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Indications

BEERS REMS

OTC:

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

Derm: ACUTE GENERALIZED EXANTHEMATOUS PUSTULOSIS, cutaneous lupus erythematosus, DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS), STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS.

F and E: hypocalcemia (especially if treatment duration ≥3 mo), hypokalemia (especially if treatment duration ≥3 mo), hypomagnesemia (especially if treatment duration ≥3 mo).

GI: abdominal pain, CLOSTRIDIOIDES DIFFICILE-ASSOCIATED DIARRHEA (CDAD), constipation, diarrhea, dry mouth, flatulence, fundic gland polyps, nausea.

GU: acute tubulointerstitial nephritis.

Hemat: vitamin B12 deficiency.

MS: bone fracture.

Neuro: headache.

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS, ANGIOEDEMA, OR TUBULOINTERSTITIAL NEPHRITIS), systemic lupus erythematosus.

Interactions

Drug-Drug:

Drug-Natural Products:

Availability

(Generic available)

Route/Dosage

Gastroesophageal Reflux Disease

Hepatic Impairment

  • PO, IV (Adults): Severe hepatic impairment: Dose should not exceed 20 mg/day.

Reduction of Risk of Rebleeding of Gastric or Duodenal Ulcers After Therapeutic Endoscopy

Hepatic Impairment

  • IV (Adults): Mild to moderate hepatic impairment: Do not exceed continuous infusion rate of 6 mg/hr; Severe hepatic impairment: Do not exceed continuous infusion rate of 4 mg/hr.

H. pylori Eradication to Reduce the Risk of Duodenal Ulcer Recurrence (Triple Therapy)

Hepatic Impairment

  • PO (Adults): Severe hepatic impairment: Dose should not exceed 20 mg/day.

Reduction in Risk of Gastric Ulcer During Continuous NSAID Therapy

Hepatic Impairment

  • PO (Adults): Severe hepatic impairment: Dose should not exceed 20 mg/day.

Pathological Hypersecretory Conditions Including Zollinger-Ellison Syndrome

Hepatic Impairment

  • PO (Adults): Severe hepatic impairment: Dose should not exceed 20 mg/day.

US Brand Names

NexIUM, NexIUM 24hr

Action

Therapeutic Effects:

Classifications

Therapeutic Classification: antiulcer agents

Pharmacologic Classification: proton pump inhibitors

Pharmacokinetics

Absorption: 90% absorbed following oral administration; food ↓ absorption.

Distribution: Unknown.

Protein Binding: 97%.

Metabolism/Excretion: Primarily metabolized by the liver via the CYP2C19 isoenzyme, with some metabolism by the CYP3A4 isoenzyme; (the CYP2C19 enzyme system exhibits genetic polymorphism; 15–20% of Asian patients and 3–5% of Caucasian and Black patients may be poor metabolizers and may have significantly ↑ esomeprazole concentrations and an ↑ risk of adverse effects); <1% excreted unchanged in urine.

Half-life: Children 1–11 yr: 0.42–0.88 hr; Adults: 1.0–1.5 hr.

Time/Action Profile

(plasma concentrations*)

ROUTEONSETPEAKDURATION
POrapid1.6 hr24 hr
IVrapidend of infusion24 hr

*Resolution of symptoms takes 5–8 days.

Patient/Family Teaching

Pronunciation

es-oh-MEP-ra-zole audio

Pill Image

esomperazole_195_8767.jpg

Code

NDC Code*