Nexium (Esomeprazole Magnesium) Drug Information: Overdosage and Contraindications

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May 27, 2012

Nexium

Gastroesophageal Reflux Disease (GERD) »

GERD Facts

GERD is a condition in which the acidified liquid content of the stomach up into the esophagus.
The causes of GERD include an abnormal lower esophageal sphincter, hiatal hernia, abnormal esophageal contractions, and slow emptying of the stomach.
GERD may damage the lining of the esophagus, thereby causing inflammation (esophagitis), although usually it does not.
The symptoms of uncomplicated GERD are heartburn, regurgitation, and nausea.
Complications of GERD include ulcers and strictures of the esophagus, Barrett's esophagus, cough and asthma, throat and laryngeal inflammation, inflammation and infection of the lungs, and collection of fluid in the sinuses and middle ear.
Barrett's esophagus is a pre-cancerous condition that requires periodic endoscopic surveillance for the development of cancer.
GERD may be diagnosed or evaluate...

Read the Gastroesophageal Reflux Disease (GERD) article »

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OVERDOSE

A single oral dose of esomeprazole at 510 mg/kg (about 103 times the human dose on a body surface area basis), was lethal to rats. The major signs of acute toxicity were reduced motor activity, changes in respiratory frequency, tremor, ataxia, and intermittent clonic convulsions.

The symptoms described in connection with deliberate NEXIUM overdose (limited experience of doses in excess of 240 mg/day) are transient. Single doses of 80 mg of esomeprazole were uneventful. Reports of overdosage with omeprazole in humans may also be relevant. Doses ranged up to 2,400 mg (120 times the usual recommended clinical dose). Manifestations were variable, but included confusion, drowsiness, blurred vision, tachycardia, nausea, diaphoresis, flushing, headache, dry mouth, and other adverse reactions similar to those seen in normal clinical experience (see omeprazole package insert - ADVERSE REACTIONS). No specific antidote for esomeprazole is known. Since esomeprazole is extensively protein bound, it is not expected to be removed by dialysis. In the event of overdosage, treatment should be symptomatic and supportive.

As with the management of any overdose, the possibility of multiple drug ingestion should be considered. For current information on treatment of any drug overdose contact a Poison Control Center at 1-800-222-1222.

CONTRAINDICATIONS

NEXIUM is contraindicated in patients with known hypersensitivity to proton pump inhibitors. Hypersensitivity reactions, e.g., angioedema and anaphylactic shock, have been reported with NEXIUM use.

Last reviewed on RxList: 1/5/2012
This monograph has been modified to include the generic and brand name in many instances.