PREPARATIONS: Capsules: 20 and 40 mgTHINGS TO BE AWARE OF
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.
PEDIATRIC DOSING
Currently not FDA approved in the treatment of children and infants.
Though when other PPI’s fail, a trial of Nexium is generally put in place,
starting on a dose of 20mg.
STORAGE
Store at room temperature, 15-30°C (59-86°F) in a tightly closed
container.
OTHER USES
Esomeprazole is approved for the treatment of gastro esophageal 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.
DRUG INTERACTIONS
The absorption of certain drugs may be affected by stomach acidity. It
has been found that PPI’s reduce stomach acid also reduce the absorption
and concentration in blood of ketoconazole (Nizoral) so it has a reduced
effectiveness and increase the absorption. It has also been found to and
concentration in blood of digoxin (Lanoxin) hence an increased toxicity.
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.
SIDE EFFECTS
Esomeprazole, like other PPI’s, 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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