esomeprazole (Nexium, Nexium 24HR, Nexium IV)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    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.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    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.

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SIDE EFFECTS: Esomeprazole, like other PPIs, is well-tolerated. The most common side effects are

Nervousness, abnormal heartbeat, muscle pain, weakness, leg cramps, and water retention occur infrequently.

Proton pump inhibitors may increase the risk of Clostridium difficile infection. High doses and long-term use (1 year or longer) may increase the risk of osteoporosis-related fractures of the hip, wrist, or spine. Prolonged use also reduces absorption of vitamin B12 (cyanocobalamin).

Long-term use of PPIs has also been associated with low levels of magnesium (hypomagnesemia). Analysis of patients taking PPIs for long periods of time showed an increased risk of heart attacks.

Therefore, it is important to use the lowest doses and shortest duration of treatment necessary for the condition being treated.

GENERIC: Yes

PRESCRIPTION:

  • Yes - Nexium, Nexium IV
  • No - Nexium 24 hour

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.

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.
  • Frequent heartburn is treated with 20 mg daily for 14 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.
Medically Reviewed by a Doctor on 6/30/2015

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