Esomeprazole

Brand Names: Nexium

Drug Class: Proton Pump Inhibitor (PPI)

Overview

Esomeprazole is a proton pump inhibitor (PPI) that suppresses gastric acid secretion by inhibiting the H+/K+ ATPase enzyme system in gastric parietal cells. It is indicated for the treatment of frequent heartburn occurring two or more days per week, with full effect typically achieved within 1-4 days of daily use. This medication is not intended for immediate relief of heartburn symptoms.

Mechanism of Action

Esomeprazole is a proton pump inhibitor that irreversibly binds to and inhibits the H+/K+ ATPase enzyme system (proton pump) at the secretory surface of gastric parietal cells, thereby suppressing gastric acid secretion.

Indications

  • Treatment of frequent heartburn (occurs 2 or more days per week)

Common Doses

  • 20 mg

Dosage

Adults 18 years and older: Take one 20 mg delayed-release tablet once daily before eating in the morning for 14 days. Swallow whole with water; do not crush or chew. May repeat 14-day course every 4 months if needed. Do not exceed one tablet daily or use for more than 14 days without medical direction.

Contraindications

  • Hypersensitivity to esomeprazole or any component of the formulation

Side Effects

  • Headache
  • Diarrhea
  • Nausea
  • Abdominal pain
  • Flatulence
  • Constipation
  • Dry mouth
  • Dizziness

Interactions

  • Drugs dependent on gastric pH for absorption (e.g., ketoconazole, iron salts, digoxin)
  • Clopidogrel (esomeprazole may reduce antiplatelet activity)
  • Methotrexate (esomeprazole may increase methotrexate levels)
  • St. John's wort and rifampin (may decrease esomeprazole levels)

Counseling Points

  • Take once daily before eating in the morning
  • Swallow tablet whole with water; do not crush or chew
  • May take 1-4 days for full effect
  • Not for immediate heartburn relief
  • Complete full 14-day course as directed
  • Do not exceed recommended dosage or duration without medical advice