Nexium (Esomeprazole) in Spain: What It Treats
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 29 October 2026
Nexium is esomeprazole, an acid-lowering PPI that needs a prescription in Spain. What it treats, long-term cautions and how it differs from omeprazole.
You don't have to figure this out alone
Dr. Pedro Yelamo Vera is an independent, bilingual GP licensed in Spain. Book a 15-minute video consultation in English or Spanish for €50, with a private electronic prescription issued under Spanish law when clinically appropriate.
Nexium is the brand name of esomeprazole, a medicine that lowers the amount of acid your stomach makes. It treats reflux, heals stomach ulcers and protects the stomach from anti-inflammatories. In Spain every Nexium product needs a prescription. Only one esomeprazole product is listed as non-prescription, for short-term heartburn in adults.
- Nexium (esomeprazole) is a proton pump inhibitor, or PPI. It cuts stomach acid for as long as you take it.
- All Nexium packs in Spain need a prescription. One other esomeprazole brand is sold without one, for adults only.
- It is a close relative of omeprazole, but they are different medicines. Do not take both.
- Long use can lower vitamin B12 and magnesium, and slightly raise the risk of bone fractures.
Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).
For a medical emergency, call 112 or go to the nearest local emergency department. Do not wait for a video consultation or an online reply.
What does Nexium treat?
The Spanish leaflet for Nexium Mups tablets lists these uses in adults:
- Reflux disease (GERD): acid rising into the food pipe, with heartburn and sour taste.
- Ulcers caused by H. pylori, a stomach germ. Here it is given together with antibiotics.
- Ulcers linked to anti-inflammatories, such as ibuprofen: to heal them, or to help prevent them.
- Zollinger-Ellison syndrome, a rare cause of very high acid.
Teenagers from 12 can take the tablets for reflux and H. pylori ulcers. For children aged 1 to 11 there is a granule sachet form, which a doctor prescribes. Packs come in different strengths; the doctor or the leaflet sets how much and for how long.
How does esomeprazole work?
The stomach lining has tiny "pumps" that push acid into the stomach. Esomeprazole switches many of them off. Less acid means less burning, and gives a sore food pipe or an ulcer time to heal.
It does not act straight away. It can take two or three days before you feel better. For a quick fix now and then, an antacid works faster but for a shorter time.
Nexium or omeprazole: are they the same?
No, but they are close relatives. Both are PPIs and work in the same way. Esomeprazole is one form of the omeprazole molecule, made into a medicine of its own. They are not swapped one for the other without a doctor, and you should never take both.
| Nexium (esomeprazole) | Omeprazole | |
|---|---|---|
| Family | Proton pump inhibitor (PPI) | Proton pump inhibitor (PPI) |
| Main uses | Reflux, ulcers, stomach protection | Reflux, ulcers, stomach protection |
| Prescription in Spain | Nexium: yes. One other esomeprazole brand: no | Small packs no; larger packs yes |
We explain omeprazole in our omeprazole guide.
Is Nexium the same in the UK and US?
The active ingredient is the same everywhere. What changes is the brand name and whether you can buy it.
| Name | Where | Prescription |
|---|---|---|
| Nexium Mups (tablets), Nexium sachets | Spain | Yes |
| Esomeprazol + maker (EFG generics) | Spain | Yes |
| Esomeprazol Sandoz Care | Spain | No (adults, short-term heartburn) |
| Nexium, Nexium Control | UK | Nexium on prescription; the lowest strength can be bought |
| Nexium, Nexium 24HR | US | Nexium on prescription; Nexium 24HR sold over the counter |
If you use Nexium 24HR or Nexium Control at home, the Spanish Nexium brand will not be sold to you without a prescription.
Do you need a prescription for Nexium in Spain?
Yes. On the AEMPS CIMA database, every Nexium product is listed as medicamento sujeto a prescripción médica. The injection form is for hospital use only. Nearly all generic esomeprazole also needs a prescription.
The one exception CIMA lists is Esomeprazol Sandoz Care capsules, marked sin receta. Its leaflet says it is for adults, for short-term reflux symptoms. If symptoms do not improve, or get worse, after 14 days, see a doctor. Our guide to which medicines need a prescription in Spain has more.
Heartburn that keeps coming back, or on a PPI for a long time?
You can book a video visit with a GP licensed in Spain, in English or Spanish. He checks the pattern, looks for warning signs and reviews whether you still need it.
Is it safe to take esomeprazole for a long time?
Many people take a PPI for years with a doctor's plan. But long use has known effects, so it should be reviewed now and then:
- Bones. Use for more than a year slightly raises the risk of hip, wrist and spine fractures.
- Vitamin B12. It can be absorbed less well. Signs include tiredness, tingling and a sore, red tongue.
- Magnesium. After three months or more it can fall. Signs include cramps, tiredness, dizziness and a fast heartbeat.
- Skin. A rash on sun-exposed skin, with joint pain, should be reported.
- Blood tests. It can change a test called chromogranin A. Tell the lab or doctor you take it.
Do not stop a long course on your own if a doctor started it for an ulcer or to protect your stomach. Ask first.
Which medicines does Nexium interact with?
Do not take it with nelfinavir, an HIV medicine. Tell your doctor if you take:
- Clopidogrel, a blood thinner.
- Warfarin, or other anticoagulants.
- Methotrexate, digoxin, tacrolimus or cilostazol.
- Some antifungals, such as ketoconazole or voriconazole.
- Citalopram, diazepam, phenytoin or rifampicin.
- St John's wort.
Do not combine it with another PPI or acid reducer. An antacid can be taken if needed.
How do you take the tablets if swallowing is hard?
Nexium Mups tablets are swallowed whole with water, not chewed or crushed. If swallowing is hard, the leaflet says the tablet can be stirred into still water until it breaks up, then drunk. Read the leaflet for the exact steps.
What esomeprazole does not treat
- Chest pain from the heart. Heart pain can feel like heartburn.
- The cause of new symptoms after age 55. New or changed heartburn at that age needs a doctor.
- Stomach pain from gallstones or the appendix. It may hide the real problem.
Our heartburn page and GERD page explain what a doctor looks for.
Side effects and warning signs
Common side effects are headache, stomach pain, diarrhoea, constipation, wind and feeling sick. See a doctor soon if you have:
- Trouble or pain when you swallow, or food feels stuck.
- Weight loss without trying.
- Stomach pain or indigestion that does not settle.
- Severe or lasting watery diarrhoea.
- Yellow skin or eyes, or fever with feeling very unwell.
Call 112 if you vomit blood, pass black or bloody stools, or have chest pain, especially with sweating, dizziness or breathlessness. Also call 112 for face or throat swelling, or blistering, peeling skin.
Talking it through with a doctor by video
Dr. Yelamo is a GP licensed in Spain. He sees adults, children and pregnant patients by video, every day from 07:30 to 20:30 (Spain time). In the visit he will:
- Ask when the burning comes, how often, and what you have tried.
- Check for warning signs that need tests, a scope or an in-person exam.
- Explain whether a PPI, an antacid or a change in habits fits you best.
- Review long-term PPI use and how it fits with your other medicines.
He does not promise any test or prescription before the visit. Where clinically appropriate, following a genuine evaluation. Treatment and prescriptions are issued solely at the doctor's discretion based on evidence-based clinical guidelines.
A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.
See how the Urgent Care video visit works. It lasts 15 minutes and costs €50.
This guide is general information. It does not replace the package leaflet or the advice of your doctor or pharmacist.
Frequently asked questions
What is Nexium?
The brand name of esomeprazole, a proton pump inhibitor. It lowers stomach acid to treat reflux and ulcers and to protect the stomach.
Can I buy Nexium without a prescription in Spain?
No. Every Nexium product needs a prescription in Spain. CIMA lists one other esomeprazole brand without prescription, for adults with short-term heartburn.
Is Nexium the same as omeprazole?
No. Both are PPIs and work the same way, but they are different medicines. Do not take them together.
Is Nexium 24HR sold in Spain?
No. Nexium 24HR is a US over-the-counter brand. In Spain, Nexium is sold only on prescription.
Is it bad to take esomeprazole for years?
Long use can lower vitamin B12 and magnesium and slightly raise fracture risk. A doctor should review it now and then.
When should I see a doctor about heartburn?
If it lasts more than 14 days, or comes with trouble swallowing, weight loss or vomiting. Call 112 for chest pain or vomiting blood.
Sources
- AEMPS CIMA: Nexium Mups package leaflet
- AEMPS CIMA: Esomeprazol Sandoz Care package leaflet
- MedlinePlus: Esomeprazole
- NHS: Esomeprazole
Related guides
Medical Citations & Sources
This content is written and reviewed by a licensed physician with reference to the following official health authorities.
