ESOMEPRAZOLE

COMMON BRAND NAME(S): Nexium

GENERIC NAME(S): ESOMEPRAZOLE MAGNESIUM

Description: Esomeprazole is a PPI that weakens the acidity of the stomach by inhibiting H⁺/K⁺ ATPase in the gastric parietal cell.
Onset: W/in 1 hr.
Pharmacokinetics:
Absorption: Rapidly absorbed (oral). Absorption is delayed and reduced w/ food. Bioavailability: Approx 90% on repeated doses. Time to peak plasma concentration: 1-2 hr.
Distribution: Volume of distribution: 16 L. Plasma protein binding: Approx 97%.
Metabolism: Extensive hepatic metabolism, via CYP2C19 isoenzyme to form hydroxy and, desmethyl metabolites, and the remainder via CYP3A4 isoenzyme to form esomeprazole sulfone.
Excretion: Mainly via urine (approx 80%), the remainder in the faeces. Plasma elimination half-life: Approx 1.3 hr.

Uses

Esomeprazole, a proton pump inhibitor (PPI), treats certain stomach and esophagus problems (such as acid reflux, ulcers). This medication helps heal acid damage to the stomach and esophagus, helps prevent ulcers, and may help prevent cancer of the esophagus by decreasing the acid production of the stomach.

How to use esomeprazole magnesium

Read the Medication Guide and the Patient Information Leaflet if available from your pharmacist before you start taking esomeprazole and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, usually once daily, at least 1 hour before a meal. If you are self-treating, follow all directions on the product package. The dosage and length of treatment are based on your medical condition and response to treatment. Do not increase your dose or take this drug more often than directed. If you have any questions, ask your doctor or pharmacist.

Do not crush or chew this medication. Swallow the capsules whole. If you have difficulty swallowing this medication whole, you may open the capsule and sprinkle the contents into a tablespoon of unheated applesauce. Swallow the applesauce mixture right away without chewing it. Do not prepare the mixture ahead of time for later use. Doing so may destroy the drug.

If needed, antacids may be taken along with this medication. If you are also taking sucralfate, take esomeprazole at least 30 minutes before sucralfate.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. Continue to take this medication for the prescribed length of treatment even if you are feeling better. If you are self-treating with the over-the-counter product, do not take it for more than 14 days unless directed by your doctor.

Tell your doctor if your condition persists or worsens. If you are self-treating, tell your doctor if your heartburn persists after 14 days or if you need to use this medication more than once every 4 months. If you think you may have a serious medical problem, get medical help right away.

Warnings

Not available.

Side Effects

Tell your doctor or pharmacist promptly if any headache or abdominal pain.

Tell your doctor right away if you have symptoms of a low magnesium blood level (such as unusually fast/slow/irregular heartbeat, persistent muscle spasms, seizures).

This medication may rarely cause a severe intestinal condition (Clostridium difficile-associated diarrhea) due to a type of bacteria.

Rarely, proton pump inhibitors (such as esomeprazole) have caused vitamin B-12 deficiency.

A very serious allergic reaction to this drug is rare.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions

Precautions

Allergic reaction to this medication.
Patients with medical history of liver disease.
In addition, before you self-treat with this medication, get medical help right away if you have any of these signs of a serious condition:
- trouble/pain swallowing food
- bloody vomit
- vomit that looks like coffee grounds
- bloody/black stools
- heartburn for over 3 months
- frequent chest pain
- frequent wheezing (especially with heartburn)
- nausea/vomiting
- stomach pain

Increased risk for bone fractures, especially with longer use, higher doses, and in older adults.
Children may be more sensitive to fever, cough, and infections of the nose/throat/airways.
Tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before having surgery.
Used only when clearly needed during pregnancy.
Consult your doctor before breast-feeding.

Consult your doctor regarding the precautions mentioned above.

Interactions

Some products that may interact with this drug include:

Cilostazol
Clopidogrel
rifampin
methotrexate (especially high-dose treatment)
St John’s wort

Esomeprazole may change how well these products work. Some affected products include:

Atazanavir
Erlotinib
Nelfinavir
Pazopanib
Rilpivirine
Certain azole antifungals (itraconazole, ketoconazole, posaconazole)

Do not use any medications containing omeprazole while using esomeprazole.

This medication may interfere with certain laboratory tests, possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Overdose & Brands

Overdose

If overdose is suspected, contact a poison control center or emergency room immediately. Symptoms of overdose may include: confusion, extreme sweating, blurred vision, or unusually fast heartbeat.

Notes

If your doctor has prescribed this medication for you, do not share it with others.

If your doctor instructs you to use this medication regularly for a long time, laboratory and medical tests (such as a magnesium blood test, vitamin B-12 levels) may be performed periodically to monitor your progress or check for side effects. Keep all regular medical and laboratory appointments.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature away from moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Brands

Available Brands

Esomep [ InnoGen Pharmaceuticals ]
Esoprazole-20 [ Stallion Labs ]
iZol [ ACME ]
Nexium/Nexium IV [ AstraZeneca ]
Nexonav [ XL Lab ]
Nexonav-40 [ Stallion Labs ]
Peprazom [ Natrapharm ]
S-Gastriloc [ Farma Iberica ]
Xsom [ Xeno ]

Also marketed as

Emep [ Aristopharma ]
Esoflux [ Swiss Parenterals ]
Mesop [ XL Lab ]