Adult:

GERD without Erosive Esophagitis

·        20 mg once daily for 4 weeks.

Consider an additional 4 weeks of treatment if symptoms do not resolve completely in the first 4 weeks

GERD with Erosive Esophagitis (Healing of Erosive Esophagitis)

Esomeprazole is indicated for the short-term treatment in the healing and symptomatic resolution of diagnostically confirmed erosive esophagitis.

·        20-40 mg once daily for 4-8 weeks

Symptomatic Gastroesophageal Reflux Disease

Esomeprazole is indicated for short-term treatment of heartburn and other symptoms associated with GERD in adults.  

·        20 mg once daily for 4-8 weeks

NSAID-Induced Gastric Ulcer

·        20 mg once daily for 4-8 weeks

H. pylori Eradication to Reduce the Risk of Duodenal Ulcer Recurrence

Triple Therapy (Esomeprazole plus amoxicillin and clarithromycin):

·        Esomeprazole 40 once daily, in combination with amoxicillin 1gm 12 hourly and clarithromycin 500mg 12 hourly for 10 days, is indicated for the treatment of patients with H. pylori infection and duodenal ulcer disease to eradicate H. pylori.

Eradication of H. pylori has been shown to reduce the risk of duodenal ulcer recurrence.

Maintenance of Healing of Erosive Esophagitis

Esomeprazole is indicated to maintain symptom resolution and healing of erosive esophagitis.

·        Maintenance: 20 mg once daily for up to 6 months.

Risk Reduction of NSAID-Associated Gastric Ulcer

Esomeprazole is indicated for the reduction in the occurrence of gastric ulcers associated with continuous NSAID therapy in patients at risk for developing gastric ulcers.

·        20-40 mg once daily for up to 6 months

Pathological Hypersecretory Conditions Including Zollinger-Ellison Syndrome

Esomeprazole magnesium is used for long-term treatment of Zollinger-Ellison syndrome.

·        40 mg divided 12 hourly (initial); adjust regimen to efficacy; up to 240 mg once daily

GERD without Erosive Esophagitis

Oral

• <1 year: Safety and efficacy not established
• 1-12 years: 10-20 mg once daily for up to 8 weeks
• >12 years: 20-40 mg once daily for up to 8 weeks

GERD with Erosive Esophagitis (Healing)

<1 month: Safety and efficacy not established

1 month to 1 year

• 3.5 kg: 2.5 mg once daily for up to 6 weeks
• >3.5-7.5 kg: 5 mg once daily for up to 6 weeks
• >7.5 kg: 10 mg once daily for up to 6 weeks

1-12 years

• <20 kg: 10 mg once daily for 8 weeks
• ≥20 kg: 10-20 mg once daily for 8 weeks

>12 years

• 20-40 mg PO once daily for 4-8 weeks
• Maintenance: 20 mg once daily up to 6 months

Oral Administration

Esomeprazole delayed-release capsules should be taken once daily and at least one hour before meals.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/022101s014021957s017021153s050lbl.pdf

https://www.medicines.org.uk/emc/product/2968/smpc#gref

https://reference.medscape.com/drug/nexium-nexium-24hr-esomeprazole-341998

https://go.drugbank.com/drugs/DB00736

https://www.rxlist.com/consumer_esomeprazole_nexium/drugs-condition.htm

Note: For informational purposes only. Consult your textbook for advising your patients.