| 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
STORAGE: Store at room temperature, 15-30癈
(59-86癋) 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. Since it is very similar to omeprazole,
it also is likely that it will be used for the treatment
of Zollinger-Ellison syndrome.
DOSING: For GERD, 20 or 40 mg of esomeprazole
is given once daily for 4-8 weeks.
For the treatment of H. pylori, 40 mg is
administered once daily in combination with amoxicillin
and clarithromycin for 10 days.
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) 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.
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
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