Esomeprazole
NEXIUM
What it isProton-pump inhibitor, the S-enantiomer of omeprazole; GERD and ulcer disease.
Why this oneIt provides somewhat more consistent acid suppression than racemic omeprazole.
What limits itLong-term use can deplete magnesium and B12 and increase fracture risk; reassess the indication periodically.
FDA-approved for
- GERD (2001)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Frequent heartburn (OTC) | Adults >=18 y | 1 capsule (20 mg) QD x14 days | 1 capsule QD x14 days | 1 capsule/day |
Renal Undefined
Hepatic Undefined
OTC label; may take 1-4 days for full effect
Instructions
- Swallow 1 capsule with a glass of water before eating in the morning
- Swallow whole; do not crush or chew
- Do not take more than 1 capsule a day
- Do not use for more than 14 days unless directed by a doctor
- Repeat 14-day course no more than every 4 months
Pregnancy Undefined
Lactation Undefined
NO BOXED WARNINGS
Principal riskLong-term use: B12 deficiency, hypomagnesemia, fracture
Cost, est. cash$10–$500/month
Generic entry2013
Classes and tags
Clinical profile
Legacy pregnancy categoryB
Defining liabilityLong-term infection, magnesium/B12 and bone risks; selected agents have clinically important CYP interactions.
Mechanism of action: Esomeprazole ballicule
Open Esomeprazole in the interactive console ↗
Memory aids: mascots and interaction avatars
single-enantiomer omeprazole: the S-enantiomer only
