Home Drug Guide Esomeprazole Strontium

Drug Guide

Generic Name

Esomeprazole Strontium

Brand Names TCellco

Classification

Therapeutic: Antiulcer Agent

Pharmacological: Proton Pump Inhibitor (PPI)

FDA Approved Indications

Gastroesophageal reflux disease (GERD)
Erosive esophagitis
Symptomatic gastroesophageal reflux disease (GERD)
Helicobacter pylori eradication (as part of combination therapy)
Zollinger-Ellison syndrome

Mechanism of Action

Esomeprazole Strontium inhibits the gastric proton pump (H+/K+ ATPase), leading to a significant decrease in gastric acid secretion.

Dosage and Administration

Adult: Typically 20-40 mg once daily before a meal; duration depends on the condition being treated.

Pediatric: Dosage varies based on age and weight; consult specific guidelines.

Geriatric: Use with caution; consider renal and hepatic function.

Renal Impairment: Adjust dose in severe impairment.

Hepatic Impairment: Use with caution; dose adjustments may be necessary.

Pharmacokinetics

Absorption: Well absorbed; bioavailability unaffected by food.

Distribution: Widely distributed in tissues; plasma protein binding approximately 97%.

Metabolism: Primarily hepatic via CYP2C19 and CYP3A4 enzymes.

Excretion: Primarily via renal and fecal routes.

Half Life: Approximately 1-1.5 hours.

Contraindications

Hypersensitivity to PPIs or any component of the formulation.

Precautions

Use cautiously in patients with hepatic impairment; monitor for signs of hypomagnesemia with long-term use; consider drug interactions.

Adverse Reactions - Common

Headache (Common)
Diarrhea (Common)
Nausea (Common)
Abdominal pain (Common)

Adverse Reactions - Serious

Clostridioides difficile-associated diarrhea (Serious)
Hypomagnesemia (Serious)
Osteoporosis-related fractures with long-term use (Serious)
Severe cutaneous adverse reactions (SJS/TEN) (Serious)

Drug-Drug Interactions

Clopidogrel (may reduce effect)
Methotrexate (elevated levels)
Atazanavir and nelfinavir (reduce absorption)

Drug-Food Interactions

Food has minimal impact on absorption

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for relief of symptoms, potential side effects, magnesium and calcium levels with long-term therapy.

Diagnoses:

Risk for infection (e.g., pneumonia)
Risk for hypomagnesemia
Imbalanced nutrition: less than body requirements

Implementation: Administer before meals; monitor magnesium levels in long-term therapy; educate patient on potential side effects.

Evaluation: Assess symptom relief and adverse effects periodically.

Patient/Family Teaching

Take medication as prescribed, preferably before meals.
Report persistent diarrhea, severe abdominal pain, or signs of hypomagnesemia.
Avoid concurrent use with certain drugs unless advised by a healthcare provider.

Special Considerations

Black Box Warnings:

Long-term use can increase risk of fractures, hypomagnesemia, and C. difficile-associated diarrhea.

Genetic Factors: CYP2C19 polymorphisms may affect metabolism; rapid and slow metabolizers may require dose adjustments.

Lab Test Interference: May interfere with urine pH testing.

Overdose Management

Signs/Symptoms: Nausea, vomiting, dizziness, abdominal pain.

Treatment: Supportive care; consider activated charcoal if ingestion recent; no specific antidote.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable until expiration date when stored properly.