MRPs shown by the e-pharmacy Tata 1mg on 23 October 2026, and Tata 1mg itself states that MRP may vary by batch, so the price printed on the pack always governs.

What is esomeprazole, alone and in its combinations?

Esomeprazole is a proton pump inhibitor (PPI), which in plain words means a medicine that reduces the amount of acid the stomach makes. The US FDA label describes it as the S-isomer of omeprazole, and the NHS calls it an acid-reducing medicine that stops the stomach lining's proton pumps from working properly.

How it works

It suppresses gastric acid secretion by specific inhibition of the H+/K+ ATPase enzyme system — the "acid pump" — at the surface of the stomach's parietal cell, blocking the final step of acid production (US FDA label, section 12.1). Because the drug is acid-labile, it is given in an enteric-coated form so that the medicine is released in the intestine to prevent break-down by stomach acid (MedlinePlus).

In the gastro-resistant tablet, esomeprazole is supplied as enteric-coated granules (UK SmPC). In the esomeprazole + domperidone capsule, esomeprazole is present as an enteric-coated tablet inside a hard gelatin capsule (Torrent Nexpro RD prescribing information).

Forms and strengths sold in India

Indian e-pharmacy listings read on 23 October 2026 show the following forms:

• Esomeprazole 40 mg gastro-resistant tablet (strip of 15)
• Esomeprazole 40 mg injection (one injection)
• Capsule SR esomeprazole 40 mg + domperidone 30 mg (strip of 10 or 15)
• Capsule SR esomeprazole 40 mg + levosulpiride 75 mg (strip of 10)
• Kit containing amoxycillin 750 mg + clarithromycin 500 mg + esomeprazole 40 mg (strip of 6 tablets)

The WHO Collaborating Centre ATC/DDD index classifies esomeprazole under code A02BC05 (proton pump inhibitors), with a defined daily dose of 30 mg oral; a defined daily dose is a statistical unit for drug-use studies and is not a recommended dose.

What each combination partner adds

Domperidone is an anti-sickness medicine (NHS). Regulators describe it as a dopamine antagonist with antiemetic properties: it works by blocking dopamine receptors in the gut and in the part of the brain linked to vomiting. In the fixed-dose combination it is present as 30 mg in a bilayered sustained-release tablet inside a hard gelatin capsule, with esomeprazole as an enteric-coated tablet (Torrent Nexpro RD prescribing information).

Levosulpiride is described in the Spanish AEMPS label as a selective antagonist of peripheral D2 dopamine receptors of the gut wall, giving a gastro-prokinetic action that helps gut movement and transit; it is also effective against nausea, vomiting and vertigo. In India, the Torrent Levazeo prescribing information calls it the active isomer of sulpiride and a D2 receptor antagonist.

In the H. pylori kit, esomeprazole is combined with two antibiotics. Clarithromycin is a macrolide antibiotic used for H. pylori, and amoxicillin is a penicillin antibiotic used with other medicines for stomach ulcers (NHS).

What is it used for?

Esomeprazole is used for acid-related conditions listed in the product labels, including erosive oesophagitis, GERD symptoms, H. pylori-associated and NSAID-associated ulcers, and H. pylori eradication; approved uses vary by label and country, and no off-label uses are described here.

Uses stated in the US FDA label

The FDA label for oral esomeprazole lists, for adults: short-term treatment (4 to 8 weeks) of healing and symptom resolution of erosive oesophagitis; maintenance of that healing (controlled studies do not extend beyond 6 months); short-term treatment (4 to 8 weeks) of heartburn and other symptoms of GERD; reduction in the occurrence of gastric ulcers associated with continuous NSAID therapy in patients at risk (age 60 years and older and/or a history of gastric ulcers); H. pylori eradication in combination with amoxicillin and clarithromycin to reduce duodenal ulcer recurrence; and long-term treatment of pathological hypersecretory conditions including Zollinger-Ellison syndrome.

For children, the FDA label covers healing of erosive oesophagitis for ages 12 to 17 (4 to 8 weeks), ages 1 to 11 years (suspension, 8 weeks), and 1 month to under 1 year (erosive oesophagitis due to acid-mediated GERD, up to 6 weeks). Short-term treatment of GERD symptoms covers ages 12 to 17 (4 weeks) and 1 to 11 years (up to 8 weeks); use for symptomatic GERD in patients 1 month to under 1 year is not established in the label.

Uses stated in the UK SmPC

The UK Summary of Product Characteristics lists, for adults: erosive reflux oesophagitis; long-term management of healed oesophagitis; symptomatic GERD; use with antibacterial regimens for H. pylori eradication (healing of H. pylori-associated duodenal ulcer and prevention of relapse of peptic ulcers); healing and prevention of NSAID-associated gastric or duodenal ulcers in patients at risk; prolonged treatment after intravenous-induced prevention of rebleeding of peptic ulcers; and Zollinger-Ellison syndrome. Adolescents from 12 years are covered for GERD and H. pylori-associated duodenal ulcer.

Uses stated in Indian manufacturer leaflets

The Torrent Nexpro 20 and 40 leaflet lists erosive reflux oesophagitis, prevention of acid release, and help in eradication of H. pylori associated peptic ulcer; its full prescribing information also lists prolonged treatment after intravenous-induced rebleeding prevention and adolescents from 12 years for GERD. The Nexpro I.V. leaflet covers GERD in patients with oesophagitis and severe reflux symptoms as an alternative to oral therapy when oral intake is not appropriate. The esomeprazole + domperidone capsule leaflet (Nexpro RD) states its use as adult patients with GERD not responding to esomeprazole alone.

The H. pylori kit

The FDA label states that esomeprazole plus amoxicillin plus clarithromycin is indicated for adults with H. pylori infection and duodenal ulcer disease (active, or within the past 5 years) to eradicate H. pylori, and that eradication reduces the risk of duodenal ulcer recurrence.

Dose as stated in the labels

Every regimen below is quoted from a named label as a reference for information; the dose in your own pack, and what your doctor prescribes for you, is what must be followed.

Tablets and capsules — adults

The US FDA label states: healing of erosive oesophagitis 20 mg or 40 mg once daily for 4 to 8 weeks, with a further 4 to 8 weeks if needed (maximum 20 mg once daily in severe liver impairment, Child-Pugh C); maintenance of healing 20 mg once daily; symptomatic GERD 20 mg once daily for 4 weeks, with 4 more weeks to be considered; NSAID-ulcer risk reduction 20 mg or 40 mg once daily. For Zollinger-Ellison syndrome the label states a starting dose of 40 mg twice daily, individualised, with doses up to 240 mg per day having been given; in severe liver impairment (Child-Pugh C) the starting dose is 20 mg twice daily.

The UK SmPC states: erosive reflux oesophagitis 40 mg once daily for 4 weeks, plus 4 more weeks if not healed; maintenance of healed oesophagitis 20 mg; symptomatic GERD 20 mg once daily; NSAID gastric ulcer healing 20 mg for 4 to 8 weeks and prevention 20 mg; after intravenous rebleeding prevention 40 mg for 4 weeks; Zollinger-Ellison 40 mg twice daily then adjusted. Severe liver impairment: do not exceed 20 mg.

The Indian Torrent Nexpro 20 and 40 leaflet states: erosive oesophagitis 40 mg once daily for 4 weeks, plus a further 4 weeks; 40 mg once daily for 4 weeks after intravenous-induced rebleeding prevention; adolescents from 12 years 40 mg for 4 weeks. Its patient section for H. pylori says one tablet twice a day for one week together with antibiotics such as amoxicillin and clarithromycin, without stating which strength.

Children

The US FDA label gives, for children 12 to 17 years, erosive oesophagitis 20 mg or 40 mg once daily for 4 to 8 weeks and symptomatic GERD 20 mg once daily for 4 weeks; for children 1 to 11 years (suspension) erosive oesophagitis 8 weeks; and for 1 month to under 1 year, erosive oesophagitis due to acid-mediated GERD up to 6 weeks. Use for symptomatic GERD is not established for patients 1 month to under 1 year. The UK SmPC covers adolescents from 12 years. The NHS states that children should take esomeprazole only if a doctor prescribes it.

Injection

The US FDA label for esomeprazole sodium for injection states, for adults with GERD and erosive oesophagitis, 20 mg or 40 mg once daily given as an intravenous injection over at least 3 minutes or an infusion over 10 to 30 minutes, for up to 10 days; children receive age- and weight-based amounts stated in the label. For risk reduction of rebleeding of gastric or duodenal ulcers in adults, the label states 80 mg by intravenous infusion over 30 minutes followed by 8 mg per hour as a continuous infusion, for a total of 72 hours, with oral acid-suppressive therapy to follow. The Indian Nexpro I.V. leaflet states that a 40 mg dose is 5 ml of the reconstituted solution (8 mg/ml) given as an intravenous injection over at least 3 minutes, and 20 mg is 2.5 ml.

Combinations and the kit

The esomeprazole + domperidone SR capsule leaflet (Torrent Nexpro RD) states one capsule per day, swallowed whole with half a glass of water and not chewed, crushed or opened; its patient section says to take it 1 hour before a meal, usually for 2 to 3 consecutive days to relieve symptoms, to see a doctor if there is no relief after 2 weeks, and not to take it for more than 4 weeks without consulting a doctor. These are the instructions for the fixed-dose combination capsule specifically.

For reference, the domperidone-alone labels state 10 mg up to three times a day, maximum 30 mg in 24 hours, for adults and adolescents 12 years and over and 35 kg or more, taken 15 to 30 minutes before meals, usually not more than one week. This is domperidone-alone dosing and is not the regimen for the esomeprazole + domperidone capsule.

For the esomeprazole + levosulpiride 75 mg SR capsule, follow the leaflet in the pack and the doctor's prescription. For the H. pylori kit, the three published regimens differ: the US label gives esomeprazole 40 mg once daily plus amoxicillin 1000 mg twice daily plus clarithromycin 500 mg twice daily for 10 days; the UK SmPC gives esomeprazole 20 mg plus amoxicillin 1 g plus clarithromycin 500 mg, all twice daily for 7 days, with duration most commonly 7 days but sometimes up to 14 days; the Indian leaflet gives one esomeprazole tablet twice daily for one week with antibiotics. The strengths and days in an Indian kit are the manufacturer's choice — read the leaflet in the kit.

Timing and food

The US label and its Medication Guide say to take esomeprazole at least one hour before meals, and note that food decreased the exposure after a single 40 mg dose by 43% to 53%. The NHS says it is usually taken once a day in the morning, with or without food, and the UK patient leaflet says the tablets can be taken with food or on an empty stomach. The India tablet leaflet (Nexpro 20 and 40) and the Nexpro RD capsule leaflet say to swallow the medicine whole with liquid and not chew, crush or open it; follow the instructions in the leaflet in your pack.

Side effects

The most common side effects are headache, abdominal pain, diarrhoea, constipation, nausea or vomiting and wind; some rare or very rare reactions listed in the labels need urgent medical help.

Common side effects

• Headache: in erosive oesophagitis trials, 5.5% on 20 mg and 5% on 40 mg (US FDA label); "common" in the UK SmPC, meaning 1 in 100 to under 1 in 10.
• Diarrhoea: 4% in symptomatic GERD trials (FDA); with amoxicillin and clarithromycin for 10 days, diarrhoea 9%, taste perversion 4% and abdominal pain 4%.
• Abdominal pain, constipation, flatulence, nausea and vomiting: listed as common in the UK SmPC and by the NHS (more than 1 in 100).
• Benign fundic gland polyps: common in the UK SmPC.
• With the injection (US label, at 1% or more): headache 11%, flatulence 10%, nausea 6%, abdominal pain 6%, diarrhoea 4%, dry mouth 4%, dizziness or vertigo 3%, constipation 3%, injection site reaction 2%, pruritus 1%.

Serious reactions that need urgent medical help

The UK SmPC lists, from rare to very rare: low blood counts, hypersensitivity including anaphylaxis, low sodium, confusion, depression, hepatitis, hallucinations, liver failure, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, DRESS, interstitial nephritis (with renal failure in some cases) and gynaecomastia. The NHS says to get medical help for liver problems (yellow skin, pale stools, dark urine), joint pain with a red sun-exposed rash, or severe or persistent diarrhoea, and to call emergency services for anaphylaxis.

Long-term use carries warnings in the FDA label: acute tubulointerstitial nephritis, Clostridioides difficile-associated diarrhoea, bone fracture (hip, wrist, spine) with high doses or therapy of a year or more, severe cutaneous reactions, cutaneous and systemic lupus, vitamin B12 deficiency with daily use longer than 3 years, low magnesium (mostly after a year, with tetany, arrhythmias or seizures), and fundic gland polyps. The labels advise using the lowest dose and shortest duration appropriate.

In India, a CDSCO order dated 4 November 2019, following the PvPI Signal Review Panel and the CDSCO Subject Expert Committee, asked manufacturers of proton pump inhibitors including esomeprazole to add Acute Kidney Injury as an adverse drug reaction in the package insert. A PvPI Monthly Drug Safety Alert dated 27 September 2023 lists esomeprazole with hyperprolactinaemia as a preliminary signal, not a confirmed causal link; reports can be made to NCC-PvPI on 1800-180-3024.

Side effects of the combination partners

Domperidone is associated with QT prolongation on ECG, and very rarely QT prolongation and torsades de pointes after marketing; the MHRA reports a small increased risk of serious cardiac side effects, higher in people older than 60, with daily doses above 30 mg, or with QT-prolonging medicines or CYP3A4 inhibitors. Levosulpiride has been reported very rarely to cause insomnia, tremor, parkinsonism, somnolence, sedation, extrapyramidal disorders, dyskinesia, dystonia, galactorrhoea, menstrual disorder, gynaecomastia, raised prolactin and weight gain, and it can cause drowsiness.

Who should not take it, and interactions

People with a known allergy to esomeprazole or other substituted benzimidazoles must not take it, and several important medicine interactions are listed in the labels.

Contraindications

• Esomeprazole (US FDA label): known hypersensitivity to substituted benzimidazoles or any component; patients receiving rilpivirine-containing products.
• Esomeprazole (UK SmPC): hypersensitivity; concomitant nelfinavir.
• Domperidone (UK SmPC): hypersensitivity, prolactinoma, phaeochromocytoma, gastrointestinal bleeding, obstruction or perforation, moderate or severe liver impairment, known QTc prolongation, significant electrolyte disturbance or heart failure, QT-prolonging drugs, and potent CYP3A4 inhibitors including clarithromycin.
• Levosulpiride (AEMPS): hypersensitivity, history of epilepsy, manic states, gastrointestinal haemorrhage, obstruction or perforation, phaeochromocytoma, malignant mastopathy, pregnancy and breastfeeding.

Key interactions

• Clopidogrel: the FDA label says to avoid concomitant use, and the UK SmPC says it should be discouraged as a precaution.
• Methotrexate (mainly high dose): PPIs may raise and prolong methotrexate levels.
• St John's wort and rifampin: the FDA label says to avoid them; the NHS says not to take St John's wort.
• HIV medicines: rilpivirine and nelfinavir are contraindicated; atazanavir is not recommended (UK SmPC); saquinavir levels rise.
• Others: esomeprazole inhibits CYP2C19, so diazepam, citalopram, imipramine, clomipramine and phenytoin levels may rise; digoxin absorption can increase; tacrolimus levels can rise; INR should be monitored with warfarin.
• With the kit: clarithromycin 500 mg twice daily doubled esomeprazole exposure in the UK SmPC, and the contraindications of clarithromycin must also be considered.
• Antacids and domperidone: the domperidone SmPC says antacids or antisecretory agents lower domperidone's oral bioavailability and should not be taken simultaneously.

Pregnancy, breastfeeding and children

The FDA label says there are no adequate studies in pregnant women, while first-trimester omeprazole data did not show increased major malformations; the UK SmPC says clinical data are insufficient and advises caution; the NHS says it is not recommended in pregnancy, though a doctor may suggest omeprazole. The esomeprazole + domperidone capsule leaflet says not to take it if pregnant or breastfeeding. For breastfeeding, the UK SmPC says it should not be used, while the NHS says the amount in milk is probably too small to harm — always check with your doctor.

Alcohol

The NHS says alcohol does not change how esomeprazole works, but it makes the stomach produce more acid than normal and can irritate the stomach lining and worsen symptoms, so it is better to reduce or avoid alcohol. For the levosulpiride combination, the levosulpiride label says alcohol should be avoided.

Rules in India

Esomeprazole is a Schedule H prescription drug in India, and it is not listed in NLEM 2022, so no NLEM-based ceiling price entry applies to it.

In the consolidated Drugs and Cosmetics Rules, 1945 (as amended up to 30 September 2020), Schedule H — the list of prescription drugs under Rules 65 and 97 — names Esomeprazole, Domperidone, Clarithromycin, Omeprazole and Sulpiride, and Note 2 says that salts, esters, derivatives and preparations containing the listed substances are also covered. A full-text search of the same Rules found none of these substances in Schedule H1 or Schedule G. In practice, the tablet, injection, capsules and the kit each contain a Schedule H substance and are therefore available only on a doctor's prescription.

NLEM 2022, notified as Schedule I of the Drugs (Prices Control) Order, 2013 by S.O. 5249(E) in the Gazette of India Extraordinary dated 11 November 2022, does not list esomeprazole; among antiulcer agents it lists omeprazole and pantoprazole, and separately domperidone, amoxicillin and clarithromycin. Levosulpiride is not listed. Because esomeprazole and its combinations are not in the NLEM 2022 text, no NLEM-based ceiling price entry applies to them.

Top brands in India

The brands in the table above are ones for which Tata 1mg carries a product page, listed in no order of merit, because no published sales-ranking source was found. They are shown here for information only and are not a recommendation of any brand.

The Vibcare range

Vibcare Pharma supplies esomeprazole 40 mg tablets and injection, esomeprazole 40 mg with domperidone 30 mg capsules in 10 and 15 strip packs, esomeprazole 40 mg with levosulpiride 75 mg capsules, and an H. pylori kit of clarithromycin 500 mg + esomeprazole 40 mg + amoxycillin 750 mg, across the Prima, Auspin, Medanor and Evermed divisions.

This range is available to Vibcare PCD franchise partners with monopoly rights in their district; see our Gastro PCD franchise and PCD pharma franchise pages.

Frequently asked questions

Sources

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• Browse the Vibcare product range