ESOMEPRAZOLE  (Generic Name)

Also called Nexium)

(Chemical formula: (C₁₇H₁₈NaO₃S)Mg)

About

Esomeprazole (Nexium) is used to treat duodenal and benign gastric ulcer (whether associated with Helicobacter pylori or not), gastro-oesophageal reflux disease (GERD), NSAID-associated duodenal or gastric ulcer, gastroduodenal erosions and Zollinger-Ellison syndrome.

Esomeprazole is also called Nexium.

Esomeprazole is a proton-pump inhibitor which inhibits the secretion of gastric juices and works in a similar way to Rabeprazole (Aciphex, Pariet).

It has been found also be effective in conjunction with antibiotics in the treatment of ulcers caused by the bacterium Helicobacter pylori.

Dosages

For healing of GERD – 20-40mg to be taken once daily for 4-8 weeks.  The maintenance dose is 20mg daily which should be increased to 40mg if symptoms return.

For oesophagitis – 20mg or 40mg for 4-8 weeks.  It may be continued at 20mg daily for maintenance.

For NSAID associated duodenal or gastric ulcer and gastroduodenal erosions,  In order to prevent recurrence in individuals continuing to take NSAIDs take 20mg once daily.

For individuals with gastric ulcer and Helicobacter pylori infection – Esomeprazole (40mg daily) is usually combined with antibiotic treatment using two different antibiotics, namely Amoxicillin (1000mg to be taken twice daily for 10 days) and Clarithromycin (500mg to be taken twice daily for 10 days).  If you are following this treatment it is very important to take the antibiotics for a full 10 days.  .

Patients with Zollinger-Ellison syndrome may require much larger doses of Esomeprazole (up to 240mg) and it is advisable to consult a doctor regarding the best dose for you.

Esomeprazole should be taken before eating.  They should be taken whole, rather than crushed or chewed.  Alternatively, empty the contents of the capsule into a small amount of apple sauce, mix together, and swallow without chewing the granules.

Do not use the combined Esomeprazole//Clarimomycin/Amoxicillin treatment if you are allergic to penicillin or other macrolide antibiotic.  (also see separate description for Amoxicillin and Clarithromycin for side effects and precautions for these drugs.  Clarithromycin should not be taken by pregnant women.

Esomeprazole is not recommended for children (without the supervision of a doctor), or nursing mothers.

Store this medication at 15-30⁰ in a dry place away from children.

Side Effects

Esomeprazole (Nexium) is well tolerated in the vast majority of individuals, both in the short and long term.

The most common side effects are:  diarrhoea, flatulence, rash, headache and abdominal pain.

Less common side effects are dry mouth, insomnia, blurred vision, rash,  and drowsiness

Rare or very rare side effects are liver dysfunction, peripheral oedema, allergic reactions, photosensitivity, fever, sweating, depression, myalgia, arthralgia, skin eruptions, interstitial nephritis and blood disorders.

If taken with antibiotics, the latter may cause a severe allergic reaction in some individuals (anaphylactic shock).  The symptoms of this are difficulty in breathing, increased heart rate, swelling of the tongue and face, panic.  If you experience these symptoms seeks medical help immediatel

Precautions

Esomeprazole should not be used in individuals who are breast feeding without first consulting a doctor although no adverse reactions have been reported.

Do not use if you are suffering from acute hepatic failure.

Esomeprazole can be taken by children, but dosage regime should be recommended by the child’s own doctor.

Esomeprazole may reduce the efficacy of ketoconazole, iron salts and digoxin.

Combined use with atazanavir is not recommended

Do not use Clarimomycin if you are taking pimozide.

If taken with antibiotics, the latter may cause a severe allergic reaction in some individuals (anaphylactic shock).  The symptoms of this are difficulty in breathing, increased heart rate, swelling of the tongue and face, panic.  If you experience these symptoms seeks medical help immediately.

Clarimomycin should not be taken if you are pregnant.

How does it work

Esomeprazole is a proton-pump inhibitor which blocks the hydrogen-potassium adenosine triphosphatase enzyme system which acts as a proton pump for gastric parietal cells. It thus inhibits the secretion of gastric juices. 

More information

Esomeprazole is metabolised in the liver, and is excreted via the urine and faeces..

 Esomeprazole (Swe)

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