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Esomeprazole

Medical and Pharmacy Editor:

Brand Name: Nexium, Nexium 24HR

Generic Name: esomeprazole

Drug Class: Proton Pump Inhibitors

What Is Esomeprazole and How Does It Work?

Esomeprazole is used to treat certain stomach and esophagus problems (such as acid reflux, ulcers). It works by decreasing the amount of acid your stomach makes. It relieves symptoms such as heartburn, difficulty swallowing, and persistent cough. This medication helps heal acid damage to the stomach and esophagus, helps prevent ulcers, and may help prevent cancer of the esophagus. Esomeprazole belongs to a class of drugs known as proton pump inhibitors (PPIs).

Esomeprazole is available under the following different brand names: Nexium, and Nexium 24HR

Dosages of Esomeprazole:

Dosage Forms and Strengths

Capsule, delayed-release (as magnesium)

  • 20 mg (Rx/OTC)
  • 40 mg
  • 24.65 mg (strontium salt) (adult only)
  • 49.3 mg (strontium salt) (adult only)

Tablet delayed release (as magnesium)

  • 20 mg

Injection, powder for reconstitution

  • 20 mg/vial
  • 40 mg/vial

Packets for oral suspension

  • 10 mg
  • 20 mg
  • 40 mg

Dosage Considerations – Should be Given as Follows:

GERD Without Erosive Esophagitis

Adult:

  • 20 mg orally once/day for 4 weeks; consider an additional 4 weeks of treatment if symptoms do not resolve completely in the first 4 weeks

Pediatric:

Oral

  • Children under 1 year: Safety and efficacy not established
  • Children 1-12 years: 10-20 mg orally once/day for up to 8 weeks
  • Children older than 12 years: 20-40 mg orally once/day for up to 8 weeks

Intravenous (IV)

Short-term treatment of GERD with erosive esophagitis when oral therapy is not possible or appropriate

  • Children under 1 month: Safety and efficacy not established
  • Children 1 month to 1 year: 0.5 mg/kg intravenously (IV) once/day
  • Children 1 year and older (less than 55 kg): 10 mg IV once/day
  • Children 1 year and older (55 kg and greater): 20 mg IV once/day

GERD with Erosive Esophagitis

Adult

  • 20-40 mg orally once/day for 4-8 weeks
  • If oral therapy inappropriate or not possible: 20-40 mg once/day intravenously (IV) up to 10 days; switch to orally once patient able to swallow
  • Maintenance: 20 mg orally once/day for up to 6 months

Pediatric

Children under 1 month: Safety and efficacy not established

Children 1 month to 1 year

  • 3.5 kg: 2.5 mg orally once/day for up to 6 weeks
  • Greater than 3.5-7.5 kg: 5 mg orally once/day for up to 6 weeks
  • Greater than 7.5 kg: 10 mg orally once/day for up to 6 weeks

Children 1-12 years

  • Less than 20 kg: 10 mg orally once/day for 8 weeks
  • 20 kg or greater: 10-20 mg once/day for 8 weeks

Children over 12 years

  • 20-40 mg orally once/day for 4-8 weeks
  • Maintenance: 20 mg orally once/day up to 6 months

Helicobacter Pylori Eradication

  • Combination therapy (with amoxicillin and clarithromycin) for eradication of H pylori in patients with duodenal ulcer
  • 40 mg orally once/day for 10 days, PLUS
  • Amoxicillin 1000 mg orally every 12 hours for 10 days, PLUS
  • Clarithromycin 500 mg orally every 12 hours for 10 days

Risk Reduction of NSAID-Associated Gastric Ulcer

  • 20-40 mg orally once/day for up to 6 months

NSAID-Induced Gastric Ulcer

  • 20 mg orally once/day for 4-8 weeks

Zollinger-Ellison Syndrome

  • 80 mg orally divided every 12 hours (initial); adjust regimen to efficacy; up to 240 mg orally once/day, OR
  • 120 mg orally every 12 hours administered to patients

Gastric or Duodenal Ulcers Following Therapeutic Endoscopy

  • Intravenous (IV) indicated for risk reduction of re-bleeding of gastric or duodenal ulcers following therapeutic endoscopy in adults
  • 80 mg IV infused over 30 min, THEN continuous IV infusion of 8 mg/hour for total treatment duration of 72 hours
  • Follow IV therapy with oral acid suppressive therapy

Frequent Heartburn

  • Over-the-counter (OTC): 20 mg orally once/day for 14 days

Hepatic Impairment

Oral administration

  • Mild to moderate (Child-Pugh A/B): No dosage adjustment required
  • Severe (Child-Pugh C): Not to exceed 20 mg/day

GERD - Intravenous (IV)

  • Mild to moderate (Child-Pugh A/B): No dosage adjustment required
  • Severe (Child-Pugh C): Not to exceed 20 mg/day IV

Bleeding gastric or duodenal ulcers - Intravenous (IV)

  • No dosage adjustment required with initial 80 mg/30 min IV dose
  • Adjust dose for continuous IV infusion
  • Mild-to-moderate (Child Pugh A/B): Not to exceed 6 mg/hour
  • Severe (Child Pugh C): Not to exceed 4 mg/hour
Medically Reviewed by a Doctor on 5/3/2017



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