Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Esomeprazole is in a class of drugs called proton pump inhibitors (PPIs) which block the production of acid by the stomach. Other drugs in the same class include omeprazole
(Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex) and pantoprazole (Protonix). Chemically, esomeprazole is very similar to omeprazole. Proton pump inhibitors are used for the treatment of conditions such as stomach and duodenal ulcers, gastroesophageal reflux disease (GERD) and the Zollinger-Ellison syndrome which all are caused by stomach acid.
Esomeprazole, like other proton-pump inhibitors, blocks the enzyme in the wall of the stomach that produces acid. By blocking the enzyme, the production of acid is decreased, and this allows the stomach and esophagus to heal. Esomeprazole was approved by the FDA in February 2001.
GENERIC: No
PRESCRIPTION: Yes
PREPARATIONS: Capsules: 20
and 40 mg. Intravenous: 20 and 40 mg; Powder for Oral Suspension: 10 mg, 20 mg, 40 mg
STORAGE: Store at room temperature, 15-30 C (59-86 F) in a tightly closed container.
PRESCRIBED FOR: Esomeprazole is approved for the treatment of gastroesophageal reflux disease (GERD) and in combination with
amoxicillin and clarithromycin (Biaxin)
for the treatment of patients with ulcers and H. pylori infection. It also is used for reducing the risk of
gastric ulcers associated with NSAIDs and the treatment of
Zollinger-Ellison syndrome. Esomeprazole also is approved for short term use in children ages 1-11 for GERD.
DOSING:
For GERD, 20 or 40
mg of esomeprazole is given once daily for 4-8 weeks. In children ages 1-11, the dose is 10 or 20 mg daily.
For the treatment of H. pylori, 40 mg is administered once daily in combination with amoxicillin and clarithromycin for 10 days.
Zollinger-Ellison syndrome is treated with 40 mg twice daily.
Esomeprazole capsules should be administered one hour before meals, swallowed whole and should not be crushed or chewed. Patients with difficulty swallowing can open the capsule and mix the pellets with applesauce. The applesauce should not be hot and the pellets should not be chewed or crushed.
DRUG INTERACTIONS: Esomeprazole potentially can increase the concentration in blood of diazepam
(Valium, Diastat) by decreasing the elimination of diazepam in the liver. Esomeprazole may have fewer drug interactions than omeprazole.
The absorption of certain drugs may be affected by stomach acidity. Therefore,
esomeprazole and other PPIs that reduce stomach acid also reduce the absorption and
concentration in blood of ketoconazole (Nizoral) and increase the absorption and
concentration in blood of digoxin (Lanoxin). This
may lead to reduced effectiveness of ketoconazole or increased digoxin toxicity,
respectively.
Through unknown mechanisms, esomeprazole may increase blood levels of
saquinavir (Invirase, Fortovase) and reduce blood levels of nelfinavir
(Viracept) and atazanavir
(Reyataz),
Therefore, nelfinavir or atazanavir should not be administered with
esomeprazole, and physicians should consider reducing the dose of saquinavir in order to avoid side effects from saquinavir.
GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid
contents of the stomach backs up into the esophagus. The symptoms of uncomplicated GERD are heartburn,
regurgitation, and nausea. Effective treatment is available for most patients with GERD.
A peptic ulcer is an ulcer in the lining of the stomach, duodenum, or esophagus. Ulcer formation is related to Helicobacter pylori bacteria in the stomach, use of anti-inflammatory medications, and cigarette smoking.
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body, leading to thickness and firmness of involved areas. Scleroderma is also referred to as systemic sclerosis, and the cause is unknown. Treatment of scleroderma is directed toward the individual features that are most troubling to the patient.
Eosinophilic esophagitis is an inflammation of the esophagus. Eosinophilic esophagitis has many causes including acid reflux, heartburn, viruses, medications that become stuck in the esophagus, allergy, asthma, hay fever, allergic rhinitis, and atopic dermatitis. Eosinophilic esophagitis symptoms include difficulty swallowing food, abdominal pain, chest pain, and heartburn.
Gastritis is an inflammation of the stomach lining. Causes of gastritis include drinking too much alcohol, medications such as NSAIDs, ibuprofen, aspirin, H. pylori infection, severe infections, burns, anemia, and autoimmune disorders. Gastritis is diagnosed with endoscopy, blood tests, or stool tests. Treatment depends upon the cause of gastritis.
Barrett's esophagus occurs as a complication of chronic gastroesophageal reflux disease (GERD), primarily in white males. GERD refers to the reflux of acidic fluid from the stomach into the esophagus (the swallowing tube), and is classically associated with heartburn.
Heartburn is a burning sensation experienced from acid reflux (GERD). Symptoms of heartburn include chest pain, burning in the throat, difficulty swallowing, the feeling of food sticking in the throat, and a burning feeling in the chest. Causes of heartburn include dietary habits, lifestyle habits, and medical causes. Treatments for heartburn include lifestyle changes, OTC medication, prescription medication, and surgery.
Acid backing up into the larynx (voice box), it causes reflux laryngitis. Irritation of the lining of the esophagus, larynx, and throat can lead to esophagitis, sinusitis, strictures, hoarseness, throat clearing, swallowing problems, asthma, chronic cough, and more. Typical symptoms of reflux laryngitis include heartburn, hoarseness, or a sensation of a foreign body in the throat. Reflux laryngitis can be treated with OTC medication, prescription medication, and lifestyle changes.
Scleroderma is an autoimmune disease of the connective tissue featuring skin thickening, spontaneous scarring, blood vessel disease, varying degrees of inflammation, associated with an overactive immune system. Autoimmune diseases are illnesses which occur when the body's tissues are attacked by its own immune system. Scleroderma is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body. This leads to thickness and firmness of involved areas. Scleroderma, when it's diffuse or widespread over the body, is also referred to as systemic sclerosis.
The cause of scleroderma is not known. Researchers have found some evidence that certain genes are important factors, but the environment seems to also play a role. The result is activation of the immune system in a susceptible individual, causing injury to tissues that result in injury similar to scar-tissue formation. The fact that genes seem to cause a predi...
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