Medications and Drugs
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; 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.
- The dose for preventing NSAID-induced ulcers is 20 to 40 mg daily for 6 months.
- 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.
Clopidogrel (Plavix) is converted to its active form by enzymes in the liver. Esomeprazole reduces the activity of these enzymes and potentially can reduce the activity of clopidogrel. Esomeprazole should not be used with clopidogrel.
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.
Reference: FDA Prescribing Information
Last Editorial Review: 1/7/2010
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
- Gastroesophageal Reflux Disease (GERD, Heartburn) - Learn about gastroesophageal reflux disease (GERD, acid reflux, heartburn) symptoms like heartburn, chest pain, regurgitation, and nausea. Causes, diagnosis, treatment and prevention information is also included.
- omeprazole, omeprazole/sodium bicarbonate, Prilosec, Zegerid - Describes the medication omeprazole (Prilosec, Zegerid ) a drug used for treating acid-induced inflammation and ulcers of the stomach and duodenum, gastroesophageal reflux disease (GERD) and Zollinger-Ellison Syndrome. Article includes descriptions, uses, drug interactions, and side effects.
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