NexiumNZ

Common Use

The tablets should be swallowed whole with a drink. They should not be chewed or crushed.

Patients who have difficulty swallowing the tablets may disperse a tablet of Nexium in half a glass of non-carbonated water. No other liquids should be used as the enteric coating may be inadvertently dissolved. Stir until full disintegration of the tablets and drink the solution immediately or within 30 minutes. Rinse the glass with half a glass of water and drink it. The granules should not be chewed or crushed.

– For patients unable to swallow the tablets may be dispersed in non-carbonated water and administered by stomach tube.

– It is important to ensure beforehand and thoroughly as the probe and the syringe selected are appropriate.

– Adults and children from 12 years

Gastroesophageal reflux:

– Processing erosive reflux esophagitis

– 40 mg once a day for 4 weeks.

– An additional 4 weeks of treatment is recommended in patients with esophagitis has not healed or whose symptoms persist.

Adults

Treatment of Zollinger-Ellison:

The recommended starting dose is 40 mg twice daily. The dose should be individually adjusted and treatment continued as long as clinically indicated. Based on clinical data, the majority of patients with controlled doses of between 80 and 160 mg per day of esomeprazole. For greater than 80 mg per day dosage, the daily dose should be divided and given in 2 doses.

In patients with continued treatment after intravenous prevention of rebleeding of peptic ulcer Nexium is administered in the amount of 40 mg once daily for 4 weeks after intravenous prevention of rebleeding of peptic ulcer.

– Nexium should not be used in children under 12 years in the absence of available data.

– No dosage adjustment is necessary in patients with renal insufficiency. Due to limited experience in patients with severe renal impairment, the use of Nexium should be prudent in these patients.

– No dosage adjustment is necessary in patients with mild to moderate hepatic impairment. It should not exceed the maximum dose of 20 mg of Nexium in patients with severe hepatic impairment.

– No dosage adjustment in the elderly.

Precautions

In the presence of one of the following alarming symptoms (such as loss of significant unintentional weight, recurrent vomiting, dysphagia, haematemesis or melena) or in case of suspicion or presence of a gastric ulcer, the possibility of malignancy should be excluded because Nexium may alleviate symptoms and delay diagnosis.

– Patients receiving maintenance treatment (and those more specifically treated for more than one year) should be monitored regularly.

Patients with on-demand treatment should be alerted about the need to contact their physician if their symptoms change. When prescribing esomeprazole treatment on demand, the impact on interactions with other drugs should be considered due to fluctuations in plasma concentrations of esomeprazole.

Contraindications

• Known hypersensitivity to esomeprazole, substituted benzimidazoles or to any component.
• Esomeprazole, like other inhibitors of proton pump should not be administered with atazanavir.
• Esomeprazole should not be used concomitantly with nelfinavir (see section Interaction with other medicinal products and other forms of interaction).

Drug Interactions

Inhibition of gastric acid during treatment with esomeprazole and other PPIs might decrease or increase the absorption of drugs if it is dependent on the gastric pH. As with other drugs that decrease intragastric acidity, the absorption of certain medications, such as ketoconazole, itraconazole and erlotinib may be decreased while the absorption of drugs such as digoxin can increase during treatment by esomeprazole.

Possible Side Effects

Side effects of Nexium may be manifested in: leucopenia, thrombocytopenia. Rarely, they may appear hypersensitivity reactions such as fever, angioedema, anaphylactic reaction / shock. On the side of metabolism and nutrition patients taking Nexium may develop peripheral edema, which is very uncommon though.

One of other rare side events of Nexium are hyponatraemia, agitation, confusion, depression, aggression, hallucinations, insomnia, dizziness, paresthesia, somnolence, taste disturbance, eye disorders. One of the most common side effects of Nexium is headache.