Nexium Capsules Dosage

Generic name: ESOMEPRAZOLE MAGNESIUM 20mg
Dosage forms: capsule, delayed release, granule, delayed release
Drug class: Proton pump inhibitors

Medically reviewed by Drugs.com. Last updated on Jul 18, 2023.

Recommended Dosage in Adults by Indication

Table 1 shows the recommended adult dosage of NEXIUM by indication.

The duration of NEXIUM treatment should be based on available safety and efficacy data specific to the defined indication and dosing frequency and individual patient medical needs. NEXIUM should only be initiated and continued if the benefits outweigh the risks of treatment.

Table 1: Recommended Dosage of NEXIUM in Adults by Indication
* A maximum dosage of 20 mg once daily is recommended for patients with severe liver impairment (Child-Pugh Class C). † Most patients are healed within 4 to 8 weeks. For patients who do not heal after 4 to 8 weeks, an additional 4 to 8 weeks of treatment may be required to achieve healing. ‡ Refer to the amoxicillin and clarithromycin prescribing information for dosage adjustments in elderly and renally-impaired patients. § A starting dosage of 20 mg twice daily is recommended for patients with severe liver impairment (Child-Pugh Class C).
Adult Indication	Recommended Dosage of NEXIUM delayed-release capsules and NEXIUM for delayed-release oral suspension	Treatment Duration
Healing of EE	20 mg or 40 mg* once daily	4 to 8 weeks†
Maintenance of Healing of EE	20 mg once daily	Controlled studies do not extend beyond 6 months
Treatment of Symptomatic GERD	20 mg once daily	4 weeks; if symptoms do not resolve completely, consider an additional 4 weeks
Risk Reduction of NSAID-Associated Gastric Ulcer	20 mg or 40 mg* once daily	Controlled studies do not extend beyond 6 months
H. pylori Eradication to Reduce the Risk of Duodenal Ulcer Recurrence (Triple Therapy)	NEXIUM 40 mg once daily*	10 days
	Amoxicillin 1000 mg twice daily‡	10 days
	Clarithromycin 500 mg twice daily‡	10 days
Pathological Hypersecretory Conditions Including Zollinger-Ellison Syndrome	Starting dosage is 40 mg twice daily§; individualize the regimen to patient needs. Dosages of up to 240 mg/day have been administered.	As long as clinically indicated

Recommended Dosage in Pediatric Patients by Indication

Table 2 shows the recommended dosage of NEXIUM in pediatric patients by indication.

Table 2: Recommended Dosage of NEXIUM in Pediatric Patients by Indication
* Dosages over 1 mg/kg/day have not been studied † Dosages over 1.33 mg/kg/day have not been studied
Indication	Patient Age	Recommended Dosage	Duration
Healing of EE	12 years to 17 years	NEXIUM delayed-release capsules or NEXIUM for delayed-release oral suspension: 20 mg or 40 mg once daily	4 to 8 Weeks
Healing of EE	1 year to 11 years*	NEXIUM for delayed-release oral suspension: Less than 20 kg 10 mg once daily 20 kg and greater 10 mg or 20 mg once daily	8 weeks
Treatment of EE due to Acid-Mediated GERD	1 month to less than 1 year†	NEXIUM for delayed-release oral suspension: 3 kg to 5 kg 2.5 mg once daily Greater than 5 kg to 7.5 kg 5 mg once daily Greater than 7.5 kg to 12 kg 10 mg once daily	Up to 6 weeks
Treatment of Symptomatic GERD	12 years to 17 years	NEXIUM delayed-release capsules or NEXIUM for delayed-release oral suspension: 20 mg once daily	4 weeks
Treatment of Symptomatic GERD	1 year to 11 years	NEXIUM for delayed-release oral suspension: 10 mg once daily1	Up to 8 weeks

Preparation and Administration Instructions

•: Take NEXIUM delayed-release capsules and NEXIUM for delayed-release oral suspension at least one hour before meals.
•: Antacids may be used concomitantly with NEXIUM.
•: Take a missed dose as soon as possible. If it is almost time for the next dose, skip the missed dose and take the next dose at the regular scheduled time. Do not take 2 doses at the same time.

NEXIUM Delayed-Release Capsules

Administer NEXIUM delayed-release capsules orally or via a nasogastric tube, as described below.

Oral Administration

•: Swallow NEXIUM delayed-release capsules whole; do not chew or crush the capsules.
•: For patients who have difficulty swallowing capsules, NEXIUM delayed-release capsules can be opened, and the contents sprinkled on applesauce. Use with other foods has not been evaluated and is not recommended.
1.: Add one tablespoon of applesauce to an empty bowl. The applesauce used should not be hot and should be soft enough to be swallowed without chewing.
2.: Open the NEXIUM delayed-release capsule and carefully empty the granules inside the capsule onto the applesauce.
3.: Mix the granules with the applesauce.
4.: Administer the mixture immediately. Do not chew or crush the granules
5.: Discard any remaining mixture. Do not store the mixture for future use.

Administration via Nasogastric Tube

1.: Open the NEXIUM delayed-release capsule and empty the granules into a 60 mL catheter-tipped syringe.
2.: Mix the granules with 50 mL of water.
3.: Replace the plunger and shake the catheter-tipped syringe vigorously for 15 seconds.
4.: Hold the catheter-tipped syringe with the tip up and check for any granules remaining in the tip.
5.: Attach the catheter-tipped syringe to a nasogastric tube and deliver the contents of the syringe through the nasogastric tube into the stomach.
6.: After administering the granules, flush the nasogastric tube with additional water.
7.: Use the mixture immediately after preparation. Do not administer the granules if they have dissolved or disintegrated.

NEXIUM For Delayed-Release Oral Suspension

Administer NEXIUM for delayed-release oral suspension orally or via a nasogastric or gastric tube, as described below.

Oral Administration

1.: Empty the contents of a 2.5 mg or 5 mg NEXIUM packet into a container containing 5 mL of water. For the 10 mg, 20 mg, and 40 mg strengths, the contents of a packet should be emptied into a container containing 15 mL of water. If two packets are needed, mix in a similar way add twice the required amount of water.
2.: Stir the packet contents into the water.
3.: Leave 2 to 3 minutes to thicken.
4.: Stir and drink within 30 minutes.
5.: If any of the contents remain after drinking, add more water, stir, and drink immediately.

Administration via Nasogastric or Gastric Tube

1.: Add 5 mL of water to a catheter-tipped syringe and then add the contents of a 2.5 mg or 5 mg NEXIUM packet. For the 10 mg, 20 mg, and 40 mg packet strengths, add at least 15 mL of water to the catheter-tipped syringe.
2.: Immediately shake the catheter-tipped syringe and leave 2 to 3 minutes to thicken.
3.: Shake the catheter-tipped syringe and inject through the nasogastric or gastric tube, French size 6 or larger, into the stomach within 30 minutes.
4.: Refill the catheter-tipped syringe with an equal amount of water (5 mL or 15 mL).
5.: Shake and flush any remaining contents from the nasogastric or gastric tube into the stomach.