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By excess stomach acid. There are no restrictions on food, beverages, or activities while taking Nexium, unless otherwise directed by your doctor. Nexium decreases the amount of acid backing up into the esophagus and causing reflux symptoms. Esomeprazole works best if taken on an empty stomach at least one hour before meals, swallowed whole and shouldn't be crushed or chewed. Nexium capsules should be applied one hour before meals, swallowed whole and shouldn't be crushed or chewed. Esomeprazole capsules should be taken at least one hour before a meal. Taking Esomeprazole? By excess stomach acid. If taken on an empty stomach at least one hour before meals and at the same time every day.