How should this medicine be used?
Prescription Esofag comes as a delayed-release (releases the medication in the intestine to prevent break-down of the medication by stomach acids) capsule to take by mouth or to open, mix with water, and give through a feeding tube, and as packets of delayed-release (releases the medication in the intestine to prevent break-down of the medication by stomach acids) granules for suspension (to be mixed with water) to take by mouth or give through a feeding tube. Nonprescription (over-the-counter) Esofag comes as a delayed-release capsule and tablet to take by mouth. Prescription Esofag is usually taken once a day at least 1 hour before a meal. When prescription Esofag is used to treat certain conditions in which the stomach makes too much acid, it is taken twice a day. The nonprescription delayed-release capsules and tablets are usually taken once a day in the morning at least 1 hour before eating for 14 days in a row. If needed, additional 14-day treatments may be repeated, not more often than once every 4 months.
Take Esofag at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Esofag exactly as directed. Do not take more or less of it or take it more often than or for a longer period of time than prescribed by your doctor or stated on the package.
Swallow the capsules whole; do not split, chew, or crush them. If you cannot swallow the capsule, put 1 tablespoon of cool, soft applesauce in an empty bowl. Open one Esofag capsule and carefully sprinkle the pellets onto the applesauce. Mix the pellets with the applesauce and swallow the entire tablespoonful of the applesauce and pellet mixture immediately. Do not crush or chew the pellets in the applesauce. Do not save the pellets and applesauce for later use.
If you are taking the granules for oral suspension, you will need to mix it with water before use. If you are using the 2.5- or 5-mg packet, place 1 teaspoonful (5 mL) of water in a container. If you are using the 10-, 20-, or 40-mg packet, place 1 tablespoonful (15 mL) of water in a container. Add the contents of the powder packet and stir. Wait 2 to 3 minutes to allow the mixture to thicken, and stir the mixture again. Drink the entire mixture within 30 minutes. If any of the mixture is stuck to the container, pour more water into the container, stir and drink all the mixture immediately.
The granules and the contents of the prescription delayed-release capsules can both be given through a feeding tube. If you have a feeding tube, ask your doctor or pharmacist how you should take the medication. Follow those directions carefully.
Do not take nonprescription Esofag for immediate relief of heartburn symptoms. It may take 1 to 4 days for you to feel the full benefit of the medication. Call your doctor if your symptoms get worse or do not improve after 14 days or if your symptoms return sooner than 4 months after you finish your treatment. Do not take nonprescription Esofag for longer than 14 days or treat yourself with Esofag more often than once every 4 months without talking to your doctor.
Continue to take prescription Esofag even if you feel well. Call your doctor if your symptoms worsen or do not improve during this time. Do not stop taking Esofag without talking to your doctor.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.
Serious side effects
Serious side effects happen in less than 1 in 1,000 people. Call a doctor straight away if you have:
- joint pain and abnormal changes in your skin, especially in parts of your body exposed to the sun, such as a red, raised rash on your arms that can spread, blisters, or a red rash on your cheeks and nose. These can be signs of a rare condition called subacute cutaneous lupus erythematosus. This can happen even if you've been taking Esofag for a long time.
- yellow skin, dark pee and tiredness. These can be signs of liver problems.
A randomized, open-label, multi-national study to evaluate the pharmacokinetics of repeated intravenous doses of once daily Esofag in pediatric patients 1 month to 17 years old, inclusive was performed. The safety results are consistent with the known safety profile of Esofag and no unexpected safety signals were identified .
Mixing Esofag with herbal remedies and supplements
Do not take St John's wort, the herbal remedy for depression, while you're taking Esofag. St John's wort may stop Esofag working as well as it should.
Q: I have been on Nexium 40 mg for five months and have noticed an increase in heart palpitations. Can this be connected?
A: Nexium (Esofag) is used to treat GERD (gastroesophageal reflux disease) and other conditions where stomach acid is too high. Heart palpitations are not listed as a side effect. However, a fast heartbeat may occur if a person overdoses. Other possible common side effects include headache, diarrhea, nausea, gas, stomach pain, constipation, and dry mouth. This is not a complete list of the side effects associated with Nexium. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, botanicals, minerals, and herbals, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your health care providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects. Tell your health care provider about any negative side effects from prescription drugs. You can also report them to the U.S. Food and Drug Administration by visiting https://www.fda.gov/Safety/MedWatch/default.htm or by calling 1-800-FDA-1088. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Patti Brown, PharmD
Dosage Forms And Strengths
NEXIUM I.V. for Injection is supplied as a freeze-dried white to off-white powder containing 20 mg or 40 mg of Esofag per single-use vial.
Q: What is the difference between Aciphex versus Nexium?
A: GERD affects approximately 14 to 20 percent of the adult U.S. population. It is a chronic condition that develops when acid content from the stomach flows back into the esophagus, and is most commonly associated with heartburn. Aciphex (rabeprazole) is a proton-pump inhibitor indicated for adolescent patients 12 years of age and above for short-term treatment of symptomatic gastroesophageal reflux disease (GERD). Aciphex tablets should be swallowed whole. In adolescents, the most common side effects with Aciphex include headache, diarrhea, nausea, vomiting, and abdominal pain. In adults, the most common side effects with Aciphex include pain, sore throat, gas, infection, and constipation. The recommended dose of Aciphex is 20 milligrams daily. Aciphex has not been studied for treatment lasting longer than 12 months (1 year). The safety and effectiveness of Aciphex has not been established for children under the age of 12. Nexium (Esofag) is a proton pump inhibitor used in the treatment of dyspepsia, peptic ulcer disease (PUD), GERD, and Zollinger-Ellison syndrome. In adults 18 and older, side effects with Nexium include headache, diarrhea, and abdominal pain. In children 1 to 17 years of age, side effects with Nexium include headache, diarrhea, abdominal pain, nausea, and sleepiness. The recommended dose of Nexium ranges between 20 to 40 milligrams daily. Nexium is not recommended for children under the age of 1 year. For children and adolescents 1 to 17 years of age, Nexium may be prescribed for up to 8 weeks for short-term treatment of GERD. Long-term and multiple daily dose proton pump inhibitor therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist, or spine.
8. Cautions with other medicines
Some medicines can interfere with Esofag and make you more likely to have side effects.
Tell your doctor if you're taking these medicines before you start taking Esofag:
- digoxin (a heart medicine)
- cilostazol (a medicine used to treat painful legs caused by poor circulation)
- antifungal medicines such as itraconazole, ketoconazole or posaconazole
- methotrexate (a medicine used to treat cancer and conditions like psoriasis and rheumatoid arthritis)
- HIV medicines
- phenytoin (an anti-epilepsy medicine)
- rifampicin (an antibiotic)
- blood thinning medicines, such as clopidogrel
- citalopram, escitalopram, clomipramine or imipramine (antidepressants)
- tacrolimus (a medicine used for eczema or to prevent organ rejection after a transplant)
These are not all the medicines that may not mix well with Esofag. For a full list see the leaflet inside your medicines packet.
Q: What are the interactions, if any, between Plavix and Nexium? I had to switch from Protonix to Nexium for insurance reasons.
A: Since you are on Plavix (clopidogrel), you should not be taking Nexium (Esofag). New studies state that these products should not be taken together and that patients should use Zantac (ranitidine) or Pepcid (famotidine) instead. Contact your health care provider and let him or her know about the medication your insurance company put you on. Gerald S. Levy, RPh