Nexium MUPS 40mg Esomeprazole Tablets 14s

Nexium MUPS 40mg Esomeprazole Tablets 14s is a prescription proton pump inhibitor containing esomeprazole magnesium trihydrate equivalent to esomeprazole 40mg in each gastro-resistant tablet.

Esomeprazole reduces the production of gastric acid. Nexium MUPS 40mg is used for selected acid-related gastrointestinal conditions, particularly the treatment of erosive reflux oesophagitis. It may also be prescribed for certain patients following treatment of bleeding peptic ulcers or for pathological gastric acid hypersecretion such as Zollinger-Ellison syndrome.

The 40mg strength is not the usual dose for every type of heartburn or gastric discomfort. Lower-strength esomeprazole is commonly used for symptomatic reflux without oesophagitis, maintenance treatment, Helicobacter pylori eradication regimens and routine prevention of ulcers associated with NSAIDs. Patients should use the exact strength stated on their prescription.

Nexium MUPS 40mg Product Information

What Does MUPS Mean?

MUPS means Multiple Unit Pellet System. A Nexium MUPS tablet contains many small enteric-coated pellets compressed into one tablet.

The enteric coating protects esomeprazole from being broken down by stomach acid before it reaches the intestine. The pellets should therefore remain intact during administration.

• Do not crush the tablet.
• Do not chew the tablet or individual pellets.
• Do not grind the tablet into powder.
• Do not dissolve it in carbonated drinks, juice or milk.

What Is Nexium MUPS 40mg Used For?

Erosive Reflux Oesophagitis

Nexium MUPS 40mg may be prescribed to treat erosive reflux oesophagitis in adults and adolescents aged 12 years and above.

Erosive reflux oesophagitis occurs when repeated exposure to refluxed stomach acid causes visible inflammation or damage to the lining of the oesophagus.

Possible symptoms include:

• Persistent heartburn
• Acid regurgitation
• Burning discomfort behind the breastbone
• Pain or difficulty when swallowing
• Sour or bitter fluid reaching the throat
• Reflux-related cough or throat irritation

The referenced product information describes 40mg once daily for four weeks for erosive reflux oesophagitis. A further four weeks may be prescribed when healing is incomplete or symptoms persist.

Prevention of Rebleeding After Intravenous Treatment

Nexium MUPS 40mg may be used for prolonged acid suppression after intravenous esomeprazole has been administered to prevent rebleeding from a gastric or duodenal ulcer.

The referenced regimen is 40mg once daily for four weeks after the intravenous treatment course. This treatment is initiated and supervised by the treating medical team.

Zollinger-Ellison Syndrome

Zollinger-Ellison syndrome is a rare condition in which one or more tumours cause the stomach to produce excessive amounts of acid.

Nexium MUPS 40mg may be used as the initial strength in this condition. The dosage is individually adjusted and may be considerably higher than the dosage used for routine reflux treatment.

High-dose treatment must only be undertaken under specialist supervision.

Other Approved Uses of Nexium MUPS

The Nexium MUPS product range may also be prescribed for:

• Symptomatic gastro-oesophageal reflux disease
• Long-term management after reflux oesophagitis has healed
• Helicobacter pylori eradication together with appropriate antibiotics
• Healing of Helicobacter pylori-associated duodenal ulcers
• Prevention of recurrence of Helicobacter pylori-associated peptic ulcers
• Healing of gastric ulcers associated with continued NSAID treatment
• Prevention of gastric and duodenal ulcers in patients at risk while taking NSAIDs
• Prevention of gastric or duodenal ulcers in selected patients taking low-dose aspirin

These indications commonly use different esomeprazole strengths and treatment schedules. The 40mg tablet should not automatically be substituted for Nexium MUPS 20mg.

How Nexium MUPS Works

Acid-producing cells in the stomach contain an enzyme known as the hydrogen-potassium adenosine triphosphatase pump, commonly called the gastric proton pump.

Esomeprazole becomes active within the acidic environment of these cells and blocks the final stage of gastric acid production.

Reducing gastric acid can:

• Reduce acid exposure in the oesophagus
• Allow inflamed or eroded oesophageal tissue to heal
• Reduce reflux-related symptoms
• Support the healing of selected gastric or duodenal ulcers
• Reduce the risk of ulcer recurrence in appropriately selected patients

Nexium is not an antacid and may not provide immediate relief after the first dose. The full treatment effect develops through continued inhibition of gastric acid production.

How to Take Nexium MUPS 40mg

• Take Nexium MUPS exactly as prescribed.
• Swallow the tablet whole with water.
• Do not chew or crush the tablet.
• Take it at approximately the same time each day.
• Follow the meal-timing instructions on the dispensing label.
• Do not increase the dose or extend the treatment duration without medical advice.
• Do not change between the 20mg and 40mg strengths without a new instruction.

How to Take Nexium If Swallowing Is Difficult

The MUPS formulation may be dispersed in non-carbonated water when the patient cannot swallow the tablet whole.

1. Place the tablet in approximately half a glass of non-carbonated water.
2. Do not use another liquid because it may damage the enteric coating.
3. Stir until the tablet breaks apart and releases the small pellets.
4. Drink the liquid with the pellets immediately or within 30 minutes.
5. Do not chew the pellets.
6. Rinse the glass with additional water and drink the rinse to ensure the full dose is taken.

Administration through a gastric tube should only be performed by appropriately trained healthcare personnel using the product-specific instructions.

What to Do If a Dose Is Missed

Take the missed dose when remembered unless it is nearly time for the next scheduled dose.

If the next dose is approaching, skip the missed dose and continue with the normal schedule. Do not take two doses together to replace a missed tablet.

Important Warning Symptoms

Acid suppression may reduce symptoms without treating the underlying cause. Obtain medical assessment before starting or continuing Nexium when alarm symptoms are present.

Seek prompt medical advice for:

• Significant or unexplained weight loss
• Difficulty or pain when swallowing
• Repeated vomiting
• Vomiting blood or material resembling coffee grounds
• Black, tar-like stools
• Visible blood in the stools
• Persistent anaemia
• Severe or continuing abdominal pain
• New reflux symptoms later in life
• Symptoms that continue despite appropriate treatment

These symptoms may require investigation to exclude ulcer complications, narrowing of the oesophagus, gastrointestinal bleeding or malignancy.

Who Should Not Take Nexium MUPS?

Nexium MUPS should not be used by patients with:

• An allergy to esomeprazole
• An allergy to omeprazole or another substituted benzimidazole proton pump inhibitor
• An allergy to another ingredient in the tablet
• Current treatment with nelfinavir

The tablet contains sucrose. Patients with certain rare hereditary disorders affecting fructose tolerance or sugar absorption should inform the prescribing doctor.

Liver and Kidney Considerations

Dose adjustment is generally not required in mild or moderate liver impairment. However, patients with severe liver impairment should not normally exceed 20mg of esomeprazole daily.

Nexium MUPS 40mg may therefore be unsuitable for patients with severe hepatic impairment.

Dose adjustment is generally not required solely because of kidney impairment, but patients with severe renal insufficiency should be treated cautiously because clinical experience is limited.

Long-Term Proton Pump Inhibitor Use

Patients receiving long-term proton pump inhibitor treatment, particularly treatment lasting more than one year, should be reviewed regularly.

Long-term or high-dose therapy may be associated with:

• Reduced magnesium levels
• Reduced vitamin B12 absorption in susceptible patients
• A modestly increased risk of hip, wrist or spinal fracture
• Increased susceptibility to certain gastrointestinal infections
• Benign fundic gland polyps
• Rare inflammatory kidney reactions
• Rare subacute cutaneous lupus erythematosus

The clinical need for continued treatment and the lowest suitable effective dose should be reviewed periodically.

Low Magnesium Warning

Severe hypomagnesaemia has been reported in patients taking proton pump inhibitors for several months, particularly during prolonged therapy.

Possible symptoms include:

• Unusual tiredness
• Muscle cramps, twitching or tremor
• Dizziness
• Confusion
• Seizures
• Irregular heartbeat

Magnesium monitoring may be considered before and during prolonged treatment, particularly in patients taking digoxin, diuretics or another medicine that may reduce magnesium levels.

Possible Side Effects

Not everyone experiences side effects. Commonly reported effects include:

• Headache
• Abdominal pain
• Diarrhoea
• Constipation
• Flatulence
• Nausea or vomiting

Other possible effects include:

• Dizziness
• Dry mouth
• Skin rash, itching or hives
• Swelling of the hands, feet or ankles
• Sleep disturbance
• Increased liver enzymes

Persistent, worsening or troublesome effects should be discussed with a doctor or pharmacist.

Serious Reactions Requiring Medical Attention

Stop the medicine and seek urgent medical attention for:

• Swelling of the face, lips, tongue or throat
• Difficulty breathing or swallowing
• A widespread blistering, peeling or painful skin reaction
• A rash with fever, facial swelling or swollen lymph nodes
• Yellowing of the skin or eyes
• Dark urine with severe tiredness
• A significant reduction in urine output
• Blood in the urine or unexplained swelling
• Severe persistent diarrhoea
• Confusion, seizure or abnormal heartbeat associated with electrolyte disturbance

Medicine Interactions

Tell the doctor and pharmacist about all prescription medicines, non-prescription medicines, traditional products and supplements being used.

Medicines requiring particular consideration include:

• Nelfinavir: concurrent use is contraindicated.
• Atazanavir: concurrent use is generally not recommended.
• Clopidogrel: esomeprazole may reduce formation of clopidogrel’s active metabolite; concurrent use is generally discouraged.
• Warfarin and related anticoagulants: additional INR monitoring may be required when Nexium is started or stopped.
• High-dose methotrexate: temporary interruption of esomeprazole may be considered.
• Tacrolimus: blood concentrations and kidney function may require closer monitoring.
• Digoxin: absorption may increase, particularly with high-dose treatment in older adults.
• Phenytoin: blood concentrations may require monitoring when esomeprazole is started or stopped.
• Diazepam, citalopram, imipramine or clomipramine: exposure may increase because esomeprazole inhibits CYP2C19.
• Ketoconazole, itraconazole or erlotinib: reduced stomach acidity may lower absorption.
• Rifampicin or St John’s wort: these may reduce esomeprazole concentrations and effectiveness.

Antibiotic combinations for Helicobacter pylori require professional review of the contraindications and interactions associated with every medicine in the regimen.

Pregnancy and Breastfeeding

Patients who are pregnant, planning a pregnancy or think they may be pregnant should tell the prescribing doctor.

Available pregnancy information has not identified a clear malformation or foetal-toxicity signal, but esomeprazole should still be used during pregnancy only when clinically appropriate.

It is not known whether esomeprazole is excreted into human breast milk. The referenced product information advises against its use while breastfeeding.

Use in Children and Adolescents

Nexium MUPS 40mg may be used in adolescents aged 12 years and above for the treatment of erosive reflux oesophagitis when prescribed.

The 40mg MUPS tablet is not the appropriate presentation for children below 12 years. Paediatric dosing and dosage forms are selected according to age, weight and clinical diagnosis.

Storage Instructions

• Store according to the temperature stated on the Malaysian carton.
• Keep the tablets in their original blister packaging until required.
• Protect from moisture and excessive heat.
• Keep out of reach of children.
• Do not use tablets that appear wet, damaged or deteriorated.
• Do not use after the expiry date printed on the carton or blister.
• Expiry varies by supplied batch.

Frequently Asked Questions

What is the active ingredient in Nexium MUPS 40mg?

Each tablet contains esomeprazole magnesium trihydrate 44.5mg, equivalent to esomeprazole 40mg.

What type of medicine is Nexium?

Nexium is a proton pump inhibitor that reduces gastric acid secretion.

What does MUPS mean?

MUPS means Multiple Unit Pellet System. The tablet contains many small enteric-coated pellets that protect esomeprazole from stomach acid.

What is Nexium MUPS 40mg used for?

The 40mg strength is principally used for erosive reflux oesophagitis and selected specialist acid-related indications, including treatment following prevention of peptic-ulcer rebleeding and Zollinger-Ellison syndrome.

Is Nexium MUPS 40mg suitable for ordinary heartburn?

Not necessarily. Symptomatic reflux without oesophagitis is commonly treated with esomeprazole 20mg. The 40mg strength should only be used when prescribed for an appropriate indication.

Can the Nexium MUPS tablet be crushed?

No. Crushing or chewing damages the gastro-resistant pellets and may affect medicine delivery.

Can Nexium MUPS be dissolved in water?

The tablet may be dispersed in non-carbonated water for patients who cannot swallow it whole. The released pellets must be swallowed without chewing.

Can Nexium MUPS be taken with juice or a carbonated drink?

No. Use only non-carbonated water for dispersion because other liquids may damage the enteric coating.

How long is Nexium MUPS 40mg taken for erosive oesophagitis?

The referenced regimen is 40mg once daily for four weeks. A further four weeks may be prescribed when healing is incomplete or symptoms continue.

Can Nexium be taken long term?

Long-term treatment may be appropriate for selected patients, but the continuing need, dose and potential risks should be reviewed regularly.

Can Nexium cause vitamin or mineral deficiencies?

Long-term acid suppression may reduce magnesium levels and vitamin B12 absorption in susceptible patients.

Can Nexium be taken with clopidogrel?

Esomeprazole may reduce formation of clopidogrel’s active metabolite. Concurrent use is generally discouraged unless the treating healthcare professional determines otherwise.

Is Nexium MUPS 40mg a prescription medicine in Malaysia?

Yes. Nexium MUPS 40mg is a prescription medicine and should only be supplied and used according to a valid prescription.

What is the Malaysian registration number?

The Malaysian registration number is MAL20020239ARZ.

Who manufactures Nexium MUPS 40mg?

The Malaysian registration record lists AstraZeneca Sdn. Bhd. as the registration holder and AstraZeneca AB, Sweden, as the manufacturer.

How many tablets are supplied?

The P-Hub product listing is for a pack containing 14 Nexium MUPS 40mg tablets.

Can pharmacies request Nexium MUPS through P-Hub?

Nexium MUPS 40mg Esomeprazole Tablets 14s is listed in the P-Hub B2B catalogue for approved pharmacy members. Quotation, ordering eligibility and supply are subject to P-Hub membership requirements, prescription medicine controls and current stock availability.

Prescription Medicine Notice

Nexium MUPS 40mg is a prescription medicine. It should only be supplied, dispensed and used according to applicable Malaysian requirements and the directions of a registered doctor or pharmacist.

The information on this page is provided for pharmacy catalogue and professional product-reference purposes. It does not replace an individual medical assessment, endoscopic investigation where required, prescription, approved Malaysian package insert or advice from a qualified healthcare professional.

Product appearance, packaging, batch number, availability and expiry date may vary. Verify all information on the physical Malaysian product packaging and approved insert before dispensing or use.

Product Information Sources

• 
  NPRA Malaysia – Modified-Release Comparator Product Register
  
• 
  NPRA Malaysia – Nexium MUPS Registration Renewal
  
• 
  Singapore National Drug Formulary – Nexium MUPS 40mg Product Information
  
• 
  AstraZeneca – Nexium 40mg Summary of Product Characteristics
  
• 
  NPRA Malaysia – Proton Pump Inhibitor Safety Communication
  

Product information last reviewed: 12 July 2026.