Indications |
Oral Erosive oesophagitis Adult: 40 mg once daily for 4 wk, extended for another 4 wk if necessary. Maintenance: 20 mg once daily. Child: <20 kg: 10 mg once daily for 8 wk; ≥20 kg: 10-20 mg once daily for 8 wk. Hepatic impairment: Severe impairment (Child-Pugh class C): Not more than 20 mg daily. Oral Peptic ulcer Adult: 20 mg bid for 7 days or 40 mg once daily for 10 days given as a triple therapy with amoxicillin and clarithromycin. Hepatic impairment: Severe impairment (Child-Pugh class C): Not more than 20 mg daily. Oral NSAID-associated ulceration Adult: 20 mg once daily for 4-8 wk. Hepatic impairment: Severe impairment (Child-Pugh class C): Not more than 20 mg daily. Oral Zollinger-Ellison syndrome Adult: Initially, 40 mg twice daily. Usual range: 80-160 mg daily. Doses >80 mg should be given in 2 divided doses. Hepatic impairment: Severe impairment (Child-Pugh class C): Not more than 20 mg daily. Oral Gastro-oesophageal reflux disease Adult: For patients without erosive oesophagitis: 20 mg once daily for 4 wk. Additional 4 wk may be considered in patients whose symptoms have not fully resolved after the 1st course. Child: 10 mg once daily for up to 8 wk. Hepatic impairment: Severe impairment (Child-Pugh class C): Not more than 20 mg daily. Intravenous Gastro-oesophageal reflux disease Adult: For short term treatment only. 20 or 40 mg once daily for ≤10 days. Convert to oral therapy as soon as possible. May be administered by inj over at least 3 minutes, intermittent infusion (10-30 minutes) or continuous infusion (over up to 72 hr). Hepatic impairment: Severe impairment (Child-Pugh class C): Not more than 20 mg daily. Special Populations: Max dose for patients with severe hepatic impairment is 20 mg. Reconstitution: Each single-use vial contains 20 or 40 mg of esomeprazole. For IV inj: Reconstitute each vial with 5 ml of normal saline. For IV infusion: Reconstitute each vial with 5 ml of normal saline, lactated Ringer's inj or dextrose 5% inj, then further dilute the resultant solution to a final volume of 50 ml. |
Contraindications |
Hypersensitivity. |
Warnings / Precautions |
Paediatric; pregnancy, lactation. Malignancy and hepatic impairment. Increased risk of developing certain infections such as community-acquired pneumonia. |
Adverse Reactions |
Headache, diarrhoea, abdominal pain, nausea, flatulence, dry mouth, constipation, hyponatraemia, photosensitivity, angioedema, anaphylaxis. |
Drug Interactions |
May interfere with the elimination of drugs metabolised by CYP2C19. Changes in gastric pH can affect the bioavailability of ketoconazole and Fe salts. Clarithromycin and amoxicillin may increase plasma level. May cause changes to prothrombin time when used with warfarin. Avoid concurrent use with clopidogrel. See Below for More esomeprazole Drug Interactions |
Lab Interactions |
Increased creatinine, uric acid, bilirubin, alkaline phosphatase, ALT, AST. Altered thyroid function tests. |
Food Interactions |
Absorption delayed with food. |
Mechanism of Actions |
Esomeprazole is a PPI that suppresses gastric acid secretion by specific inhibition of the H+/K+ ATPase in the gastric parietal cell. Absorption: Rapid (oral). Peak plasma levels after 1-2 hrs; food delays and decreases absorption. Distribution: Protein-binding: 97% Metabolism: Extensively hepatic; converted to hydroxy and desmethyl metabolites. Excretion: Urine (as metabolites); 1.3 hrs (elimination half-life). |
Administration |
Delayed-release cap: Should be taken on an empty stomach. (Take on an empty stomach 1 hr before meals.) Tab: May be taken with or without food. |
Storage Conditions |
Intravenous: Pwd for inj: Store at 25°C (77°F). Protect from light. Reconstituted solution for inj should be stored at room temperature up to 30°C and administered within 12 hr after preparation. Reconstituted solution for infusion should be stored at room temperature up to 30°C and administered within 12 hr (if normal saline or lactated Ringer's inj is used as the diluent) or 6 hr (if dextrose 5% inj is used as the diluent). Oral: Store at 25°C. |
ATC Classification |
A02BC05 - esomeprazole ; Belongs to the class of proton pump inhibitors. Used in the treatment of peptic ulcer and gastro-oesophageal reflux disease (GERD). |
Storage |
Intravenous: Pwd for inj: Store at 25°C (77°F). Protect from light. Reconstituted solution for inj should be stored at room temperature up to 30°C and administered within 12 hr after preparation. Reconstituted solution for infusion should be stored at room temperature up to 30°C and administered within 12 hr (if normal saline or lactated Ringer's inj is used as the diluent) or 6 hr (if dextrose 5% inj is used as the diluent). Oral: Store at 25°C. |
Available As |
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Esomeprazole
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Esomeprazole Containing Brands
Esomeprazole is used in following diseases
Drug - Drug Interactions of Esomeprazole
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