GENERIC NAME: esomeprazole

BRAND NAME: Nexium

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.

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. Since it is very similar to omeprazole, it also is likely that it will be used for 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.

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) 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.

PREGNANCY: Use of esomeprazole in pregnant women has not been adequately evaluated.

NURSING MOTHERS: Esomeprazole has not been adequately studied in nursing women.

SIDE EFFECTS: Esomeprazole, like other PPIs, is well-tolerated. The most common side effects are diarrhea, nausea, vomiting, headaches, rash and dizziness. Nervousness, abnormal heartbeat, muscle pain, weakness, leg cramps and water retention occur infrequently.

From the Doctors at MedicineNet.com

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