Esomeprazole

Overview

What is Esomeprazole? 

Esomeprazole, marketed primarily under the brand name Nexium, is a proton pump inhibitor (PPI) used to reduce stomach acid production. 

Esomeprazole is the S-isomer of omeprazole, made through a process that isolates this specific molecule. It works by binding to the hydrogen-potassium ATPase pump in the stomach lining, inhibiting the final step of acid production. 

Global Name

Generic Names: Esomeprazole 

Global Brand Names:  Nexium, Esomep, Nexpro  

Usage

What is Esomeprazole used for? 

Esomeprazole is primarily used to treat: 

• Gastroesophageal reflux disease (GERD) 
• Zollinger-Ellison syndrome 
• Erosive esophagitis 
• Helicobacter pylori (H. Pylori) eradication (in combination with antibiotics) 
• Prevention of gastric ulcers caused by NSAIDs and high oxidative stress states such as major surgery, sepsis and burns 
• Treatment of non-H. Pylori, non-NSAID induced gastroduodenitis/ulcers 

How do you use Esomeprazole? 

Availability:

Esomeprazole is available in the form of capsules, tablets, and powder for oral suspension.

Dosage information: 

• For GERD: 20-40 mg once daily for 4-8 weeks 
• For erosive esophagitis: 20-40 mg once daily for 4-8 weeks 
• For Zollinger-Ellison Syndrome: The starting dose is 40 mg twice a day 
• For H. pylori eradication: 20-40 mg in combination with antibiotics for 10-14 days 

Suitability: 

• Children: Suitable for children above 1 year for GERD. 
• Adults: Suitable following the correct dosage for the specific condition. 
• Elderlies: Generally safe, but dose adjustment may be necessary.

• Allergies: People who are allergic to esomeprazole, other PPIs, or any components of the medication should not take it.  

Is there anyone who can’t take Esomeprazole? 

• Children: Not recommended for infants under 1 year old. 
• Adults: Those with severe liver problems or known hypersensitivity to the drug should avoid it. 
• Elderlies: Can take the drug with adjusted dosages if necessary. 
• Pregnancy and Lactation: To be used only if clearly needed and under the guidance of a healthcare provider. 

Any warnings and precautions : 

Long-term use of esomeprazole may be associated with an increased risk of bone fractures, kidney issues, vitamin B12 and iron deficiency (leading to anemia), and Clostridium difficile infection. 

Interactions: 
Esomeprazole can interact with drugs like warfarin, clopidogrel, and certain antifungals. It should not be used in individuals with a known hypersensitivity to esomeprazole, other PPIs, or substituted benzimidazoles. 

Side Effects

Common side effects include headache, nausea, abdominal pain, constipation, and dry mouth. Serious side effects may include severe allergic reactions, hypomagnesemia, and Clostridium difficile-associated diarrhea. 

Pharmacist Tips

• Timing is Key: Always take Esomeprazole at least one hour before a meal, as food can affect the absorption and effectiveness of the drug. 
• Correct Dosage: Do not alter the dosage without consulting your healthcare provider, even if you feel better, to prevent relapse or resistance. 
• Swallow Whole: Esomeprazole capsules or tablets should be swallowed whole with water. Do not crush, split, or chew them, as this may impact the drug's effectiveness. 
• Missed Dose Protocol: If you miss a dose of Esomeprazole, take it as soon as you remember. However, if it's almost time for your next scheduled dose, skip the missed dose—do not double up to make up for it. 
• Consistency: For the best results, take Esomeprazole at the same time each day to maintain consistent levels of medication in your body. 

• Avoiding Interactions: Certain foods like grapefruit and supplements such as St. John’s Wort can affect how Esomeprazole works. Discuss with your pharmacist about potential dietary restrictions or interactions. 
• Over-the-Counter Medications: Be cautious when using over-the-counter medications, particularly antacids, as they may interact with Esomeprazole. Seek advice from your pharmacist on how to coordinate these treatments. 
• Awareness of Side Effects: Familiarize yourself with the potential side effects of Esomeprazole, and report any unusual or severe symptoms to your healthcare provider immediately. 
• Long-Term Use: If you are on long-term Esomeprazole therapy, your healthcare provider may recommend monitoring for magnesium levels, bone health, and B12 levels. 

Availability

Where is Esomeprazole available in Hong Kong?

Esomeprazole is a prescription medication that can be prescribed by healthcare providers then bought in pharmacies.   

FAQs

Is Esomeprazole the same as Nexium?

Yes, Nexium is a brand name for the generic drug esomeprazole.  

Can I take Esomeprazole long-term?

Long-term usage of esomeprazole should be discussed with a healthcare provider due to potential risks.

Is Esomeprazole available for purchase over the counter?

How long does Esomeprazole take to work?