Esomeprazole Magnesium (Perprazole, S-Omeprazole)(ess oh me’ pray zol)
NexiumDNC, Nexium IV
PREGNANCY CATEGORY B
Drug Classes
Antisecretory drug
Proton pump inhibitor
Therapeutic Actions
Gastric acid-pump inhibitor: Suppresses gastric acid secretion by specific inhibition of the hydrogen–potassium ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid production; is broken down less in the first pass through the liver than the parent compound omeprazole, allowing for increased serum levels.
Indications
GERD—treatment of heartburn and other related symptoms
Erosive esophagitis—short-term (4–8 wk) treatment for healing and symptom relief; also used for maintenance therapy following healing of erosive esophagitis
Short-term treatment of GERD with a history of erosive esophagitis by IV route for up to 10 days, when oral therapy is not possible for patients 1 mo and older
As part of combination therapy for the treatment of duodenal ulcer associated with Helicobacter pylori
Reduction in occurrence of gastric ulcers associated with continuous NSAID use in patients at risk (60 yr and older, history of gastric ulcers) for developing gastric ulcers
Treatment of pathologic hypersecretory conditions, including Zollinger-Ellison syndrome
Unlabeled uses: Non-GERD dyspepsia, Barrett esophagus, stress ulcer prophylaxis, prevention of GI bleeding in patients receiving antiplatelet drugs
Contraindications and Cautions
Contraindicated with hypersensitivity to omeprazole, esomeprazole, or other proton pump inhibitor.
Use cautiously with hepatic impairment, hypomagnesemia, pregnancy, lactation.
Available Forms
DR capsulesDNC—20, 40 mg; DR powder for suspension—2.5, 5, 10, 20, 40 mg; injection—20, 40 mg/vial
Dosages
Adults
Healing of erosive esophagitis: 20–40 mg PO daily for 4–8 wk. An additional 4–8 wk course of therapy can be considered for patients who have not healed.
Maintenance of healing of erosive esophagitis: 20 mg PO daily.
Symptomatic GERD: 20 mg daily for 4 wk. An additional 4-wk course of therapy can be considered if symptoms have not resolved.
Short-term treatment of GERD when oral therapy is not possible: 20–40 mg IV by injection over at least 3 min or IV infusion over 10–30 min.
Duodenal ulcer: 40 mg/day PO for 10 days with 1,000 mg PO bid amoxicillin and 500 mg PO bid clarithromycin.
Reduction of risk of gastric ulcers with NSAID use: 20–40 mg PO daily for 6 mo.
Pediatric patients (12–17 yr)
Short-term treatment of GERD: 20–40 mg/day PO for up to 8 wk.
Pediatric patients (1–11 yr)
Treatment of GERD: 10 mg/day PO for up to 8 wk.
Healing of erosive esophagitis: Weight less than 20 kg: 10 mg/day PO for up to 8 wk.
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