Monograph Details
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Gastrointestinal Tract
> Hyperacidity, GERD, and ulcers
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NEXIUM |
| Manufacturer |
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AstraZeneca Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Acid pump inhibitor. |
| Generic Name |
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Esomeprazole (as magnesium trihydrate) 20mg, 40mg; caps containing e-c delayed-release pellets. |
| Also |
• NEXIUM for ORAL SUSPENSION
• NEXIUM IV
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| Indications |
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Triple therapy (w. amoxicillin + clarithromycin) for H. pylori eradication in duodenal ulcer disease. Short-term treatment and maintenance of healing of erosive esophagitis (EE), symptomatic GERD. To reduce risk of NSAID-associated gastric ulcer. Long-term treatment of pathological hypersecretory conditions (eg, Zollinger-Ellison syndrome). |
| Children |
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<1yr: not recommended. GERD: 1–11yrs: <20kg: 10mg; ≥20kg: 10 or 20mg; 12–17yrs: 20 or 40mg. For all: give once daily for up to 8 weeks. |
| Adults |
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Take 1 hour before food. Caps: swallow whole or may open caps and sprinkle pellets on 1 tablespoon applesauce and take immediately. May open caps and mix granules in 50mL of water and give via NG tube; flush tube with more water. Susp: mix contents of packet in 15mL of water, leave 2–3 minutes, then drink within 30 minutes. May give via NG or gastric tube (see literature). Triple therapy: esomeprazole 40mg once daily + amoxicillin 1g twice daily + clarithromycin 500mg twice daily; all for 10 days. EE: 20 or 40mg once daily for 4–8 weeks, may continue 4–8 more weeks. Maintenance of healing of EE: 20mg once daily. Symptomatic GERD: 20mg once daily for 4 weeks, may continue 4 more weeks. NSAID-associated ulcer risk reduction: 20mg or 40mg once daily for up to 6 months. Hypersecretory conditions: initially 40mg twice daily, adjust if needed; doses up to 240mg daily have been used. Severe hepatic impairment: max 20mg/day. |
| Precautions |
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Pregnancy (Cat.B). Nursing mothers: not recommended. |
| Interactions |
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May alter absorption of gastric pH-dependent drugs (eg, ketoconazole, iron salts, digoxin). May affect drugs metabolized by CYP2C19. May antagonize atazanavir. Monitor warfarin. May give antacids concomitantly. |
| Adverse Reactions |
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Headache, diarrhea, abdominal pain, nausea, flatulence, constipation, dry mouth, inj site reactions; rare: rash, allergic reactions. |
| Extra Text |
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Note: See Biaxin for more information on clarithromycin. See Trimox or Amoxil for more information on amoxicillin. |
| How Supplied |
Caps—30, 90, 1000
Susp—30 packets/box
IV soln (single-use vial)—10 |
| Additional Resources |
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• Related Prescribing Note |
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