Intravenous Esomeprazole is used to treat excess acid in the stomach. This condition is otherwise known as GERD or Gastroesophageal Reflux Disease, particularly when this is accompanied by Erosive Esophagitis (EE).
Additionally, Intravenous Esomeprazole may be prescribed to lower the chances of bleeding in patients who experience the following after an endoscopy:
Esomeprazole is indicated for both adults and children over the age of 1-month-old. Available by prescription only, it is sold under the U.S. brand name NEXIUM I.V. This drug is supplied in many formats. However, this guide focuses on intravenous treatments of Esomeprazole.
What is GERD
GERD is defined as when excess acid in the stomach rediverts into the Esophagus.
As a Proton Pump Inhibitor, injectable Esomeprazole lowers acidity levels in the stomach, which typically causes a great deal burning, pain, and discomfort in patients.
In most cases, intravenous Esomeprazole is prescribed for the short-term (usually 10 days) to expedite relief of GERD symptoms. Following preliminary injectable doses, an oral form of Esomeprazole may be prescribed to help manage the condition.
Patients are generally counseled about the main side effects of Esomeprazole, which include but aren't limited to:
The Most Common Side Effects of Esomeprazole:
Most of the side effects of Esomeprazole injections go away with time. However, certain adverse reactions should never be ignored. These include when you suspect or experience:
1. An Allergic Reaction to the Drug ' Anaphylaxis could be fatal if left untreated. Read more in the warnings below.
2. Persistent Diarrhea' If you have watery stools that are accompanied by a high temperature and pain in the stomach, contact your healthcare provider immediately.
A trained nurse or healthcare will inject a metered dose of Esomeprazole into the veins.
Dose Amounts for GERD with EE
Children Doses for GERD with EE
The dosage amounts for children who have GERD with EE vary based on the patient's age and weight:
Children 1-17 Years Old
The following doses are outlined for children between the ages of 1 and 17 years of age, based on weight:
Infants 1-Month-Old to Less Than 12 Months Old
In infants and children, the dose should be administered by IV Infusion lasting 10-30 minutes.
Adult Doses for GERD with EE
This dose can be administered by:
1. IV Infusion lasting 10-30 minutes
2. Intravenous Injection (Minimal 3 Minutes)
Patients with Acute Liver Impairment
The dose should not exceed 20 mg within a 24-hour period.
Lowering the Risk of Bleeding - for Gastric and Duodenal Ulcers
NEXIUM I.V. may be prescribed within the preliminary 72 hours after patients receive therapeutic endoscopy. It's generally prescribed to reduce the risk of bleeding. The following dosage amounts are recommended:
Note: Adjusted doses are needed for patients with severe liver impairment.
Dosage Instructions for Medical Workers
All dosage requirements must be adhered to improve patients' safety. Some of the main protocols include:
For new or continuous treatments, be sure to flush the IV line with any of the following solutions:
NEXIUM I.V. is supplied in 20-40 mg vials containing a freeze-dried powder which must be reconstituted before use.
Multiple drug interactions have been identified for Esomeprazole. There are also noteworthy food, alcohol, and disease interactions with this drug, which are explored in detail below:
The above list is not all-inclusive. As a synopsis, the following classes of drugs should be avoided with Esomeprazole injections:
Alcohol should be avoided when undergoing treatment with Esomeprazole as serious adverse reactions have been noted with concurrent use.
Healthcare specialists recommend avoiding cranberry products, including cranberry juice, when undergoing treatment with Esomeprazole. Studies suggest that concomitant use increases the risk of side effects, although in some cases this may be inevitable.
When completing any new medical treatment, patients are advised to create a full list of all underlying conditions and medications being taken. This provides healthcare workers with invaluable information to gauge dosage amounts and if certain treatments are safe to prescribe. Based on medical research, certain precautions must be taken if Esomeprazole injections are ordered for patients who are diagnosed with:
Esomeprazole injections may cause these conditions to become worse. Reduced dosage amounts and close monitoring are necessary in these cases.
Special warnings have been given to avoid using Esomeprazole with St. John's Wort herbal supplement.
Follow the below precautions to improve safety while taking this medicine:
After receiving an injectable dose of Esomeprazole, it may take a few days before relief is experienced. To get short-term relief of GERD symptoms, your doctor may recommend taking over-the-counter antacids. Be sure to speak with your medical provider before starting antacids or any new treatment within days of receiving Esomeprazole injections.
Injectable NEXIUM I.V.is considered safe for use in children, except in neonates younger than one-month-old.
Esomeprazole injections are indicated for use in seniors. However, due to the high propensity of seniors having underlying conditions, care should be taken to prescribe the appropriate dosage amounts in this profile group.
Senior patients are advised to attend all follow-ups to determine if the medicine is working or causing any adverse effects.
Patients over the age of 50 who receive Esomeprazole injections are at a higher risk of developing bone health issues, including fractures. The chances of getting a hip, wrist, or spine fracture is increased exponentially in patients taking this medicine for a prolonged period of more than 12 months or when higher quantities are prescribed.
Animal studies suggest that Esomeprazole use during pregnancy could cause serious injury to developing fetuses. It is therefore not recommended for use during pregnancy.
If you are pregnant, breastfeeding, or plan to be, inform your medical provider.
There's a possibility of developing Anaphylaxis after getting NEXIUM I.V. This is especially true for patients with a history of hypersensitivities. Anaphylaxis is a serious and potentially fatal condition that requires immediate medical intervention. Some of the warning signs include:
Precautions for Medical Providers:
Due to the risk of anaphylaxis, the medical facilities should be equipped with the right counteractive drugs and tools to resolve anaphylaxis in a timely manner. This includes providing quick ways for patients to alert a nurse or healthcare worker on duty via a call button or drawstring near beds, sitting areas, and in the restroom.
Query the patient's full medical history before prescribing this medicine and monitor the patient closely following administration.
Acute Interstitial Nephritis
There is also a possibility of developing acute interstitial nephritis when taking Esomeprazole. Tell your doctor if you experience any of the following symptoms after receiving treatment:
If you have systematic or cutaneous Lupus Erythematosus, the condition may progress or get worse if you receive Esomeprazole injections. Be sure to follow your doctor's orders and attend all follow-up appointments post-treatment. You should also advise your medical provider right away if you experience the following symptoms after receiving Esomeprazole or NEXIUM I.V.:
Hypomagnesemia is the term used to define low magnesium levels in the bloodstream. There is an increased chance of developing this condition when patients receive:
Magnesium deficiencies are serious and require prompt medical intervention. You should inform your healthcare provider if any of the following symptoms arise post-treatment:
Esomeprazole injections may alter certain medical readings. If you have an upcoming medical test or dental appointment, inform your provider of recent treatments with Esomeprazole.
Over-the-counter (OTC) drugs should never be taken without your doctor's consent if you receive Esomeprazole. Seek medical advice before commencing treatment with vitamins, herbal supplements, NSAIDs, or other types of OTCs.
To preserve the quality and usefulness of this medicine, follow the below storage instructions:
NEXIUM I.V. vials should be stored at temperatures of 25°C (77°F.) Keep in the original cartons until the vial is ready for use. Do not place in well-lit areas.
Storage Instructions for Diluents of NEXIUM I.V.
The storage instructions for NEXIUM I.V. depend on the reconstituted mix. All diluents for injection can be stored at a room temperature of 30°C (86°F) for the following timeframes:
Note: Discard the mix if it isn't used within this period.
NEXIUM I.V. for injection or Esomeprazole is used to treat Gastroesophageal Reflux Disease (GERD) with Erosive Esophagitis (EE) and other stomach-related ailments, such as ulcers, gastritis, esophagitis, and more. Additionally, this medicine may be ordered for patients who have developed ulcers following an endoscopy to reduce the risk of bleeding.
The medicine decreases the amount of acid in the stomach and provides patients with much-needed relief from burning chest pain and other discomforts associated with GERD.
It is indicated for children and adults. However, this medicine should not be prescribed for infants younger than four weeks old.
NEXIUM I.V. may cause flatulence, headaches, pain in the stomach, and skin irritations. These are some of the most commonly reported side effects, many of which subside with time.
Some adverse reactions require immediate medical intervention, however. These include anaphylaxis, low magnesium, and interstitial nephritis. Your doctor should provide an outline of precautions for when to call for help.
Treatment general lasts 10 days and follow-ups may be needed. When suitable, healthcare workers substitute injectable NEXIUM I.V. for oral doses.
GERD with EE is a common condition, but with treatments such as injectable NEXIUM I.V., the symptoms can be effectively managed for patients to enjoy a better quality of life.