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Esomeprazole 💊
📘 About
- Always check the BNF entry for the most up-to-date prescribing advice.
- Esomeprazole is the S-isomer of omeprazole, a proton pump inhibitor (PPI) used to suppress gastric acid secretion.
⚙️ Mode of Action
- Irreversibly inhibits the H⁺/K⁺-ATPase proton pump in gastric parietal cells.
- Blocks the final step in acid secretion → sustained reduction in gastric acidity.
- Promotes ulcer healing and reduces oesophageal mucosal damage from reflux.
💊 Indications & Example Doses
- GORD / reflux oesophagitis: 20–40 mg PO daily (maintenance 20 mg daily).
- Peptic ulcer disease (PUD): 20 mg PO daily for 4–8 weeks.
- H. pylori eradication (with 2 antibiotics): 20 mg PO BD for 7 days.
- NSAID-associated ulcer prophylaxis: 20 mg PO daily.
- Zollinger–Ellison syndrome: 40 mg PO BD (titrate to control symptoms).
⚠️ Doses may vary depending on indication and patient factors - always check BNF/local guidelines.
🔀 Interactions
- PPI use may reduce the effectiveness of clopidogrel (CYP2C19 inhibition).
- Can ↑ levels of drugs dependent on gastric pH for absorption (e.g. ketoconazole, atazanavir).
⚠️ Cautions
- Long-term use: risk of vitamin B12 deficiency, hypomagnesaemia, osteoporosis/fractures.
- Increased risk of Clostridioides difficile diarrhoea and other enteric infections.
- Masking of gastric cancer symptoms - review need if persistent dyspepsia.
🚫 Contraindications
- Hypersensitivity to esomeprazole, omeprazole, or other substituted benzimidazoles.
💥 Side Effects
- Common: GI upset (diarrhoea, constipation, abdominal pain), headache.
- Occasional: nausea, flatulence, dry mouth, dizziness.
- Rare but important: C. difficile infection, interstitial nephritis, subacute cutaneous lupus, hyponatraemia.
📚 References
- BNF – Esomeprazole
- NICE CKS – Dyspepsia and GORD
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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