In the U.S.—

• Gastric acid pump inhibitor
• antiulcer agent

Esomeprazole ( e-so-MEP-ra-zole ) is used to treat conditions in which there is too much acid in the stomach. It is used to treat duodenal ulcers and gastroesophageal reflux disease (GERD). This is a condition in which the acid in the stomach washes back up into the esophagus. Sometimes esomeprazole is used along with antibiotics to treat ulcers associated with infection caused by the H. pylori bacteria (germ).

Esomeprazole works by decreasing the amount of acid produced by the stomach.

This medicine is available only with your doctor's prescription, in the following dosage form:

Oral
• Delayed-release capsules (U.S.)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For esomeprazole, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to esomeprazole. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Esomeprazole has not been studied in pregnant women. However, esomeprazole has not been shown to cause birth defects or other problems in animal studies.

Breast-feeding—It is not known whether esomeprazole passes in human breast milk. Since this medicine has been shown to cause unwanted effects in animals, it may be necessary for you to take another medicine or to stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of the medicine with your doctor.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing the use of esomeprazole in children with use in other age groups.

Older adults—This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

• Liver disease or a history of liver disease—This condition may cause esomeprazole to build up in the body

Take esomeprazole at least one hour before a meal.

Swallow the capsule whole. Do not crush, break, or chew the capsule. If you cannot swallow the capsule whole, you may open it and sprinkle the granules contained in the capsule on one tablespoonful of applesauce or yogurt and swallow it immediately; or you may mix the granules in some tap water or fruit juice and drink it immediately. The applesauce should not be hot, and the juices you may use include apple or orange juice. Do not chew or crush the granules.

Take this medicine for the full time of treatment, even if you begin to feel better. Also, keep your appointments with your doctor for check-ups so that your doctor will be better able to tell you when to stop taking this medicine.

Dosing—

The dose of esomeprazole will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of esomeprazole. If your dose is different, do not change it unless your doctor tells you to do so.

The number of doses you take each day and the length of time you take the medicine depend on the medical problem for which you are taking esomeprazole

• To treat gastroesophageal reflux disease (GERD):
  • Adults—20 or 40 milligrams (mg) taken once a day for 4 to 8 weeks.
  • Children up to 18 years of age—Use and dose must be determined by your doctor.
• To prevent gastroesophageal reflux disease (GERD):
  • Adults—20 mg taken once a day.
  • Children up to 18 years of age—Use and dose must be determined by your doctor.
• To treat ulcers related to infection with H. pylori
  • Adults—40 mg once daily, plus amoxicillin 1000 mg (1 gram) plus clarithromycin 500 mg, taken together before meals twice a day for ten days.
  • Children up to 18 years of age—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Store away from heat and direct light.
• Do not keep outdated medicine or medicine no longer needed. Ask your health care professional how you should dispose of any medicine you do not use. Be sure that any discarded medicine is out of the reach of children.

It is very important that your doctor check you at regular visits. If your condition does not improve, or if it becomes worse, discuss this with your doctor.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

• Incidence unknown (observed post marketing)
  • Blistering, peeling, loosening of skin;  bloating;  chills;  cough ;  darkened urine;  difficulty swallowing;  dizziness;  fast heartbeat;  fever;  hives;  indigestion;  itching ;  joint or muscle pain;  loss of appetite;  pains in stomach, side, or abdomen, possibly radiating to the back;  puffiness or swelling of the eyelids or around the eyes, face, lips or tongue;  red irritated eyes;  red skin lesions, often with a purple center;  shortness of breath;  skin rash;  sore throat;  sores, ulcers, or white spots in mouth or on lips;  tightness in chest;  unusual tiredness or weakness;  vomiting;  wheezing;  yellow eyes or skin 
  
  

The following side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

• Less common
  • Abdominal pain;  constipation;  diarrhea;  dryness of mouth;  gas;  headache;  nausea 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.