Nexium (Esomeprazole) magnesium (a substituted benzimidazole), reduces gastric acid secretion through a highly targeted mechanism of action. It is a specific inhibitor of the gastric enzyme H+, K+-ATPase (the proton pump) which is responsible for acid secretion by the parietal cells of the stomach.
Mechanism of action:
Esomeprazole is a proton pump inhibitor that suppresses gastric acid secretion by specific inhibition of H+/K+-ATPase in the gastric parietal cell. By acting specifically on the proton pump, esomeprazole blocks the final step in acid production, thus reducing gastric acidity. This effect is dose-related up to a daily dose of 20 to 40 mg and leads to inhibition of gastric acid secretion.
Esomeprazole magnesium trihydrate tablets are indicated for treatment of circumstances where a reduction of gastric acid secretion is essential such as: reflux esophagitis, maintenance treatment of patients with reflux esophagitis, symptomatic gastroesophageal reflux disease (i.e. heartburn and regurgitation), and H. pylori eradication.
* dizziness, confusion;
* fast or uneven heart rate;
* jerking muscle movements;
* jittery feeling;
* muscle cramps, muscle weakness or limp feeling;
* cough or choking feeling; or
* Seizure (convulsions).
* It is contraindicated in patients with known hypersensitivity to any component of the formulation or to substituted benzimidazoles
* Symptomatic response to therapy does not rule out the presence of gastric malignancy
* Atrophic gastritis has occasionally been noted with long-term therapy with omeprazole
* PPI therapy may be associated with increased risk of Clostridium difficile-associated diarrhea
* Avoid concomitant use of this product with clopidogrel, due to a reduction in plasma concentrations of the active metabolite of clopidogrel. When using this drug consider alternative anti-platelet therapy
* Long-term and multiple daily dose proton pump inhibitor (PPI) therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist, or spine
* Hypomagnesemia has been reported rarely with prolonged treatment with PPI therapy and may require discontinuing PPI therapy
* Concomitant use of this product and St. John’s wort or rifampin can substantially decrease NEXIUM concentrations. Avoid concomitant use
Esomeprazole may increase the risk for bone fractures, especially with longer use, higher doses, and in older adults. To prevent bone loss/fracture, by taking such as calcium (such as calcium citrate) and vitamin D supplements.
During pregnancy, this medication should be used only when clearly needed.
* For GERD, 20 or 40 mg of esomeprazole is given once daily for 4-8 weeks. In children ages 1-11, the dose is 10 or 20 mg daily.
* For the treatment of H. pylori, 40 mg is administered once daily in combination with amoxicillin and clarithromycin for 10 days.