Eso Protocol

Esomeprazole 40 mg

Dosing & Uses

Dosage Forms & Strengths

capsule, delayed-release (as magnesium)

• 20 mg (Rx/OTC)
  
• 40 mg
  
• 24.65 mg (strontium salt)
  
• 49.3 mg (strontium salt)
  

tablet delayed release (as magnesium)

• 20 mg
  

injection, powder for reconstitution

• 20 mg/vial
  
• 40 mg/vial
  

packets for oral suspension

• 10 mg
  
• 20 mg
  
• 40 mg
  

GERD Without Erosive Esophagitis

20 mg PO qDay for 4 weeks; consider an additional 4 weeks of treatment if symptoms do not resolve completely in the first 4 weeks

GERD With Erosive Esophagitis

20-40 mg PO qDay for 4-8 weeks

If oral therapy inappropriate or not possible: 20-40 mg qDay IV up to 10 days; switch to PO once patient able to swallow

Maintenance: 20 mg PO qDay for up to 6 months

Helicobacter Pylori Eradication

Combination therapy (with amoxicillin and clarithromycin) for eradication of H pylori in patients with duodenal ulcer

40 mg PO qDay for 10 days, PLUS

Amoxicillin 1000 mg PO q12hr for 10 days, PLUS

Clarithromycin 500 mg PO q12hr for 10 days

Risk Reduction of NSAID-Associated Gastric Ulcer

20-40 mg PO qDay for up to 6 months

NSAID-Induced Gastric Ulcer

20 mg PO qDay for 4-8 weeks

Zollinger-Ellison Syndrome

80 mg PO divided q12hr (initial); adjust regimen to efficacy; up to 240 mg PO qDay, OR

120 mg PO q12hr administered to patients

Gastric or Duodenal Ulcers Following Therapeutic Endoscopy

IV indicated for risk reduction of rebleeding of gastric or duodenal ulcers following therapeutic endoscopy in adults

80 mg IV infused over 30 min, THEN continuous IV infusion of 8 mg/hr for total treatment duration of 72 hr

Follow IV therapy with oral acid suppressive therapy

Frequent Heartburn

OTC: 20 mg PO qDay x14 days

Hepatic Impairment

Oral administration

• Mild to moderate (Child-Pugh A/B): No dosage adjustment required
  
• Severe (Child-Pugh C): Not to exceed 20 mg/day
  

GERD (IV)

• Mild to moderate (Child-Pugh A/B): No dosage adjustment required
  
• Severe (Child-Pugh C): Not to exceed 20 mg/day IV
  

Bleeding gastric or duodenal ulcers (IV)

• No dosage adjustment required with initial 80 mg/30 min IV dose
  
• Adjust dose for continuous IV infusion
  
• Mild-to-moderate (Child Pugh A/B): Not to exceed 6 mg/hr
  
• Severe (Child Pugh C): Not to exceed 4 mg/hr
  

Pediatric