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ESOMEPRAZOLE MAGNESIUM (esomeprazole magnesium)
- Gastroesophageal reflux disease
- Pathological gastric acid hypersecretory condition
- Prevention of NSAId-induced gastric ulcer
- Duodenal ulcer due to h. pylori
- Erosive esophagitis
- Gastric hypersecretion with systemic mastocytosis
- Heartburn
- Helicobacter pylori gastritis
- Maintenance of healing erosive esophagitis
- Zollinger-ellison syndrome
- Nexium Capsule,delayed Release
- Nexium 24Hr Capsule,delayed Release
- Heartburn Treatment Capsule,delayed Release
- Esomeprazole Magnesium Capsule,delayed Release
- By Indication
20 mg capsule,delayed release
- 1 capsule (20 mg) by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
40 mg capsule,delayed release
- 1 capsule (40 mg) by oral route once daily
Nexium 20 mg capsule,delayed release
- 1 capsule (20 mg) by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
Nexium 40 mg capsule,delayed release
- 1 capsule (40 mg) by oral route once daily
20 mg capsule,delayed release
- 1 capsule (20 mg) by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
20 mg capsule,delayed release
- 1 capsule (20 mg) by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
20 mg capsule,delayed release
- 1 capsule (20 mg) by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
40 mg capsule,delayed release
- 1 capsule (40 mg) by oral route once daily
Duodenal ulcer due to h. pylori
- 2 capsules (40 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal for 10 days swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) by oral route once daily at least 1 hour before a meal for 10 days swallowing whole. Do not crush or chew granules.
- 1 capsule (40 mg) by oral route once daily
- 1 capsule (40 mg) by oral route once daily for 10 days
Erosive esophagitis
- 1 capsule (20 mg) by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 1 capsule (20 mg) by oral route once daily at least 1 hour before a meal for 4 weeks swallowing whole. Do not crush or chew granules.
- 1 capsule (20 mg) by oral route once daily at least 1 hour before a meal for 8 weeks swallowing whole. Do not crush or chew granules.
- 1 capsule (20 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 1 capsule (20 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal for 4 weeks swallowing whole. Do not crush or chew granules.
- 1 capsule (20 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal for 8 weeks swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal for 8 weeks swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal for 4 weeks swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) by oral route once daily at least 1 hour before a meal for 8 weeks swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) by oral route once daily at least 1 hour before a meal for 4 weeks swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 1 capsule (40 mg) by oral route once daily
- 1 capsule (40 mg) by oral route once daily for 4 weeks
- 1 capsule (40 mg) by oral route once daily for 8 weeks
Gastric hypersecretion with systemic mastocytosis
- 2 capsules (40 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route 2 times per day at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) by oral route 2 times per day at least 1 hourbefore a meal swallowing whole. Do not crush or chew granules.
- 1 capsule (40 mg) by oral route 2 times per day
Gastroesophageal reflux disease
- 1 capsule (20 mg) by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 1 capsule (20 mg) by oral route once daily at least 1 hour before a meal for 4 weeks swallowing whole. Do not crush or chew granules.
- 1 capsule (20 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 1 capsule (20 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal for 4 weeks swallowing whole. Do not crush or chew granules.
Heartburn
- 1 capsule (20 mg) by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 1 capsule (20 mg) by oral route once daily at least 1 hour before a meal for 4 weeks swallowing whole. Do not crush or chew granules.
- 1 capsule (20 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 1 capsule (20 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal for 4 weeks swallowing whole. Do not crush or chew granules.
Helicobacter pylori gastritis
- 2 capsules (40 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal for 10 days swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) by oral route once daily at least 1 hour before a meal for 10 days swallowing whole. Do not crush or chew granules.
- 1 capsule (40 mg) by oral route once daily
- 1 capsule (40 mg) by oral route once daily for 10 days
Maintenance of healing erosive esophagitis
- 1 capsule (20 mg) by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 1 capsule (20 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
Pathological gastric acid hypersecretory condition
- 2 capsules (40 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route 2 times per day at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) by oral route 2 times per day at least 1 hourbefore a meal swallowing whole. Do not crush or chew granules.
- 1 capsule (40 mg) by oral route 2 times per day
Prevention of NSAId-induced gastric ulcer
- 1 capsule (20 mg) by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 1 capsule (20 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) by oral route once daily at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 1 capsule (40 mg) by oral route once daily
Zollinger-ellison syndrome
- 2 capsules (40 mg) ;Sprinkle entire contents on small amount applesauce; immediately by oral route 2 times per day at least 1 hour before a meal swallowing whole. Do not crush or chew granules.
- 2 capsules (40 mg) by oral route 2 times per day at least 1 hourbefore a meal swallowing whole. Do not crush or chew granules.
- 1 capsule (40 mg) by oral route 2 times per day
- atazanavir
- Complera
- Edurant
- emtricitab-rilpivirine-tenofov
- nelfinavir
- Reyataz
- rilpivirine
- Viracept
Contraindicated
- Bosulif
- bosutinib
- Cellcept
- Cellcept Intravenous
- citalopram
- clobazam
- clopidogrel
- dasatinib
- erlotinib
- itraconazole
- ketoconazole
- methotrexate sodium
- methotrexate sodium (PF)
- mycophenolate mofetil
- mycophenolate mofetil HCl
- nilotinib
- Noxafil
- Onfi
- Onmel
- Plavix
- posaconazole
- Sporanox
- Sporanox Pulsepak
- Sprycel
- Tarceva
- Tasigna
Severe
Moderate
- Adderall
- Adderall Xr
- Amphetamine Salt Combo
- Astagraf Xl
- Ceftin
- cefuroxime axetil
- Celexa
- Dexedrine Spansule
- dextroamphetamine
- dextroamphetamine-amphetamine
- escitalopram oxalate
- Hecoria
- Isentress
- Lexapro
- Methotrexate (anti-rheumatic)
- Procentra
- Prograf
- raltegravir
- Rheumatrex
- tacrolimus
- Trexall
- Zenzedi
- None
Contraindicated
- Clostridium difficile infection
- Interstitial nephritis
- Severe hepatic disease
- Subacute cutaneous lupus erythematosus
- Systemic lupus erythematosus
Severe
Moderate
- CYp2c19 poor metabolizer
- Fracture
- Hypomagnesemia
- Osteoporosis
- Vitamin b12 deficiency
ESOMEPRAZOLE MAGNESIUM (esomeprazole magnesium)
- Gastroesophageal reflux disease
- Pathological gastric acid hypersecretory condition
- Prevention of NSAId-induced gastric ulcer
- Duodenal ulcer due to h. pylori
- Erosive esophagitis
- Gastric hypersecretion with systemic mastocytosis
- Heartburn
- Helicobacter pylori gastritis
- Maintenance of healing erosive esophagitis
- Zollinger-ellison syndrome
- None
- Acute abdominal pain
- Constipation
- Diarrhea
- Dizziness
- Flatulence
- Headache disorder
- Injection site sequelae
- Nausea
- Pruritus of skin
- Vertigo
More Frequent
Severe
Less Severe
- Sinusitis
- Dyspepsia
- Dyspnea
- Insomnia
- Pharyngitis
- Symptoms of anxiety
- Urinary tract infection
- Vomiting
- Xerostomia
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Abnormal hepatic function tests
- Aggressive behavior
- Agitation
- Agranulocytosis
- Anaphylaxis
- Anemia
- Angioedema
- Arthralgias
- Atrial fibrillation
- Benign fundic gland polyposis of stomach
- Biliary calculus
- Blurred vision
- Bronchospastic pulmonary disease
- Clostridium difficile infection
- Depression
- Erythema multiforme
- Fracture
- Gastritis
- Gastroenteritis
- Gastrointestinal candidiasis
- Goiter
- Hallucinations
- Hepatic failure
- Hepatitis
- Herpes simplex infection
- Hypertension
- Increased alanine transaminase
- Increased aspartate transaminase
- Interstitial nephritis
- Jaundice
- Muscle weakness
- Myalgias
- Neutropenic disorder
- Pancreatitis
- Pancytopenia
- Skin inflammation
- Skin photosensitivity
- Stevens-johnson syndrome
- Stomatitis
- Subacute cutaneous lupus erythematosus
- Systemic lupus erythematosus
- Thrombocytopenic disorder
- Toxic epidermal necrolysis
- Urticaria
Less Severe
- Abdominal distension
- Alopecia
- Anorexia
- Back pain
- Bradycardia
- Chest pain
- Chills
- Colitis
- Dehydration
- Drowsy
- Dysgeusia
- Dysphagia
- Edema
- Facial edema
- Fatigue
- Fever
- Flu-like symptoms
- Flushing
- General weakness
- Gynecomastia
- Hyperhidrosis
- Hypomagnesemia
- Increased appetite
- Increased defecation frequency
- Increased urinary frequency
- Malaise
- Pain
- Palpitations
- Peripheral edema
- Tachycardia
- Tenesmus
- Upper respiratory infection
- Vitamin b12 deficiency
- Weight gain
- Weight loss
Contraindicated
None
Severe Precaution
Esomeprazole
Safety and efficacy not established.
- 1 Day – 29 Days
- Safety and efficacy not established.
Management or Monitoring Precaution
Esomeprazole
Increased incidence of tachypnea, regurgitation and increased ALT in patients age < 1 year.
- 30 Days – 364 Days
- Increased incidence of tachypnea, regurgitation and increased ALT in patients age < 1 year.
Esomeprazole
- Severity Level:
2
- Additional Notes: Insufficient human data avail; animal data do not sug dev tox
Contraindicated
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Precaution Exists
Esomeprazole
Insufficient human data avail; similar drug omeprazole excreted at low levels
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Unknown | Not known; no or inclusive data | Insufficient human data avail; similar drug omeprazole excreted at low levels |
No Known Risk
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Contraindicated
None
Precaution Exists
Esomeprazole
General-Prolonged use may dec absorption of Vitamin B-12. Avoid for >8 weeks duration unless for high risk patients (eg. oral corticosteroids or chronic NSAID use), erosive esophagitis, Barrett's esophagitis, pathologic hypersecretory condition, or demonstrated need for maint treatment. Musculoskeletal-Inc risk of fracture with high dose or use >1 year. Gastrointestinal-Long term use may be associated with C. difficile or GI malignancy. Pulmonary-Long term use may be assoc w/pneumonia.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | N | N | N | N | Y | N |
BEERS: Y HEDIS: N STOPP: Y
No Known Risk
None
- None
| Duodenal ulcer due to h. pylori | |
| B96.81 | Helicobacter pylori [h. pylori] as the cause of diseases classified elsewhere |
| Erosive esophagitis | |
| K22.1 | Ulcer of esophagus |
| K22.10 | Ulcer of esophagus without bleeding |
| K22.11 | Ulcer of esophagus with bleeding |
| Gastric hypersecretion with systemic mastocytosis | |
| C96.21 | Aggressive systemic mastocytosis |
| D47.02 | Systemic mastocytosis |
| K31.89 | Other diseases of stomach and duodenum |
| Gastroesophageal reflux disease | |
| K21 | Gastro-esophageal reflux disease |
| K21.0 | Gastro-esophageal reflux disease with esophagitis |
| K21.9 | Gastro-esophageal reflux disease without esophagitis |
| Heartburn | |
| R12 | Heartburn |
| Helicobacter pylori gastritis | |
| B96.81 | Helicobacter pylori [h. pylori] as the cause of diseases classified elsewhere |
| Maintenance of healing erosive esophagitis | |
| K22.1 | Ulcer of esophagus |
| K22.10 | Ulcer of esophagus without bleeding |
| K22.11 | Ulcer of esophagus with bleeding |
| Pathological gastric acid hypersecretory condition | |
| K31.89 | Other diseases of stomach and duodenum |
| Prevention of NSAId-induced gastric ulcer | |
| Z79.1 | Long term (current) use of non-steroidal anti-inflammatories (NSAId) |
| Zollinger-ellison syndrome | |
| E16.4 | Increased secretion of gastrin |
| 0-9 | A-Z |
|---|---|
| B96.81 | Helicobacter pylori [h. pylori] as the cause of diseases classified elsewhere |
| B96.81 | Helicobacter pylori [h. pylori] as the cause of diseases classified elsewhere |
| C96.21 | Aggressive systemic mastocytosis |
| D47.02 | Systemic mastocytosis |
| E16.4 | Increased secretion of gastrin |
| K21 | Gastro-esophageal reflux disease |
| K21.0 | Gastro-esophageal reflux disease with esophagitis |
| K21.9 | Gastro-esophageal reflux disease without esophagitis |
| K22.1 | Ulcer of esophagus |
| K22.1 | Ulcer of esophagus |
| K22.10 | Ulcer of esophagus without bleeding |
| K22.10 | Ulcer of esophagus without bleeding |
| K22.11 | Ulcer of esophagus with bleeding |
| K22.11 | Ulcer of esophagus with bleeding |
| K31.89 | Other diseases of stomach and duodenum |
| K31.89 | Other diseases of stomach and duodenum |
| R12 | Heartburn |
| Z79.1 | Long term (current) use of non-steroidal anti-inflammatories (NSAId) |
Formulary Reference Tool