- 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.
Quick GuideHeartburn: Causes, Symptoms, Remedies, Treatments
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.
Reference: FDA Prescribing Information
Quick GuideHeartburn: Causes, Symptoms, Remedies, Treatments
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
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...
Heartburn (Acid Reflux)
Heartburn is a burning sensation experienced from acid reflux (GERD). Symptoms of heartburn include chest pain, burning in...
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...
H. pylori (Helicobacter Pylori ) Infection
Helicobacter pylori (H. pylori) is a bacteria that causes chronic inflammation (gastritis) of the inner lining of the stomach,...
GERD (Acid Reflux, Heartburn)
GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid contents of the stomach backs up into the...
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in...
Indigestion (Dyspepsia, Upset Stomach)
Indigestion (dyspepsia) can be caused by diseases or conditions that involve the gastrointestinal (GI) tract, and also by some...
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...
Eosinophilic esophagitis is an inflammation of the esophagus. Eosinophilic esophagitis has many causes including acid reflux,...
Barrett's esophagus occurs as a complication of chronic gastroesophageal reflux disease (GERD), primarily in white males. GERD...
Acid backing up into the larynx (voice box) causes reflux laryngitis. Irritation of the lining of the esophagus, larynx, and...
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...
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...
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
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Generic Drugs, Are They as Good as Brand-Names?
- Drugs: Buying Prescription Drugs Online Safely
- Medication Disposal - What to Do with Old or Unusable Medication
- Dangers of Mixing Medications
- Drugs: The Most Common Medication Errors
Medications & Supplements
- Proton Pump Inhibitors (PPIs) Drug Class
- pantoprazole, Protonix
- lansoprazole (Heartburn Relief 24 Hour, Heartburn Treatment 24 Hour, Prevacid 24)
- omeprazole, omeprazole/sodium bicarbonate, Prilosec, Zegerid, Prilosec OTC, Zegerid OTC
- Drug Interactions
- Prilosec (omeprazole) vs. Nexium (esomeprazole)
- rabeprazole, Aciphex
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
Daily Health News
Subscribe to MedicineNet's General Health Newsletter
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.
Top esomeprazole Related ArticlesComplete List
Barrett's EsophagusBarrett'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. Learn the symptoms, causes, and treatments for Barrett's esophagus.
Indigestion (dyspepsia) can be caused by diseases or conditions that involve the gastrointestinal (GI) tract, and also by some diseases and conditions that do not involve the GI tract. Indigestion can be a chronic condition in which the symptoms fluctuate infrequency and intensity. Signs and symptoms that accompany indigestion include:
- Upper abdominal pain
- Abdominal bloating and distention
- Feeling full after eating only a small portion of food
Home remedies, medication, and lifestyle changes can help relieve and cure indigestion and its associated symptoms.
Eosinophilic EsophagitisEosinophilic 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.
Esophagus PictureThe esophagus is a muscular tube connecting the throat (pharynx) with the stomach. See a picture of the Esophagus and learn more about the health topic.
Gastritis (acute and chronic) is an inflammation of the lining of the stomach Some people have no gastritis symptoms, but when they do occur they may include bloating, belching, loss of appetite, nausea, and vomiting. H. pylori infection and nonsteroidal anti-inflammatory drugs (NSAIDs) are the two main causes of gastritis. Alcohol, caffeine, and high-fat foods also can cause gastritis.
Fried, fatty, and spicy foods, and alcohol aggravate gastritis symptoms. Other stomach lining irritants that aggravate symptoms include cigarette smoking, acidic juices, caffeine, tomato products, peppers, and chili powder.
Foods that sooth gastritis symptoms, and that help reduce and stop H. pylori infection growth in the stomach include apples, onions, garlic, teas, green leafy vegetables, coconut water, and wheat bran.
Gastritis is diagnosed with endoscopy, blood tests, or stool tests. Some people get relief from gastritis symptoms with prescription and non-prescription antacids, histamine blockers like famotidine (Pepcid AC) or ranitidine (Zantac 75), or proton pump inhibitors (PPIs) like omeprazole (Prilosec) and esomeprazole (Nexium). These drugs will not cure gastritis.
Complications of gastritis include gastric cancers, MALT lymphoma, renal problems, and death
Gastroesophageal Reflux Disease (GERD)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:
- regurgitation, and
Take the GERD QuizWho 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 it.
Heartburn (Reflux)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.
- dietary habits,
- lifestyle habits, and
- medical causes.
- lifestyle changes,
- OTC medication,
- prescription medication, and
Helicobacter PyloriHelicobacter pylori (H. pylori) is a bacteria that causes chronic inflammation (gastritis) of the inner lining of the stomach, and also is the most common cause of ulcers worldwide. About 50% of people in the world carries or is infected with H. pylori. Common symptoms of H. pylori infection are occasional abdominal discomfort, bloating, belching or burping, and nausea and vomiting. H. pylori infection is difficult to erdicate, and treatment is with two or more antibiotics.
How to Stop Coughing
Coughing is a reflex that helps a person clear their airways of irritants. There are many causes of an excessive or severe cough including:
- Irritants like
- cigarette and secondhand smoke
- air fresheners
- Medications like beta blockers and ACE inhibitors
- Medical conditions like
- the common cold
- lung cancer
- heart disease
Natural and home remedies that help cure and soothe a cough are:
Natural and home remedies to help cure and soothe a cough are:
- Stay hydrated
- Gargle saltwater
- Use cough drops or lozenges
- Use herbs and supplements like ginger, mint, licorice, and slippery elm
- Don't smoke
Over-the-counter products (OTC)to cure and soothe a cough include
- cough suppressants and expectorants, and
- anti-reflux drugs.
Prescription drugs that help cure a cough include
- narcotic medications,
- inhaled steroids, and
- anti-reflux drugs like proton pump inhibitors or PPIs, for example,
- omeprazole (Prilosec),
- rabeprazole (Aciphex), and
- pantoprazole (Protonix).
- Irritants like
Peptic or stomach ulcers are ulcers are an ulcer in the lining of the stomach, duodenum, or esophagus. Ulcer formation is related to H. pylori bacteria in the stomach, use of anti-inflammatory medications, and cigarette smoking. Symptoms of peptic or stomach ulcers include:
- Abdominal burning or hunger pain
- Abdominal discomfort after meals
Treatment for stomach ulcers depends upon the cause.
SclerodermaScleroderma 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.