Esomeprazole
Indications for use
- Short-term treatment of reflux symptoms (such as heartburn, acid regurgitation) in adults
Age
- 18 years +
Dose/Directions
- One tablet daily
- Swallow whole, do not crush or chew. Alternatively, the tablet can be dispersed in half a glass of non-carbonated water. No other liquids should be used as the enteric coating may be dissolved. The water should be stirred until the tablet disintegrates then drunk immediately or within 30 minutes (the pellets should not be chewed or crushed)
Duration
- It might be necessary to take the tablets for 2-3 consecutive days to achieve improvement of symptoms
- Discontinue once complete relief of symptoms has occurred; treatment should not exceed 2 weeks without consulting a doctor
- If no symptom relief is obtained within 2 weeks of continuous treatment, the patient should seek medical advice
Contra-indications/referral criteria
- Hypersensitivity to esomeprazole, substituted benzimidazoles or to any of the excipients
- have unintentional weight loss, anaemia, gastrointestinal bleeding, dysphagia, persistent vomiting or vomiting with blood (since diagnosis of a severe condition may be delayed/masked)
- have had previous gastric ulcer or gastrointestinal surgery
- have jaundice, hepatic impairment, or liver disease (or any other serious disease affecting general well-being)
- are aged over 55 years with new or recently changed symptoms
Examples of drug interactions
- Co-administration with nelfinavir is contra-indicated
- Co-administration of esomeprazole with atazanavir is not recommended
- Medicinal products known to induce CYP2C19 or CYP3A4 or both may affect esomeprazole serum levels
- Methotrexate
- Warfarin and other derivatives: monitoring is recommended when initiating and ending concomitant esomeprazole treatment
- Phenytoin: monitor plasma concentrations when treatment with esomeprazole is introduced or withdrawn
- Gastric acid suppression during treatment with esomeprazole might decrease or increase the absorption of medicinal products with a gastric pH dependent absorption
- Clopidogrel: concomitant use is discouraged; esomeprazole may reduce the antiplatelet effect
- Digoxin: treatment with esomeprazole may lead to increased digoxin levels; monitoring is recommended, particularly at initiation and cessation of esomeprazole
Side-effects
- Among the most common: headache, abdominal pain, diarrhoea and nausea
Other pertinent information
- Not intended to provide immediate relief
- Available as Nexium Control 20 mg gastro-resistant tablets (GSL) and generic esomeprazole 20 mg gastro-resistant tablets (P)
- Reclassified POM→P: 2013; P→GSL: 2015