- What is esomeprazole, and how does it work (mechanism of action)?
- What brand names are available for esomeprazole?
- Do I need a prescription for esomeprazole?
- What are the side effects of esomeprazole?
- What is the dosage for esomeprazole?
- Which drugs or supplements interact with esomeprazole?
- Is esomeprazole safe to take if I'm pregnant or breastfeeding?
- What else should I know about esomeprazole?
What is esomeprazole, and how does it work (mechanism of action)?
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.
What are the side effects of esomeprazole?
Esomeprazole, like other PPIs, is well-tolerated. The most common side effects are
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.
What is the dosage for esomeprazole?
- 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.
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.
Which drugs or supplements interact with esomeprazole?
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.
Esomeprazole increases the concentration of cilostazol (Pletal) and its metabolites. The dose of cilostazol should be reduced from 100 mg twice daily to 50 mg twice daily when given with esomeprazole.
Is esomeprazole safe to take if I'm pregnant or breastfeeding?
Use of esomeprazole in pregnant women has not been adequately evaluated.
Esomeprazole has not been adequately studied in nursing women.
What else should I know about esomeprazole?
What preparations of esomeprazole are available?
Capsules: 20 and 40 mg. Intravenous: 20 and 40 mg; Powder for Oral Suspension: 10 mg, 20 mg, 40 mg
How should I keep esomeprazole stored?
Store at room temperature, 15-30 C (59-86 F) in a tightly closed container.
Quick GuideHeartburn: Foods to Eat, Foods to Avoid
Esomeprazole (Nexium, Nexium 24HR, Nexium IV) is a proton pump inhibitor prescribed for the treatment of gastroesophageal reflux disease (GERD), Zollinger-Ellison syndrome, and for the treatment of H. pylori in combination with antibiotics. Side effects, dosing, warnings and precautions, and pregnancy safety should be reviewed prior to taking any medication.
Multimedia: Slideshows, Images & Quizzes
GERD Quiz: Test Your Digestive Diseases IQ
Who is at risk for developing GERD? Are you? Take this quiz to learn what GERD is, if you're at risk, and what you can do about...
Picture of Gastroesophageal Reflux (GERD)
The stomach contents regurgitate and back up (reflux) into the esophagus The food in the stomach is partially digested by...
Picture of Esophagus
The esophagus is a muscular tube connecting the throat (pharynx) with the stomach. See a picture of the Esophagus and learn more...
Related Disease Conditions
GERD (Acid Reflux, Heartburn)
GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid contents of the stomach backs up into the...
H. pylori (Helicobacter Pylori ) Infection Symptoms, Test, Treatment
Helicobacter pylori (H. pylori) is a bacteria that causes chronic inflammation (gastritis) of the inner lining of the stomach,...
Peptic Ulcer (Stomach Ulcer)
Peptic or stomach ulcers are ulcers are an ulcer in the lining of the stomach, duodenum, or esophagus. Ulcer formation is related...
Reflux Laryngitis (Diet, Home Remedies, Medicine)
Reflux laryngitis is caused by acid refluxing back up through the esophagus and voice box. Reflux laryngitis causes irritation...
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in...
Barrett's esophagus occurs as a complication of chronic gastroesophageal reflux disease (GERD), primarily in white males. GERD...
Indigestion (Dyspepsia, Upset Stomach Pain) Symptoms, Relief Remedies, Medicine
Indigestion (dyspepsia) can be caused by diseases or conditions that involve the gastrointestinal (GI) tract, and also by some...
GERD and GER (Acid Reflux) in Infants and Children
GERD (gastroesophageal reflux disease) is the upward movement of stomach content, including acid, into the esophagus and...
Eosinophilic esophagitis is an inflammation of the esophagus. Eosinophilic esophagitis has many causes including acid reflux,...
Gastritis (Symptoms, Pain, Home Remedies, and Cure)
Gastritis (acute and chronic) is an inflammation of the lining of the stomach Some people have no gastritis symptoms, but when...
Heartburn (Acid Reflux) Symptoms, Relief Medicine, Cures
Heartburn is a burning sensation experienced from acid reflux (GERD). Symptoms of heartburn include chest pain, burning in the...
Is H. pylori Contagious? Symptoms and Tests
H. pylori (Helicobacter pylori) infection: Is it contagious? H. pylori infection is caused by fecal contamination in either food...
19 Tips on How to Stop a Cough
Coughing is a reflex that helps a person clear their airways of irritants. There are many causes of an excessive or severe...
Heartburn vs. Acid Reflux (Differences and Similarities)
Heartburn and acid reflux are not the same thing. Heartburn is actually a symptom of acid reflux. Heartburn gets its name...
Treatment & Diagnosis
- GERD Gastroesophageal Reflux Disease FAQs
- Medication Disposal
- Dangers of Mixing Medications
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Drugs: Buying Prescription Drugs Online Safely
- Drugs: The Most Common Medication Errors
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
Prevention & Wellness
- Popular Heartburn Drugs May Boost Death Risk: Study
- Could Common Heartburn Drugs Up Stroke Risk?
- Clues to How Popular Heartburn Drug Might Harm Arteries
- 1 in 4 Hospitalized Newborns Gets Heartburn Drugs, Despite Risks
- FAQ: Heartburn Meds and Health Risks
- The 10 Most-Prescribed and Top-Selling Medications
- Generic Form of Nexium Approved
- Could Popular Heartburn Drugs Upset Your 'Good' Gut Bugs?
- Chronic Heartburn May Raise Odds for Throat Cancer: Study
- Heartburn Meds May Often Be Taken for Too Long, at Too-High Doses
- Anti-Reflux Drugs, Antibiotics May Raise C. diff Risk
- Some Acid Reflux Drugs Linked to C. diff
- Study: Stomach Acid Drugs Linked to Fracture Risk
- Infections, Fractures Linked to Acid Reflux Drugs
Health Solutions From Our Sponsors
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.