esomeprazole (Intravenous route)

Pronunciation

es-oh-MEP-ra-zole SOE-dee-um

Commonly used brand name(s)

In the U.S.

  • Nexium I.V.

Available Dosage Forms:

  • Powder for Solution

Therapeutic Class: Gastric Acid Secretion Inhibitor

Pharmacologic Class: Esomeprazole

Uses For esomeprazole

Esomeprazole injection is used to treat conditions where there is too much acid in the stomach. It is used for the short-term treatment (up to 10 days) of gastroesophageal reflux disease (GERD) with erosive esophagitis in adults and children 1 month of age and older. GERD is a condition where the acid in the stomach washes back up into the esophagus.

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Esomeprazole is a proton pump inhibitor (PPI). It works by decreasing the amount of acid that is produced by the stomach.

esomeprazole is available only with your doctor's prescription.

Before Using esomeprazole

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For esomeprazole, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to esomeprazole or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of esomeprazole injection in children greater than 1 month of age. However, safety and efficacy have not been established in infants younger than 1 month of age.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of esomeprazole injection in the elderly.

Pregnancy

Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving esomeprazole, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using esomeprazole with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Rilpivirine

Using esomeprazole with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Atazanavir
  • Bosutinib
  • Citalopram
  • Clopidogrel
  • Dabrafenib
  • Dasatinib
  • Erlotinib
  • Eslicarbazepine Acetate
  • Ketoconazole
  • Methotrexate
  • Mycophenolate Mofetil
  • Nelfinavir
  • Nilotinib
  • Pazopanib
  • Ponatinib
  • Posaconazole
  • Saquinavir
  • Tacrolimus
  • Vismodegib

Using esomeprazole with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Cranberry
  • Risedronate
  • Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of esomeprazole. Make sure you tell your doctor if you have any other medical problems, especially:

  • Diarrhea or
  • Osteoporosis (thinning of the bones)—Use with caution. May make these conditions worse.
  • Liver disease, severe—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of esomeprazole

A nurse or other trained health professional will give you or your child esomeprazole in a clinic or hospital. esomeprazole is given through a needle placed in one of your veins.

Your doctor will give you a few doses of esomeprazole until your condition improves, and then switch you to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

Precautions While Using esomeprazole

It is important that your doctor check the progress of you or your child at regular visits. Blood tests may be needed to check for unwanted effects. If your or your child's condition does not improve, or if it becomes worse, check with your doctor.

esomeprazole may cause atrophic gastritis (inflammation in the stomach). This has happened in patients who used a similar medicine called omeprazole (Prilosec®) for a long time. Check with your doctor right away if you or your child have a burning feeling in the chest or stomach; indigestion; stomach upset; or tenderness in the stomach area.

Esomeprazole injection may increase your risk of having fractures of the hip, wrist, and spine. This is more likely if you are 50 years of age and older, if you receive high doses of esomeprazole, or use it for one year or more.

Check with your doctor right away if you have watery diarrhea that does not go away, stomach pain, and a fever while receiving esomeprazole.

Make sure any doctor or dentist who treats you knows that you or your child are using esomeprazole. esomeprazole may affect the results of certain medical tests.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

esomeprazole Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Incidence not known
  • Blistering, peeling, or loosening of the skin
  • bloating
  • chills
  • cough
  • darkened urine
  • difficulty with swallowing
  • dizziness
  • fast heartbeat
  • fever
  • hives
  • indigestion
  • itching
  • joint or muscle pain
  • loss of appetite
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • red, irritated eyes
  • red skin lesions, often with a purple center
  • shortness of breath
  • skin rash
  • sore throat
  • sores, ulcers, or white spots in the mouth or on the lips
  • tightness in the chest
  • unusual tiredness or weakness
  • vomiting
  • wheezing
  • yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Acid or sour stomach
  • belching
  • heartburn
  • stomach discomfort, upset, or pain
Less common
  • Burning, itching, redness, skin rash, swelling, or soreness at the injection site
  • diarrhea
  • difficulty having a bowel movement (stool)
  • dryness of the mouth
  • feeling of constant movement of self or surroundings
  • gas
  • headache
  • lightheadedness
  • nausea
  • pain or tenderness around the eyes and cheekbones
  • sensation of spinning
  • sneezing
  • stuffy or runny nose
  • wheezing

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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