Hello, This is Dr. Papaqako answering your question. Thank you for posting your question to HCM. This is the recommend dosage of Nexium: --Acid reflux without Erosive Esophagitis: 20 mg once daily for 4 weeks; may give an additional 4 weeks of therapy. --Treatment of Erosive Esophagitis: 20 or 40 mg once daily for 4–8 weeks; may give an additional 4–8 weeks of therapy. If I was your mother s caring doctor, I would recommend to start with the tablets of 20-22 mg that you may find in your local pharmacy, for 1-2 weeks. Meanwhile she should be careful of her diet: eat frequently and small amounts, have dinner early, use a high cushion to sleep so the head will be higher then the body and avoid reflux, avoid spicy foods or foods that seems to aggravate reflux, ect. If after 2 weeks the medicine seems to not help, I would recommend to do a Fibrogastroscopy and check if the problem is not only the reflux but other problems that may require a different approach and dose of the treatment. Hope this helps, Let me know if you have any other question.