The active ingredient, Esomeprazole, works by decreasing the quantity of acid that your stomach produces, thereby addressing the problem at its source, getting to work within 1 hour and giving 24 hour relief. Full benefits may take 2 to 3 days. Nexium can be taken at any time of the day either with or without food. Swallow whole with a glass of water. Do not chew or crush – contains coated pellets, stopping the medicine from being broken down by the acid in your stomach, therefore, it is important not to damage the pellets. When your reflux symptoms have completely gone you should stop taking this medicine. If your reflux symptoms get worse or do not improve after taking this medicine for 14 days in a row, you should consult a doctor.