Esomeprazole Magnesium

A to Z Drug Facts

 Action Suppresses gastric acid secretion by blocking proton pump within gastric parietal cells.

 Indications Treatment of heartburn and other symptoms of gastroesophageal reflux disease (GERD); short-term treatment in healing and symptomatic resolution of erosive esophagitis; maintain symptom resolution and healing of erosive esophagitis; in combination with amoxicillin and clarithromycin for treatment of organism Helicobacter pylori infection and duodenal ulcer disease to eradicate H. pylori.

 Contraindications Standard considerations.

 Route/Dosage

Healing of Erosive Esophagitis

ADULTS: PO 20 or 40 mg once daily for 4 to 8 wk.

Maintenance of Healing of Erosive Esophagitis

ADULTS: PO 20 mg once daily.

Symptomatic GERD

ADULTS: PO 20 mg once daily for 4 wk.

H. pylori Eradication to Reduce Risk of Duodenal Ulcer Recurrence

ADULTS: PO 40 mg once daily for 10 days in combination with amoxicillin 1000 mg bid and clarithromycin 500 mg bid for 10 days.

 Interactions

Drugs dependent on gastric pH for bioavailability (ketoconazole, iron salts, digoxin): Absorption of these drugs may be affected.

 Lab Test Interferences None well documented.

 Adverse Reactions

CNS: Headache. EENT: Dry mouth. GI: Diarrhea; nausea; flatulence; abdominal pain; constipation.

 Precautions

Pregnancy: Category B. Lactation: Undetermined. Children: Safety and efficacy not determined.

 Administration/Storage

• Do not crush or chew; swallow capsule whole. If patient has difficulty swallowing capsule whole, open the capsule and gently mix the pellets with 1 tablespoon of cool or cold applesauce in a small bowl. Swallow mixture immediately without chewing. Do not crush or chew the pellets. Discard remaining pellet/applesauce mixture.
• Administer once daily ³ 1 hr before meals.
• Store at controlled room temperature. Keep container tightly closed.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies. Note history of liver disease.
• Assess for bloody or coffee ground emesis and black tarry stools.
• Assess for symptoms of esophageal reflux (eg, heart burn, acid regurgitation) or peptic ulcer activity (eg, indigestion, abdominal pain, nausea).
• Assess for headache and dry mouth.
• Monitor elimination patterns, and document any problems such as constipation or diarrhea.

 Patient/Family Education

• Explain name, dose, action, and potential side effects of drug.
• Instruct patient to not crush or chew medication and to swallow the capsule whole.
• Advise patient that if experiencing difficulty swallowing the capsule, to open the capsule and gently mix the pellets with 1 tablespoon of cool or cold applesause and then immediately swallow the mixture without chewing. Remind patient that pellets should not be crushed or chewed and that the pellet/applesauce mixture should not be stored for future use.
• Instruct patient to take each dose ³ 1 hr before meals.
• Inform patient that antacids may be taken concurrently with esomeprazole.
• Remind patient that esomeprazole should be taken daily and not “as needed” or only when symptoms are present.
• Instruct patient to notify physician if pregnant, planning on becoming pregnant, or breastfeeding.
• Advise patient to report any of the following symptoms to the physician: bloody or coffee ground emesis, black tarry stools, recurrent heart burn, recurrent indigestion or abdominal pain, increasing need for antacid use.

Books@Ovid
Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts