Tablet: Adults and Adolescents ≥12 years: Gastroesophageal Reflux Disease (GERD): Treatment of Erosive Reflux Esophagitis: 40 mg once daily for 4 weeks. An additional 4 weeks treatment is recommended for patients in whom esophagitis has not healed or who have persistent symptoms.
Long-Term Management of Patients with Healed Esophagitis to Prevent Relapse: 20 mg once daily.
Symptomatic Treatment of GERD: 20 mg once daily in patients without esophagitis. If symptom control has not been achieved after 4 weeks, the patient should be further investigated. Once symptoms have resolved, subsequent symptom control can be achieved using 20 mg once daily. In adults, an on demand regimen taking 20 mg once daily, when needed, can be used. In NSAID-treated patients at risk of developing gastric and duodenal ulcers, subsequent symptom control using an on demand regimen is not recommended.
Adults: In Combination with Appropriate Antibacterial Therapeutic Regimens for the Eradication of H. pylori, Healing of H. pylori-Associated Duodenal Ulcer and Prevention of Relapse of Peptic Ulcers in Patients with H. pylori-Associated Ulcers: 20 mg with amoxicillin 1 g and clarithromycin 500 mg, all twice daily for 7 days.
Patients Requiring Continued NSAID Therapy: Healing of Gastric Ulcers Associated with NSAID Therapy: Usual Dose: 20 mg once daily. Treatment Duration: 4-8 weeks.
Prevention of Gastric and Duodenal Ulcers Associated with NSAID Therapy in Patients at Risk: 20 mg once daily.
Prolonged Treatment After IV-Induced Prevention of Rebleeding of Peptic Ulcers: 40 mg once daily for 4 weeks after IV-induced prevention of rebleeding of peptic ulcers.
Treatment of Zollinger Ellison Syndrome: Recommended Initial Dose: 40 mg twice daily. The dosage should then be individually adjusted and treatment continued as long as clinically indicated. Based on the clinical data available, the majority of patients can be controlled on doses between esomeprazole 80-160 mg daily. With doses >80 mg daily, the dose should be divided and given twice daily.
Granules: Gastroesophageal Reflux Disease (GERD): Treatment of Endoscopically Proven Erosive Reflux Esophagitis: Children 1-11 years, weighing ≥10 to <20 kg: 10 mg once daily for 8 weeks, ≥20 kg: 10 mg or 20 mg once daily for 8 weeks.
Symptomatic Treatment of GERD: Children 1-11 years, weighing ≥10 kg: 10 mg once daily for up to 8 weeks.
Doses >1 mg/kg/day have not been studied.
Elderly: Dose adjustment is not required in the elderly.
Impaired Renal Function: Dose adjustment is not required in patients with impaired renal function. Due to limited experience in patients with severe renal insufficiency, such patients should be treated with caution (see Pharmacology: Pharmacokinetics under Actions).
Impaired Hepatic Function: Dose adjustment is not required in patients with mild to moderate liver impairment.
Tablet: For patients with severe liver impairment, a maximum dose of 20 mg.
Granules: For patients ≥12 years with severe liver impairment, a maximum dose of Nexium 20 mg should not be exceeded. For children 1-11 years with severe liver impairment, a maximum dose of 10 mg should not be exceeded (see Pharmacology: Pharmacokinetics under Actions).
Administration: Tablet: The tablets should be swallowed whole with liquid. The tablets should not be chewed or crushed.
For patients who have difficulty in swallowing, the tablets can also be dispersed in ½ a glass of non-carbonated water. No other liquids should be used as the enteric coating may be dissolved. Stir until the tablets disintegrate and drink the liquid with the pellets immediately or within 30 min. Rinse the glass with ½ a glass of water and drink. The pellets must not be chewed or crushed.
For patients who cannot swallow, the tablets can be dispersed in non-carbonated water and administered through a gastric tube. It is important that the appropriateness of the selected syringe and tube is carefully tested. For preparation and administration instructions, see Instructions for Use, Handling and Disposal under Cautions for Usage.
Granules: For a 10-mg dose, empty the contents of a 10-mg sachet into a glass containing 15 mL water. For a 20-mg dose, empty the contents of two 10-mg sachets into a glass containing 30 mL water. Do not use carbonated water. Stir the contents until the granules have been dispersed and leave for a few minutes to thicken. Stir again and drink within 30 min. The granules must not be chewed or crushed. Rinse with 15 mL water to obtain all granules.
For patients who have a nasogastric or gastric tube in place, see Instructions for Use and Handling under Cautions for Usage, for preparation and administration instructions.