Esomeprazole Dosage

Usual Adult Dose for Gastroesophageal Reflux Disease

20 mg orally once a day for 4 to 8 weeks. It may be administered by the intravenous route if unable to use oral route.

Usual Adult Dose for Erosive Esophagitis

Healing: 20 to 40 mg orally once a day for 4 to 8 weeks. It may be administered by the intravenous route if unable to use oral route.

Maintenance of healing: 20 mg orally once daily, for up to 6 months.

Usual Adult Dose for Helicobacter pylori Infection

40 mg orally once a day for 10 days along with amoxicillin 1000 mg and clarithromycin 500 mg orally twice a day for 10 days.

Usual Adult Dose for NSAID-Induced Gastric Ulcer

20 to 40 mg orally once daily for up to 6 months.

Usual Adult Dose for Zollinger-Ellison Syndrome

40 mg orally twice daily. Doses up to 240 mg daily have been used.

Usual Adult Dose for Pathological Hypersecretory Conditions

40 mg orally twice daily. Doses up to 240 mg daily have been used.

Usual Pediatric Dose for Gastroesophageal Reflux Disease

Short-term treatment:
1 to 11 years old: 10 mg orally once daily for up to 8 weeks.
12 to 17 years old: 20 mg to 40 mg orally once daily for up to 8 weeks.

When oral therapy is not possible or appropriate (GERD with Erosive Esophagitis):
1 month to less than 1 year of age: 0.5 mg/kg once daily IV over 10 minutes to 30 minutes.
1 year to 17 years:
Body weight less than 55 kg: 10 mg once daily IV over 10 minutes to 30 minutes
Body weight 55 kg or greater: 20 mg once daily IV over 10 minutes to 30 minutes

Usual Pediatric Dose for Erosive Esophagitis

Healing:
Less than 20 kg: 10 mg orally once daily for up to 8 weeks.
Greater than or equal to 20 kg: 10 mg to 20 mg orally once daily for up to 8 weeks.

Renal Dose Adjustments

No adjustments recommended

Liver Dose Adjustments

No dosage adjustment is recommended for patients with mild to moderate hepatic insufficiency (Child-Pugh class A and B). In patients with severe hepatic insufficiency (Child-Pugh class C), the maximum daily dose should not exceed 20 mg.

Precautions

Hypersensitivity side effects including angioedema and anaphylactic reaction/shock have been reported.

Proton pump inhibitors may interfere with the detection of Helicobacter pylori by the urea breath test. Therefore, testing for H pylori with the urea breath test is not recommended in patients who have received proton pump inhibitors in the preceding two weeks.

Symptomatic response to therapy with esomeprazole does not preclude the presence of gastric malignancy.

Atrophic gastritis has been noted occasionally in gastric corpus biopsies from patients treated long-term with omeprazole, of which esomeprazole is an enantiomer.

Safety and effectiveness have not been established in pediatric patients less than 1 year of age.

Dialysis

Not dialyzable

Other Comments

Orally administered esomeprazole should be taken at least 1 hour before meals.

The intravenous injection of esomeprazole should be administered over no less than 3 minutes. The intravenous infusion should be administered over 10 to 30 minutes.

Therapy with esomeprazole injection is intended for short-term treatment (up to 10 days).

See also...