Skip to Main Content

We have a new app!

Take the Access library with you wherever you go—easy access to books, videos, images, podcasts, personalized features, and more.

Download the Access App here: iOS and Android


esomeprazole (es-oh-mep-ra-zole)



Therapeutic: antiulcer agents

Pharmacologic: proton-pump inhibitors


GERD/erosive esophagitis. Hypersecretory conditions, including Zollinger-Ellison syndrome. With amoxicillin and clarithromycin to eradicate Helicobacter pylori in duodenal ulcer disease or history of duodenal ulcer disease. Decrease risk of gastric ulcer during continuous NSAID therapy.


Binds to an enzyme on gastric parietal cells in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen. Therapeutic Effects: Diminished accumulation of acid in the gastric lumen with lessened gastroesophageal reflux. Healing of duodenal ulcers. Decreased incidence of gastric ulcer during continuous NSAID therapy.

Adverse Reactions/Side Effects

CNS: headache. GI: abdominal pain, constipation, diarrhea, dry mouth, flatulence, nausea.


Examination and Evaluation

  • Monitor improvements in GI symptoms (gastritis, heartburn, and so forth) to help determine if drug therapy is successful.


  • In cases of NSAID-induced gastritis, implement appropriate manual therapy techniques, physical agents, and therapeutic exercises to reduce pain and decrease the need for aspirin and other NSAIDs.

Patient/Client-Related Instruction

  • Advise patient to avoid alcohol and foods that may cause an increase in GI irritation.

  • Instruct patient to report bothersome or prolonged side effects, including headache or GI effects (nausea, constipation, diarrhea flatulence, abdominal pain, dry mouth).


Absorption: 90% absorbed following oral administration; food decreases absorption.

Distribution: Unknown.

Protein Binding: 97%.

Metabolism and Excretion: Extensively metabolized by the liver (cytochrome P450 [CY P450] system, primarily CYP2C19 isoenzyme); <1% excreted unchanged in urine.

Half-life: 1.0–1.5 hr.

|Download (.pdf)|Print

TIME/ACTION PROFILE (blood levels*)

PO rapid 1.6 hr 24 hr
IV rapid end of infusion 24 hr

*Resolution of symptoms takes 5–8 days.


Contraindicated in: Hypersensitivity; OB: Lactation (not recommended).

Use Cautiously in: Severe hepatic impairment (daily dose should not exceed 20 mg); Geri: Increased risk of hip fractures in patients using high doses for >1 year; OB: Pregnancy (use only if clearly needed); Pedi: Children <1 yr (safety not established).


Drug-Drug: May ↓ absorption of drugs requiring acid pH, including ketoconazole, itraconazole, atazanavir, ampicillin, iron salts, and digoxin. May ↑ risk of bleeding with warfarin (monitor INR and PT).


Gastroesophageal Reflux Disease

PO (Adults): Healing of erosive esophagitis—20 or 40 mg once daily for 4–8 wk; ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.