Whats the physlogical impact of taking two 20 mg nexium (esomeprazole) in the morning opposed to taking one in the morning and one 12 hours later?

Bioavailability: Taking 1 pill twice a day may improve symptom control over 24 h due to unpredictable individual variation in drug metabolism. Typically used in patients with partial response to treatment.

Nexium: Since it has such a long half life, you essentially get the same effect by taking 40 mg each morning as you would from taking 20 mg twice a day. Therefore we usually recommend the once daily dosing. Good luck.