esomeprazole (Oral route)

Pronunciation

es-oh-MEP-ra-zole mag-NEE-zee-um

Commonly used brand name(s)

In the U.S.

  • Nexium

Available Dosage Forms:

  • Packet
  • Capsule, Delayed Release

Therapeutic Class: Gastric Acid Secretion Inhibitor

Pharmacologic Class: Esomeprazole

Uses For esomeprazole

Esomeprazole is used to treat conditions where there is too much acid in the stomach. It is used to treat duodenal and gastric ulcers, erosive esophagitis, gastroesophageal reflux disease (GERD), and the Zollinger-Ellison syndrome. Esomeprazole is also used with antibiotics (e.g., amoxicillin, clarithromycin) to treat ulcers that are caused by the H. pylori bacteria. esomeprazole is also used to prevent stomach ulcers and stomach irritation in patients taking pain and arthritis drugs called NSAIDs, such as aspirin or ibuprofen, for long periods of time.

Slideshow: Top 10 Money-Making Drugs of 2012

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 for GERD in infants and children 1 month of age and older. Safety and efficacy have not been established for 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 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 taking 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
  • Hypomagnesemia (low magnesium in the blood), history of or
  • Osteoporosis (thinning of the bones) or
  • Seizures, history of—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

Take esomeprazole exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

esomeprazole comes with a patient information leaflet. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Take esomeprazole at least one hour before a meal and for the full time of treatment, even if you begin to feel better after a few days.

If you are taking esomeprazole to treat an ulcer with an H. pylori infection, take it together with the antibiotics (e.g., amoxicillin, clarithromycin).

To use the capsule:

  • Swallow the capsule whole. Do not break, crush, or chew it.
  • If the capsule cannot be swallowed, open it and sprinkle the contents on one tablespoonful of applesauce.
  • Swallow the mixture right away. Do not chew or crush the granules.

To use the capsule with a nasogastric (NG) tube:

  • Open the capsule and empty the granules into a 60 mL catheter-tipped syringe and mix it with 50 mL of water.
  • Shake the syringe well for 15 seconds.
  • Inject or pour the mixture into the nasogastric tube.
  • Refill the syringe with a small amount of water and shake.
  • Flush the tube to rinse all of the medicine into the stomach.

To use the oral suspension:

  • Empty the contents of a 2.5 mg or 5 mg packet into a container with 5 mL of water.
  • Empty the contents of a 10 mg, 20 mg, or 40 mg packet into a container with 15 mL of water.
  • Stir and leave it for 2 to 3 minutes to thicken.
  • Stir well and drink within 30 minutes.
  • If any medicine remains after drinking, add more water, stir, and drink immediately.

To use the oral suspension with a nasogastric or gastric tube:

  • Add 5 mL of water to a catheter-tipped syringe and add the contents of a 2.5 mg or 5 mg packet.
  • Add 15 mL of water to a catheter-tipped syringe and add the contents of a 10 mg, 20 mg, or 40 mg packet.
  • Shake the syringe right away and leave it for 2 to 3 minutes to thicken.
  • Shake the syringe again and inject or pour the mixture into the tube within 30 minutes.
  • Refill the syringe with 15 mL of water and shake.
  • Flush the tube to rinse all of the medicine into the stomach.

Dosing

The dose of esomeprazole will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of esomeprazole. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (capsules or suspension):
    • To prevent NSAID-associated gastric ulcer:
      • Adults—20 or 40 milligrams (mg) once a day for up to 6 months. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor.
    • To treat duodenal ulcers with H. pylori infection:
      • Adults—40 milligrams (mg) once a day for 10 days. The dose is usually taken together with amoxicillin and clarithromycin. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor.
    •  To treat erosive esophagitis:
      • Adults and teenagers—20 or 40 milligrams (mg) once a day for 4 to 8 weeks. Your doctor may adjust your dose if needed.
      • Children 1 to 11 years of age and weighing 20 kilograms (kg) or more—10 or 20 mg once a day for 8 weeks. Your doctor may adjust your dose if needed.
      • Children 1 to 11 years of age and weighing less than 20 kg—10 mg once a day for 8 weeks. Your doctor may adjust your dose if needed.
      • Children 1 month to less than 1 year of age and weighing more than 7.5 kg to 12 kg—10 mg once a day for up to 6 weeks. Your doctor may adjust your dose as needed.
      • Children 1 month to less than 1 year of age and weighing more than 5 kg to 7.5 kg—5 mg once a day for up to 6 weeks. Your doctor may adjust your dose as needed.
      • Children 1 month to less than 1 year of age and weighing 3 kg to 5 kg—2.5 mg once a day for up to 6 weeks. Your doctor may adjust your dose as needed.
      • Infants younger than 1 month of age—Use and dose must be determined by your doctor.
    • To treat gastroesophageal reflux disease (GERD):
      • Adults and teenagers—20 or 40 milligrams (mg) once a day for up to 8 weeks. Your doctor may adjust your dose if needed.
      • Children 1 to 11 years of age—10 mg once a day for up to 8 weeks. Your doctor may adjust your dose if needed.
      • Children younger than 1 year of age—Use and dose must be determined by your doctor.
    • To treat Zollinger-Ellison syndrome:
      • Adults—40 milligrams (mg) two times a day. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of esomeprazole, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using esomeprazole

It is very important that your doctor check the progress of you or your child at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and other laboratory 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 is sometimes given together with amoxicillin (Amoxil®) and clarithromycin (Biaxin®) to treat ulcers. Be sure you understand about the risks and proper use of any other medicines your doctor prescribes together with esomeprazole.

Atrophic gastritis (inflammation in the stomach) may occur, especially if you take esomeprazole for a long time. Talk with your doctor if you have concerns about this.

esomeprazole 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, use high doses, or use it for one year or more.

esomeprazole may cause hypomagnesemia (low magnesium in the blood). This is more likely to occur if you are taking esomeprazole for more than one year, or if you are taking esomeprazole together with digoxin (Lanoxin®) or certain diuretics or "water pills". Stop using esomeprazole and check with your doctor right away if you have convulsions (seizures); fast, racing, or uneven heartbeat; muscle spasms (tetany); tremors; or unusual tiredness or weakness.

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

Do not stop using esomeprazole without first checking with your doctor, or unless told to do so by your doctor.

Make sure any doctor or dentist who treats you knows that you 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 immediately if any of the following side effects occur:

Incidence not known
  • Blistering, peeling, or loosening of the skin
  • bloating
  • chills
  • constipation
  • cough
  • darkened urine
  • difficulty with swallowing
  • dizziness
  • drowsiness
  • fast heartbeat
  • fever
  • hives
  • indigestion
  • itching
  • joint or muscle pain
  • loss of appetite
  • mood or mental changes
  • muscle spasms (tetany) or twitching
  • nausea
  • 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
  • seizures
  • shortness of breath
  • skin rash
  • sore throat
  • sores, ulcers, or white spots in the mouth or on the lips
  • tightness in the chest
  • trembling
  • 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
  • Bad, unusual, or unpleasant (after) taste
  • change in taste
Less common
  • Sleepiness or unusual drowsiness
Rare
  • Acne
  • back pain
Incidence not known
  • Agitation
  • dry mouth
  • excess air or gas in the stomach or intestines
  • full feeling
  • hair loss or thinning of the hair
  • muscular weakness
  • passing gas
  • seeing, hearing, or feeling things that are not there
  • swelling of the breasts or breast soreness in both females and males
  • swelling or inflammation of the mouth
  • swollen joints

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)

The information contained in the Truven Health Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Truven Health products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Truven Health and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, TRUVEN HEALTH MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Truven Health does not assume any responsibility or risk for your use of the Truven Health products.

Hide
(web4)