Nexium

Nexium is an antisecretory medication used in the treatment of peptic ulcer disease. It contains the drug esomeprazole magnesium. Esomeprazole is S- isomer of omeprazole. It belongs to the group of peptic ulcer medications called proton pump inhibitors. H+, K+-ATPase is called the proton pump. It helps in the secretion of acid from the stomach glands. The PPIs decrease gastric acid secretion through inhibition of H+, K+-ATPase. There are five PPI approved by FDA for the treatment of peptic ulcer disease and Nexium which contains esomeprazole magnesium is one of them. It was developed and is marketed by AstraZeneca.

Composition

Nexium contains esomeprazole magnesium. It is available as film coated tablet. Esomeprazole magnesium is available as 20 mg and 40 mg enteric coated tablets.

Indications

Nexium (esomeprazole magnesium) is indicated in patients with the following conditions –

• Gastroesophageal reflux disease
• Prevention of relapse of reflux esophagitis
• Eradication of helicobacter pylori infection associated with peptic ulcer
• Reducing the risk of NSAID induced peptic ulcer

Other indications include:

• Gastric ulcer
• Maintenance therapy for GERD
• Zollinger Ellison Syndrome
• Multiple Endocrine Neoplasia
• Systemic mastocytosis

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Contraindications

Nexium (esomeprazole magnesium) should be avoided in patients with the following conditions:

• Patients with known allergic reaction to esomeprazole magnesium and other similar proton pump inhibitors

Dosage

The dosage recommendation for adults is:

• For treatment of gastroesophageal reflux disease - 20 mg or 40 mg tablet once daily for up to 8 weeks. For those patients who have not healed after 8 weeks of treatment, an additonal 8 weeks therapy may be considered.
• For prevention of relapse of reflux esophagitis - 20 mg or 40 mg tablet once daily
• For treating Helicobacter pylori infection which is associated with peptic ulcer - 40 mg tablet should be taken once daily along with 1000 mg of amoxycillin in two divided doses and 500 mg of clarithromycin in two divided dosease for 10 days.

Side effects

The safety of esomeprazole has been evaluated in over 15,000 patients aged 18-84 years in clinical trials worldwide including over 8500 in the United States and over 6500 in Europe and Canada. Over 2900 patients were treated in long term studies for up to 6-12 months. In general esomeprazole is a well tolerated medication similar to other proton pump inhibitors. The various side effects caused by Nexium (esomeprazole magnesium) are:

• Head ache
• Diarrhea
• Constipation
• Nausea
• Flatulence
• Abdominal pain
• Dry mouth
• Allergic reactions
• Rapid heart beats
• Osteoporosis

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In combination treatment for the eradication of Helicobacter pylori infection, the commonly encountered side effects are diarrhea, taste perversion and abdominal pain.

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