esomeprazole(nexium)

7/31/2019 Esomeprazole(Nexium)

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esomeprazole, Nexium

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

includeomeprazole (Prilosec),lansoprazole(Prevacid),rabeprazole(Aciphex)

andpantoprazole(Protonix). Chemically, esomeprazole is very similar toomeprazole. 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 otherproton-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. Intravenous: 20 and 40 mg; Powder for Oral

Suspension: 10 mg, 20 mg, 40 mg

STORAGE: Store at room temperature, 15-30 C (59-86 F) in a tightly closed container.

PRESCRIBED FOR: Esomeprazole is approved for the treatment of gastroesophageal reflux

disease (GERD) and in combination withamoxicillinandclarithromycin (Biaxin) for the treatment of

patients with ulcers andH. pyloriinfection. It also is used for reducing the risk ofgastric

ulcersassociated with NSAIDs and the treatment ofZollinger-Ellison syndrome. Esomeprazole also

is approved for short term use in children ages 1-11 for GERD.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

includeomeprazole (Prilosec),lansoprazole(Prevacid),rabeprazole(Aciphex)

andpantoprazole(Protonix). Chemically, esomeprazole is very similar toomeprazole. 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 otherproton-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
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PREPARATIONS: Capsules: 20 and 40 mg. Intravenous: 20 and 40 mg; Powder for Oral

Suspension: 10 mg, 20 mg, 40 mg

STORAGE: Store at room temperature, 15-30 C (59-86 F) in a tightly closed container.

PRESCRIBED FOR: Esomeprazole is approved for the treatment of gastroesophageal reflux

disease (GERD) and in combination withamoxicillinandclarithromycin (Biaxin) for the treatment of

patients with ulcers andH. pyloriinfection. It also is used for reducing the risk ofgastric

ulcersassociated with NSAIDs and the treatment ofZollinger-Ellison syndrome. Esomeprazole also

is approved for short term use in children ages 1-11 for GERD.

esomeprazole, Nexium (cont.)

Pharmacy Author:

Omudhome Ogbru, PharmD

Medical and Pharmacy Editor:

Jay W. Marks, MD

Through unknown mechanisms, esomeprazole may increase blood levels ofsaquinavir(Invirase,Fortovase) and reduce blood levels ofnelfinavir(Viracept) andatazanavir(Reyataz), Therefore,

nelfinavir or atazanavir should not be administered with esomeprazole, and physicians should

consider reducing the dose of saquinavir in order to avoid side effects from saquinavir.

Clopidogrel(Plavix) is converted to its active form by enzymes in the liver. Esomeprazole reduces

the activity of these enzymes and potentially can reduce the activity of clopidogrel. Esomeprazole

should not be used with clopidogrel.

Esomeprazole increases the concentration ofcilostazol(Pletal) and its metabolites. The dose of

cilostazol should be reduced from 100 mg twice daily to 50 mg twice daily when given withesomeprazole.

PREGNANCY: Use of esomeprazole inpregnant womenhas not been adequately evaluated.

NURSING MOTHERS: Esomeprazole has not been adequately studied innursing women.

SIDE EFFECTS: Esomeprazole, like other PPIs, is well-tolerated. The most common side effects

arediarrhea,nausea,vomiting,headaches,rashanddizziness. Nervousness, abnormal

heartbeat,muscle pain,weakness, leg cramps, and water retention occur infrequently.

High doses and long-term use (1 year or longer) may increase the risk ofosteoporosis-related

fracturesof the hip, wrist, or spine. Therefore, it is important to use the lowest doses and shortest

duration of treatment necessary for the condition being treated.

USES:Esomeprazoleis used to treat stomach and throat (esophagus) problems caused by too

much stomach acid (e.g., acid reflux or GERD, erosiveesophagitis, Zollinger-Ellison syndrome). It

works by blocking acid production in the stomach. Decreasing extra stomach acid can help relieve

symptoms such as heartburn, difficulty swallowing, persistent cough, and trouble sleeping. It can

also prevent conditions caused by serious acid damage to your digestive system (e.g.,
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ulcers,cancerof the esophagus).Esomeprazole may also be used to prevent ulcers caused by the

long-term use of certain drugs for pain or swelling (nonsteroidal anti-inflammatory drugs-NSAIDs). In

addition, this medication may be used with antibiotics to treat certain types of ulcers caused by

bacterial infection. Esomeprazole belongs to a class of drugs known as proton pump inhibitors

(PPIs).

HOW TO USE: Read the Patient Information Leaflet provided by your pharmacist before you start

using esomeprazole and each time you get a refill. If you have any questions, consult your doctor or

pharmacist.Take this medication by mouth at least 1 hour before a meal, usually once daily or as

directed by your doctor. This medication may also be given through a tube into the stomach

(nasogastric or gastric tube).If you are taking this medication by mouth, empty the contents of the

medication packet into a container with 1 tablespoon (half an ounce or 15 milliliters) of water. Stir the

mixture well and leave it for 2 to 3 minutes to thicken. Stir again and drink all of the mixture within 30

minutes. If any medication remains in the container, add more water, stir, and drink immediately to

make sure you take the entire dose. Do not crush or chew the medication granules. Doing so may

destroy the drug and/or increase side effects.If you are giving this medication through a nasogastric

or gastric tube, consult your health care professional for detailed instructions on how to properly mixand give it.If needed, antacids may be taken along with this medication.The dosage and length of

treatment is based on your medical condition and response to treatment.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 full prescribed time, even if you are feeling better.Tell your

doctor if your condition persists or worsens.

SIDE EFFECTS:Headache,diarrhea, nausea, gas, stomach pain,constipation, ordry mouthmay

occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember

that your doctor has prescribed this medication because he or she has judged that the benefit to you

is greater than the risk of side effects. Many people using this medication do not have serious side

effects.Tell your doctor immediately if any of these unlikely but serious side effects occur: signs of alung infection calledpneumonia(e.g.,fever, cough, trouble breathing).Tell your doctor immediately if

any of these rare but very serious side effects occur: severe stomach/abdominal pain, persistent

nausea, vomiting, unusual tiredness, dark urine, yellowing eyes/skin, signs of vitamin B12 deficiency

in people taking this medication for longer than 3 years (e.g., unusual weakness, sore tongue,

numbness or tingling of the hands/feet).A very serious allergic reaction to this drug is rare. However,

seek immediate medical attention if you notice any symptoms of a serious allergic reaction,

including:rash, itching/swelling (especially of the face/tongue/throat), severedizziness, trouble

breathing.This is not a complete list of possible side effects. If you notice other effects not listed

above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side

effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada - Call your doctor formedical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before taking esomeprazole, tell your doctor or pharmacist if you are allergic to it;

or to similar drugs (e.g.,lansoprazole,omeprazole); or if you have any other allergies.Before using

this medication, tell your doctor or pharmacist your medical history, especially of:liver disease, other

stomach problems (e.g., tumors).Some symptoms may actually be signs of a more serious condition.

Tell your doctor immediately if you have: heartburn combined with

lightheadedness/sweating/dizziness, chest painor shoulder/jaw pain (especially with trouble
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breathing), pain spreading to arms/neck/shoulders, unexplained weight loss.Duringpregnancy, this

medication should be used only when clearly needed. Discuss the risks and benefits with your

doctor.Based on information for similar drugs, this medication may pass into breast milk. Breast-

feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug

interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any

medicine before checking with your doctor or pharmacist first.This drug should not be used with the

following medications because very serious interactions may occur:atazanavir,nelfinavir.If you are

currently using any of these medications listed above, tell your doctor or pharmacist before starting

esomeprazole.Before using this medication, tell your doctor or pharmacist of all prescription and

nonprescription/herbal products you may use, especially of:cilostazol,warfarin, HIV drugs (such

assaquinavir).Some products need stomach acid so that the body can absorb them properly (such

asampicillin, iron supplements, calcium supplements, dasatinib, azole antifungals

includingketoconazole). Esomeprazole decreases stomach acid, so it may change how well these

other products work. Before using esomeprazole, consult your doctor or pharmacist about the other

medications you take and for advice on how to reduce or avoid these types of interactions.Based oninformation for similar drugs, esomeprazole may increase the amount ofdigoxinthat is absorbed into

your blood. If you take digoxin, consult your doctor or pharmacist for details.This document does not

contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist

of all the products you use. Keep a list of all your medications with you, and share the list with your

doctor and pharmacist.

OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room

immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada

residents can call a provincial poison control center. Symptoms of overdose may include: confusion,

extreme sweating, blurred vision, unusually fast heartbeat.

NOTES: Do not share this medication with others.Laboratory and/or medical tests may be performedperiodically to monitor your progress or check for side effects. Consult your doctor for more details.

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 at 77 degrees F (25 degrees C) away from light and

moisture. Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Do not store in the

bathroom. Keep all medicines 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 for more details

about how to safely discard your product.
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esomeprazole(nexium)

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