Monograph Details

Gastrointestinal Tract > Hyperacidity, GERD, and ulcers
NEXIUM for ORAL SUSPENSION
Manufacturer
AstraZeneca Pharmaceuticals
Legal Classification
Rx
Pharmacological Class
Acid pump inhibitor.
Generic Name
Esomeprazole (as magnesium trihydrate) 20mg, 40mg; per packet; e-c delayed release granules.
Also
NEXIUM
NEXIUM IV
Indications
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
<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
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
Pregnancy (Cat.B). Nursing mothers: not recommended.
Interactions
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
Headache, diarrhea, abdominal pain, nausea, flatulence, constipation, dry mouth, inj site reactions; rare: rash, allergic reactions.
Extra Text
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
Related Prescribing Note