Uses
Nexium (Esomeprazole) is a proton pump inhibitor which works by absorbing into the blood stream and eventually acting on the K+/H+ ATPase pump which secretes stomach acid from the stomach’s parietal cells. It is effective in the treatment of heartburn, ulcers, and other secretory conditions.
How to Use
Take this medication by mouth with water.
Take this medication on an empty stomach one hour before meals.
Do not break or crush.
The capsules may be opened and sprinkled on top of food or into applesauce. Do not crush or break the pellets within the capsule that are sprinkled on.
Take it exactly as directed, do not take it more than directed.
If you miss a dose, take it as soon as you can. If it is already almost time for your next dose, take only that next dose. Do not double up on any dose.
Important Information
It may a few days before this medication begins to work for relieving heartburn.
Notify your doctor if your symptoms do not improve.
Be sure that your prescribing doctor is aware if you have any of the the following conditions before taking this medication
Tarry or bloody stools, have had heartburn for more than 3 months, if you experience dizziness, lightheadedness, or sweating, liver disease, vomiting, stomach pain, trouble or pain when swallowing, weight loss, vomiting with blood, wheezing, history of allergic reactions, pregnancy, breastfeeding, trying to become pregnant.
Side effects that should be immediately reported to your healthcare provider
Allergic reactions(hives, rashes, itching, swelling of the face or mouth), trouble breathing, yellowish skin or eyes, stomach upset, excessive fatigue, unexplained or excessive bleeding or bruising, tremors, muscle spasms, fever, sore throat, lightheadedness or fainting, heart beat changes(increased heart rate), chest pain, bone or joint pain.
Other Side Effects
Headache, nausea, gas, vomiting, dry mouth, constipation. diarrhea.
Adult Dose
Heartburn(Gastroesophageal Reflux Disease)
20 mg by mouth once daily for 4 weeks. The therapy is sometimes extended for another 4 weeks if the issue has not been fully resolved. If you have been taking this medication for more than 8 weeks consult with your doctor.
Erosive Gastroesophageal Reflux Disease
20-40 mg by mouth once daily for between 4-8 weeks. The therapy may be extended according to patient response.
Zollinger Ellison Syndrome
40 mg by mouth twice daily. The doses may be adjusted based on patient specific factors.
H. Pylori Infection/Duodenal Ulcer Disease
Triple Therapy: 40 mg by mouth once daily taken with amoxicillin 1000 mg twice daily AND clarithormycin 500 mg by mouth twice daily for 10 days.
Triple Therapy: 40 mg by mouth once daily taken with metronidazole 500 mg by mouth twice daily AND clarithormycin 500 mg by mouth twice daily for between 10-14 days.
Quadruple Therapy: 40 mg by mouth once daily taken with metronidazole 250 mg by mouth four times per day AND bismuth subsalicylate 525 mg by mouth 4 times per day, AND 500 mg of tetracycline Hydrochloride 4 times per day for between 10-14 days.
Sources
1. Nexium (esomeprazole) capsules, granules [package insert]. Wilmington, DE: AstraZeneca; 2016.
2. Chey WD, Wong BCY. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol 2007;102:1808-25.
3. Calvet X, Garcia N, Lopez T, et al. A meta-analysis of short versus long therapy with a proton pump inhibitor, clarithromycin and either metronidazole or amoxycillin for treating Helicobacter pylori infection. Aliment Pharmacol Ther 2000;14:603-9.
4. Chey WD, Wong BC, & Practice Parameters Committee of the American College of Gastroenterology: American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol 2007; 102(8):1808-1825.
