AHFS Class:

56:28.36 Proton-pump Inhibitors

Esomeprazole sodium is available as a lyophilized powder or cake in single-dose vials containing the equivalent of esomeprazole 20 or 40 mg as the sodium salt with edetate disodium 1.5 mg and sodium hydroxide to adjust pH.³⁹⁸⁸; ³⁹⁸⁹ For direct intravenous injection, reconstitute either size vial with 5 mL of sodium chloride 0.9%.³⁹⁸⁸; ³⁹⁸⁹

For intravenous infusion, reconstitute the 20- or 40-mg vial with 5 mL of sodium chloride 0.9%; Ringer’s injection, lactated; or dextrose 5%, and then dilute the reconstituted solution to 50 mL with additional infusion solution to yield a solution containing esomeprazole 0.4 or 0.8 mg/mL, respectively.²⁰⁵³; ³⁹⁸⁸; ³⁹⁸⁹

To prepare an 80-mg dose for intravenous infusion as a loading dose or continuous infusion for certain indications, reconstitute two 40-mg vials each with 5 mL of sodium chloride 0.9% and then dilute the contents of both vials in 100 mL of sodium chloride 0.9%.³⁹⁸⁸

Equivalency

Esomeprazole sodium 21.3 or 42.5 mg is equivalent to 20 or 40 mg of esomeprazole.³⁹⁸⁸; ³⁹⁸⁹

pH

Reconstituted solutions have a pH ranging from 9 to 11.³⁹⁸⁸; ³⁹⁸⁹

Trade Name(s)

NexIUM I.V.

Esomeprazole sodium may be administered by direct intravenous injection over at least 3 minutes, by intravenous infusion over 10 to 30 minutes, or by continuous intravenous infusion.³⁹⁸⁸ The line should be flushed with sodium chloride 0.9%; Ringer’s injection, lactated; or dextrose 5% both before and after intravenous administration.³⁹⁸⁸ The manufacturers state that esomeprazole sodium should not be administered concomitantly with any other drugs through the same intravenous site and/or tubing.³⁹⁸⁸; ³⁹⁸⁹

Esomeprazole sodium is a white to off-white powder.³⁹⁸⁸ Intact vials should be stored at controlled room temperature in the original carton and protected from light.³⁹⁸⁸

Solutions diluted in sodium chloride 0.9% or Ringer's injection, lactated should be stored at room temperature and administered within 12 hours of preparation.³⁹⁸⁸ Solutions diluted in dextrose 5% should be stored at room temperature and administered within 6 hours of preparation.³⁹⁸⁸ Any unused portions should be discarded.³⁹⁸⁸

pH Effects

The stability of esomeprazole sodium in solution is strongly dependent on pH.³⁹⁸⁸ The stability of the drug decreases with decreasing pH.³⁹⁸⁸

Solution Compatibility

Y-Site Injection Compatibility (1:1 Mixture)

For a list of references cited in the text of this monograph, search the monograph titled References.

ASHP^® Injectable Drug Information^TM. Selected Revisions March 31, 2024. © Copyright, 2024. American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.