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The following serious adverse reactions are described below and elsewhere in labeling.

What should I discuss with my healthcare provider before taking esomeprazole?

Frequency not reported . Anemia.anemia hypochromic.cervical lymphadenopathy.decreased/increased hemoglobin.decreased/increased platelets.decreased/increased white blood cell count.leukocytosis [Ref]

Case reports.published population pharmacokinetic studies.and retrospective analyses suggest that concomitant administration of PPIs and methotrexate (primarily at high dose. see methotrexate prescribing information) may elevate and prolong serum levels of methotrexate and/or its metabolite hydroxymethotrexate. However.no formal drug interaction studies of methotrexate with PPIs have been conducted [see WARNINGS AND PRECAUTIONS ].Symptom relief does not rule out the presence of other serious conditions.

Drug-diagnostic tests. Alanine aminotransferase.alkaline phosphatase.aspartate aminotransferase.bilirubin.creatinine.uric acid. increased levels.

A pre- and postnatal development study in rats with esomeprazole strontium (using equimolar doses compared to esomeprazole magnesium study) produced similar results in dams and pups as described above.

One theory is that PPIs interfere with calcium absorption.which may weaken bones.

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