Nexium - Instructions For Use, Price, Reviews, Analogues, Tablets

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Nexium

Nexium: instructions for use and reviews

1. 1. Release form and composition
2. 2. Pharmacological properties
3. 3. Indications for use
4. 4. Contraindications
5. 5. Method of application and dosage
6. 6. Side effects
7. 7. Overdose
8. 8. Special instructions
9. 9. Drug interactions
10. 10. Analogs
11. 11. Terms and conditions of storage
12. 12. Terms of dispensing from pharmacies
13. 13. Reviews
14. 14. Price in pharmacies

Latin name: Nexium

ATX code: A02BC05

Active ingredient: Esomeprazole (Esomeprazol)

Manufacturer: AB AstraZeneca, Sweden

Description and photo update: 2019-12-08

Prices in pharmacies: from 128 rubles.

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Nexium is a drug that reduces the secretion of hydrochloric acid in the stomach.

Release form and composition

Nexium is available in three dosage forms:

• Film-coated tablets: biconvex, oblong, at the break - white with yellow blotches; 20 mg - light pink, engraved with "20 mG" on one side, on the other - "A / EH" in the form of a fraction; 40 mg - pink, engraved with "40 mG" on one side, on the other - "A / EI" in the form of a fraction (in blisters of 7 pcs., 1, 2 or 4 blisters in a cardboard box);
• Enteric-coated granules and pellets for the preparation of a suspension for oral administration: various sizes, pale yellow, brownish granules may occur (in triple laminated bags of 3042.7 mg, 28 bags in a cardboard box);
• Lyophilisate for the preparation of a solution for intravenous administration: a compressed mass of almost white or white color (5 ml in glass vials, 10 vials in paper racks, 1 stand in a cardboard box with control of the first opening).

The composition of 1 tablet includes:

• Active ingredient: esomeprazole - 20 or 40 mg (in the form of esomeprazole magnesium trihydrate - 22.3 or 44.5 mg);
• Auxiliary components (20/40 mg, respectively): glyceryl monostearate 40-55 - 1.7 / 2.3 mg, hyprolose - 8.1 / 11 mg, hypromellose - 17/26 mg, dye iron oxide red (E172) - 0, 06 / 0.45 mg, dye iron oxide yellow (E172) - 0.02 / 0 mg, microcrystalline cellulose - 273/389 mg, magnesium stearate - 1.2 / 1.7 mg, copolymer of ethacrylic and methacrylic acids (1: 1) - 35/46 mg, paraffin - 0.2 / 0.3 mg, polysorbate 80 - 0.62 / 1.1 mg, macrogol - 3 / 4.3 mg, crospovidone - 5.7 / 8.1 mg, sodium stearyl fumarate - 0.57 / 0.81 mg, sucrose spherical granules (sugar, spherical granules 0.25-0.355 mm in size) - 28/30 mg, titanium dioxide (E171) - 2.9 / 3.8 mg, talc - 14/20 mg, triethyl citrate - 10/14 mg.

The composition of 1 package of granules and pellets includes:

• Active ingredient: esomeprazole - 10 mg (in the form of esomeprazole magnesium trihydrate - 11.1 mg);
• Auxiliary components: talc - 8.4 mg, hyprolose - 32.2 mg, copolymer of ethyl acrylate and methacrylic acid (1: 1) - 9.5 mg, sugar, spherical granules (sucrose, spherical granules 0.250-0.355 mm in size) - 7, 4 mg, dextrose - 2813 mg, magnesium stearate - 0.65 mg, hypromellose - 1.7 mg, triethyl citrate - 0.95 mg, glycerol monostearate 40-55 - 0.48 mg, anhydrous citric acid - 4.9 mg, crospovidone - 75 mg, polysorbate 80 - 0.27 mg, xanthan gum - 75 mg, dye iron oxide yellow - 1.8 mg.

The composition of 1 bottle of lyophilisate for the preparation of an injection solution includes:

• Active ingredient: esomeprazole - 40 mg (in the form of esomeprazole sodium - 42.5 mg);
• Auxiliary components: disodium edetate dihydrate - 1.5 mg, sodium hydroxide - 0.2-1 mg.

Pharmacological properties

Nexium is a proton pump inhibitor.

Pharmacodynamics

Esomeprazole is the S-isomer of omeprazole and reduces the production of hydrochloric acid in the stomach by specifically inhibiting the proton pump in the parietal cells of the stomach wall. The R- and S-isomers of omeprazole have similar pharmacodynamic activity.

Esomeprazole is a weak base that transforms into an active form in an environment with increased acidity of the secretory tubules of parietal cells localized in the gastric mucosa. Also, the substance inhibits the proton pump - the enzyme H + / K + -ATPase. At the same time, both stimulated and basal secretion of hydrochloric acid is inhibited.

Esomeprazole takes effect within 1 hour after oral administration of 20 or 40 mg of Nexium. With daily use of the drug at a dose of 20 mg for 5 days 1 time per day, the maximum content of hydrochloric acid after stimulation with pentagastrin decreases on average by 90% (when determining the concentration of acid 6-7 hours after taking Nexium on the 5th day of treatment).

In patients with gastroesophageal reflux disease (GERD), accompanied by severe clinical symptoms, after 5 days of daily oral intake of esomeprazole at a dose of 20 or 40 mg, intragastric pH remained more than 4 for about 13 and 17 hours, respectively, out of 24 hours. Against the background of the use of esomeprazole in a daily dose of 20 mg, the intragastric pH remained stable above 4 for at least 16, 12 and 8 hours in 24%, 54% and 76% of patients, respectively. In the case of a dose of 40 mg, this ratio is 56%, 92% and 97%.

With the intravenous administration of esomeprazole at a dose of 80 mg for 30 minutes, followed by a prolonged intravenous infusion of the drug at a dose of 8 mg / h for 23.5 hours, the pH of the stomach remained on average above 4 for 21 hours and above 6 for 11 13 hours.

The level of esomeprazole in plasma correlates with the intensity of inhibition of the synthesis of hydrochloric acid (the AUC (area under the concentration-time curve) is used to determine the concentration).

When Nexium is taken at a dose of 40 mg in 78% of patients, healing of reflux esophagitis is observed after 4 weeks of treatment and in 93% - after 8 weeks of treatment. Taking the drug in a dosage of 20 mg 2 times a day in combination with carefully selected antibiotics for 1 week determines the successful eradication of Helicobacter pylori in about 90% of patients. Patients with uncomplicated peptic ulcer disease, after completing a weekly eradication course, do not need subsequent monotherapy with drugs that reduce the secretion of gastric glands to eliminate symptoms and effectively heal the ulcer.

With the help of Nexium treatment, great success was achieved in stopping bleeding from a peptic ulcer, diagnosed during endoscopic examination.

In 93.3% of patients aged 1–11 years, healing of erosive esophagitis was observed after 8 weeks of treatment with Nexium, which was confirmed by endoscopic studies. For patients weighing less than 20 kg, the drug was prescribed in a daily dose of 5 and 10 mg, and for patients weighing more than 20 kg - in a daily dose of 10 mg or 20 mg.

During therapy with drugs that suppress the secretion of gastric glands, the plasma gastrin content increases due to a decrease in the production of hydrochloric acid. Due to the inhibition of the synthesis of hydrochloric acid, the concentration of chromogranin A (CgA) increases. This phenomenon can affect the results of examinations that can detect neuroendocrine tumors. To prevent this, treatment with proton pump inhibitors should be discontinued 5-14 days prior to the CgA study. If after this period of time the concentration of the substance exceeds the normal values, it is recommended to repeat the analyzes.

In children and adult patients treated with esomeprazole for a long time, there is an increase in the number of enterochromaffin-like cells, probably due to an increase in the concentration of gastrin in plasma. The clinical significance of this phenomenon is minimal.

In patients who take drugs that inhibit the secretion of gastric glands for a long period of time, glandular cysts are more likely to form in the stomach. This is due to physiological changes due to pronounced inhibition of the production of hydrochloric acid. Cysts are benign and regressive.

The use of Nexium may be accompanied by the growth of microbial flora normally present in the gastrointestinal tract, and a slight increase in the risk of developing infectious diseases of the gastrointestinal tract, the causative agents of which are Campylobacter spp., Salmonella spp. and, probably, in patients in hospital with Clostridium difficile.

Nexium has a better efficacy compared to ranitidine in the healing of gastric ulcers in patients taking non-steroidal anti-inflammatory drugs (NSAIDs), including selective inhibitors of cyclooxygenase-2 (COX-2). In patients who took NSAIDs (over 60 years of age and / or a history of peptic ulcers), including selective COX-2 inhibitors, the drug has been shown to be highly effective as a prophylactic agent for the prevention of gastric and duodenal ulcers.

Pharmacokinetics

Esomeprazole is not stable in an acidic environment, therefore enteric-coated pellets are often used for oral administration. Under in vivo conditions, only a small part of the active component of Nexium is converted to the R-isomer. Esomeprazole is absorbed quickly enough: its maximum plasma level is recorded 1-2 hours after administration. The absolute bioavailability of the substance after a single dose of Nexium at a dose of 40 mg is 64% and increases to 89% with a daily intake of 1 time per day. When taking esomeprazole in a single dose of 20 mg, these figures are about 50% and 68%, respectively. In healthy people, the volume of distribution at the equilibrium concentration is approximately 0.22 l / kg of body weight. The degree of binding of esomeprazole to plasma proteins is approximately 97%.

With repeated intravenous administration of Nexium at a dose of 40 mg, its maximum plasma content on average reaches about 13.6 μmol / L.

Food intake inhibits and reduces the absorption of esomeprazole in the stomach, but this does not affect the effectiveness of inhibiting the synthesis of hydrochloric acid. The compound is metabolized with the participation of the cytochrome P450 system. The metabolism of the main part is carried out through a special polymorphic isoenzyme CYP2C19, and the final products are desmethylated and hydroxylated metabolites of esomeprazole. In the metabolic processes of the rest of esomeprazole, the isoenzyme CYP3A4 is involved, which is responsible for the formation of the sulfo-derivative of the active substance Nexium, the main metabolite found in plasma.

The total clearance is approximately 17 l / h after a single dose of Nexium and 9 l / h after multiple doses. The half-life is 1.3 hours with systematic administration at least 1 time per day. The area under the concentration-time curve (AUC) increases with repeated dosing. In this case, the dose-dependent increase in AUC is non-linear, which is caused by inhibition of metabolism due to the effect of "first pass" through the liver, as well as a decrease in systemic clearance, probably triggered by inhibition of the CYP2C19 isoenzyme by the active substance of Nexium and / or its sulfo derivative. With a daily intake of 1 time per day, esomeprazole is almost 100% excreted from the blood plasma in the intervals between its intake into the body and is not subject to cumulation.

With intravenous administration of Nexium at doses of 120 mg, 80 mg and 40 mg for 30 minutes, followed by administration at a dose of 8 mg / h or 4 mg / h for 23.5 hours, the linear dependence of AUC on the administered dose is determined.

The main metabolites of esomeprazole do not affect the production of hydrochloric acid. When taken orally, up to 80% of the dose is excreted through the kidneys, the rest through the intestines. Less than 1% of unchanged esomeprazole is present in urine.

In elderly patients (71–80 years), the metabolism of the drug does not change significantly. After a single dose of esomeprazole at a dose of 40 mg, the average AUC in women is 30% higher than that in men. With daily intake of Nexium 1 time per day, differences in pharmacokinetics in women and men are not recorded.

In patients with mild to moderate hepatic impairment, metabolic disorders of esomeprazole are sometimes observed. In patients with severe hepatic insufficiency, the metabolic rate decreases, which causes a 2-fold increase in the AUC value. In such patients, it is not recommended to exceed the maximum daily dose of 20 mg. When taking Nexium 1 time per day, esomeprazole and its main metabolites are not accumulated in the body.

The pharmacokinetics of the drug in patients with renal insufficiency is poorly understood. Since not esomeprazole itself is excreted in the urine, but its metabolites, it can be assumed that in such patients the metabolism of the active substance of Nexium does not change.

In children aged 12-18 years after repeated administration of 20 and 40 mg of esomeprazole, the AUC and the time to reach the maximum concentration of the substance in the blood plasma were similar to these parameters in adults. Repeated administration of 10 mg of the drug in children aged 1–11 years did not lead to a change in AUC compared to adolescents and adults who took this dose. Repeated intake of 20 mg of esomeprazole by patients of the same age group causes an increase in AUC 6-11 times compared with adolescents and adults who took this dose.

Indications for use

Granules and pellets for oral suspension, tablets

• Treatment of erosive reflux esophagitis;
• Long-term maintenance treatment in patients after healing of erosive reflux esophagitis (in order to prevent relapse);
• Symptomatic treatment of gastroesophageal reflux disease;
• Therapy for duodenal ulcers associated with Helicobacter pylori;
• Prevention of recurrence of peptic ulcer associated with Helicobacter pylori;
• Long-term acid suppression treatment after bleeding from a peptic ulcer (after intravenous administration of drugs that reduce the secretion of gastric glands to prevent relapse);
• Healing of stomach ulcers associated with the use of non-steroidal anti-inflammatory drugs;
• Prevention of gastric and duodenal ulcers associated with the use of non-steroidal anti-inflammatory drugs in patients at risk;
• Zollinger-Ellison syndrome or other conditions characterized by pathological hypersecretion (including idiopathic hypersecretion).

Lyophilisate for preparation of injection solution

Nexium in this dosage form is prescribed when it is impossible to conduct oral therapy (as an alternative).

For adults, the drug should be used if the following indications are present:

• Treatment of gastroesophageal reflux disease in patients with esophagitis and / or severe signs of reflux disease;
• Healing of peptic ulcers associated with the use of non-steroidal anti-inflammatory drugs;
• Prevention of peptic ulcers associated with the use of non-steroidal anti-inflammatory drugs in patients at risk;
• Prevention of recurrence of bleeding from peptic ulcers after endoscopic hemostasis.

For children 1-18 years old, Nexium is prescribed for gastroesophageal reflux disease against the background of erosive reflux esophagitis and / or severe symptoms of reflux disease.

Contraindications

• Glucose-galactose malabsorption, hereditary fructose intolerance, sucrose-isomaltase deficiency (tablets, granules and pellets);
• Concomitant use with atazanavir and nelfinavir;
• Hypersensitivity to the components of the drug, as well as to substituted benzimidazoles.

According to the instructions, Nexium should be used with caution in patients with severe renal failure.

Depending on the dosage form, Nexium is contraindicated in children in the following cases:

• Tablets: under 12 years old - all indications; age 12-18 years - all indications, except for gastroesophageal reflux disease;
• Granules and pellets: age up to 1 year or body weight less than 10 kg - all indications; age 1-11 years - all indications, except for erosive esophagitis and symptomatic treatment of gastroesophageal reflux disease; age 12-18 years - all indications, except for gastroesophageal reflux disease;
• Lyophilisate for preparation of injection solution: age up to 1 year - all indications; age 1-18 years - all indications except gastroesophageal reflux disease.

Pregnant women can be prescribed Nexium only after assessing the benefit / risk ratio for maternal and fetal health. During lactation for the period of therapy, it is recommended to interrupt breastfeeding.

Instructions for the use of Nexium: method and dosage

Granules and pellets for oral suspension, tablets

Nexium in the form of tablets must be swallowed whole (without chewing or crushing), washed down with liquid. If it is difficult to swallow, the tablet can be dissolved in 1/2 glass of still water. You should drink the resulting suspension of microgranules for 30 minutes, after which you need to fill the glass with 100 ml of water again, stir the rest of the drug and drink.

Nexium in the form of granules and pellets for the preparation of a suspension for oral administration, as a rule, is prescribed for children and patients with difficulty swallowing. To obtain 10 mg of the drug, the contents of 1 packet should be dissolved in 15 ml of water. Stir the resulting solution and wait a few minutes (until a suspension forms). The resulting suspension should be taken within 30 minutes, after which you need to fill the glass with the same volume of water again, stir the rest and take inside.

Use carbonated water to dissolve the drug, and do not crush or chew microgranules.

Patients who cannot swallow tablets diluted in still water or a suspension obtained from granules and pellets are administered through a nasogastric tube.

The following dosing regimen is recommended:

• Treatment of erosive reflux esophagitis (children 1-11 years old with a body weight of 10 kg, Nexium in the form of granules and pellets): a single dose for children weighing 10-20 kg is 10 mg, over 20 kg - 10-20 mg. Frequency rate of admission - 1 time per day, duration of therapy - 8 weeks;
• Symptomatic treatment of gastroesophageal reflux disease (children 1-11 years old with a body weight of 10 kg, Nexium in the form of granules and pellets): 1 time per day, 10 mg for up to 8 weeks;
• Treatment of erosive reflux esophagitis (adults and children from 12 years old): 1 time a day, 40 mg for a month. An additional four-week course of treatment is recommended if the symptoms of the disease persist or if the esophagitis is not cured after the first course;
• Long-term supportive therapy to prevent relapse (adults and children over 12 years old): 20 mg once a day;
• Symptomatic therapy of gastroesophageal reflux disease without esophagitis (adults and children from 12 years old): 20 mg 1 time per day. If symptoms persist after a month of therapy, an additional examination is necessary. After improvement, it is possible to switch to the Nexium reception mode "on demand", i.e. the drug is taken at the onset of symptoms before their removal in a daily dose of 20 mg in 1 dose. For patients taking non-steroidal anti-inflammatory drugs, and patients at risk of developing gastric or duodenal ulcers, therapy in the "as needed" mode is not recommended;
• Peptic ulcer and duodenal ulcer (simultaneously with other drugs) for the eradication of Helicobacter pylori, as well as treatment of duodenal ulcer associated with Helicobacter pylori, and prevention of recurrence of peptic ulcers associated with this bacterium in patients with peptic ulcer disease (adults): 2 times a day for 20 mg of Nexium, 500 mg of clarithromycin and 1000 mg of amoxicillin. The therapy is carried out for 7 days;
• Long-term acid suppression therapy in patients who have had bleeding from a peptic ulcer after intravenous administration of antisecretory drugs, for the prevention of relapse (adults): 1 time per day, 40 mg for 30 days (after the end of intravenous therapy with antisecretory drugs);
• Healing of stomach ulcers associated with prolonged use of non-steroidal anti-inflammatory drugs (adults): 1 time a day, 20 or 40 mg, course duration - 1-2 months;
• Prevention of gastric and duodenal ulcers associated with the use of non-steroidal anti-inflammatory drugs: 1 time per day, 20 or 40 mg;
• Conditions characterized by pathological hypersecretion, including Zollinger-Ellison syndrome and idiopathic hypersecretion: the initial dose is 40 mg 2 times a day. In the future, the dose is selected individually, the duration of the course is determined by the clinical picture of the disease.

Lyophilisate for preparation of injection solution

To dissolve the drug, you need to use only 0.9% sodium chloride solution.

Nexium Injection Solution should not be mixed or administered simultaneously with other drugs.

The drug is recommended to be administered immediately after its preparation. If necessary, it can be stored for 12 hours at temperatures up to 30 ° C.

Intravenous Nexium is prescribed when it is impossible to take the drug inside, the frequency of use is 1 time per day.

The dosage regimen is determined by the indications (daily dose):

• Treatment of esophagitis in gastroesophageal reflux disease: children 1-11 years old with a body weight of up to 20 kg - 10 mg; children 1-11 years old with a body weight of 20 kg - 10 or 20 mg; adults and children from 12 years old - 40 mg;
• Symptomatic treatment of gastroesophageal reflux disease: children 1-11 years old - 10 mg; adults and children from 12 years old - 20 mg;
• Healing of peptic ulcers associated with the use of non-steroidal anti-inflammatory drugs in patients at risk: adults - 20 mg;
• Prevention of peptic ulcers associated with the use of non-steroidal anti-inflammatory drugs: adults - 20 mg.

The period of parenteral administration of Nexium, as a rule, is short; it is recommended that the patient be transferred to taking the drug inside as soon as possible.

To prevent recurrence of bleeding from a peptic ulcer after endoscopic hemostasis, 80 mg of Nexium is usually prescribed as an intravenous infusion for 30 minutes, followed by an extended intravenous infusion at a dose of 8 mg per hour for 72 hours. To suppress acid secretion after the end of parenteral administration, it is recommended to carry out antisecretory therapy (for example, esomeprazole 1 time per day, 40 mg for 1 month).

The duration of Nexium administration is:

• Intravenous injections: 10, 20 and 40 mg - from 3 minutes;
• Intravenous infusion: 10, 20, and 40 mg - 10-30 minutes 80 mg - 30 minutes; 8 mg / h - 71.5 hours (as an extended infusion).

When bleeding from a peptic ulcer in patients with severe functional impairment of the liver, Nexium is prescribed 80 mg as an intravenous infusion for 30 minutes, followed by an extended intravenous infusion at a maximum dose of 4 mg per hour for 71.5 hours.

When Nexium is prescribed in all dosage forms for patients with impaired renal function, dose adjustment is not required. The drug is used with caution in patients with renal insufficiency.

Due to limited clinical experience, patients with severe renal failure should use Nexium with caution. The maximum daily dose for severe liver failure in adults and children over 12 years old should be no more than 20 mg, in children 1-11 years old - no more than 10 mg.

Elderly patients should not adjust the dosage regimen.

Side effects

• Nervous system: often - headache; infrequently - paresthesia, dizziness, drowsiness; rarely - taste disturbance;
• Musculoskeletal system: rarely - myalgia, arthralgia; very rarely - muscle weakness;
• Hematopoietic system: rarely - leukopenia, thrombocytopenia; very rarely - pancytopenia, agranulocytosis;
• Urinary system: very rarely - interstitial nephritis;
• Respiratory system: rarely - bronchospasm;
• Gastrointestinal tract: often - constipation, abdominal pain, diarrhea, flatulence, vomiting / nausea; infrequently - dry mouth; rarely - candidiasis of the gastrointestinal tract, stomatitis; very rarely - microscopic colitis confirmed by histological studies;
• Skin and subcutaneous tissues: often - reactions at the injection site (with intravenous administration); infrequently - dermatitis, rash, itching, urticaria; rarely - photosensitivity, alopecia; very rarely - toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme;
• Breasts and reproductive system: very rarely - gynecomastia;
• Liver and biliary tract: infrequently - increased activity of liver enzymes; rarely - hepatitis (with or without jaundice); very rarely - liver failure, encephalopathy in patients with liver disease;
• Organ of vision: rarely - blurred vision;
• Mental disorders: infrequently - insomnia; rarely - agitation, depression, confusion; very rarely - aggressive behavior, hallucinations;
• Metabolism: rarely - hyponatremia; very rarely - hypomagnesemia, hypocalcemia (associated with severe hypomagnesemia), hypokalemia (caused by hypomagnesemia);
• Allergic reactions: rarely - hypersensitivity reactions (in the form of fever, angioedema, anaphylactic reactions / anaphylactic shock);
• Others: infrequently - peripheral edema; rarely - sweating, malaise.

When Nexium is administered intravenously to critically ill patients, especially when high doses are administered, irreversible visual impairment may develop (a causal relationship with therapy has not been established).

Overdose

To date, there are references to isolated cases of deliberate overdose. Oral ingestion of esomeprazole at a dose of 280 mg was accompanied by unpleasant gastrointestinal symptoms and general weakness. A single dose of 80 mg of the drug did not lead to any negative consequences.

No antidote for esomeprazole has been found at this time. Dialysis is characterized by low efficiency due to the high binding of the active component of Nexium to plasma proteins. If necessary, symptomatic and general supportive therapy is prescribed.

special instructions

If any alarming signs appear (in the form of a significant sudden loss of body weight, repeated vomiting, dysphagia, vomiting mixed with blood), as well as in the presence of a stomach ulcer (or if it is suspected), it is necessary to exclude the presence of malignant neoplasms, since the use of Nexium can lead to smoothing of symptoms, which will delay the diagnosis.

When carrying out long-term treatment (especially longer than a year), patients should undergo regular medical supervision.

In cases of using the drug "as needed", the doctor should be informed about the appearance of atypical symptoms.

During the therapy for the eradication of Helicobacter pylori, it is necessary to take into account the possibility of drug interaction of all drugs used.

Patients who are at high risk of developing fractures or osteoporosis should be monitored clinically.

During therapy, care should be taken when driving vehicles, which is associated with the likelihood of side effects such as dizziness, drowsiness and blurred vision.

Drug interactions

With the simultaneous use of Nexium with some drugs, the following effects may occur:

• Ketoconazole, itraconazole, erlotinib: decrease in their absorption;
• Digoxin: increasing its absorption;
• Antiretroviral drugs (atazanavir, nelfinavir): decrease in serum concentration (combination not recommended);
• Saquinavir: increased serum concentration;
• Citalopram, diazepam, imipramine, phenytoin, clomipramine and other drugs, in the metabolism of which the isoenzyme CYP2C19 is involved: an increase in their concentration in plasma;
• Phenytoin: an increase in its residual concentration in patients with epilepsy;
• Tacrolimus, methotrexate: increased serum concentration;
• St. John's wort preparations, rifampicin: a decrease in the concentration of esomeprazole in the blood plasma.

Analogs

Analogues of Nexium are: Nexpro, Neo-Zext, Ezoxium, Ezonexa, Ezox, Ezolong, Esomealox, Emanera, Barol, Esomeprazole, Esomeprazole Canon, Esomeprazole Zentiva, Veloz, Geerdin, Controlok, Ozol, Omez, Normicidum, Razol, Ultop.

Terms and conditions of storage

Keep out of the reach of children.

Shelf life:

• Tablets: 3 years when stored at temperatures up to 30 ° C;
• Granules and pellets for preparation of a suspension for oral administration: 3 years when stored at temperatures up to 25 ° C;
• Lyophilisate for preparation of injection solution: 2 years when stored at temperatures up to 30 ° C, protected from light. Without a cardboard box, the bottle under room lighting can be stored for up to 24 hours.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Nexium

According to reviews, Nexium is an effective drug - a proton pump inhibitor that allows you to normalize acidity in the digestive tract. It has a pronounced therapeutic effect. Patients speak well of him, noting that the improvement came fairly quickly. Side effects are extremely rare, but some patients do not like the high cost of Nexium.

The price of Nexium in pharmacies

The approximate price of Nexium in tablets with a dosage of 20 mg is 1431-1584 rubles (for a pack of 14 pcs.) And 2557-2837 rubles (for a pack of 28 pcs.). You can buy tablets with a dosage of 40 mg for 1797-1994 rubles (14 pcs per pack) or 3274-3588 rubles (28 pcs per pack).

Enteric-coated granules and pellets are available for purchase for 1,846–2049 rubles (packaging includes 28 bags). A lyophilisate for preparing a solution for intravenous administration will cost 5534-5710 rubles (the package includes 10 bottles).

Nexium: prices in online pharmacies

Drug name Price Pharmacy

Nexium 20 mg film-coated tablets 14 pcs. RUB 128 Buy

Nexium 20 mg film-coated tablets 28 pcs. 201 RUB Buy

Nexium 40 mg film-coated tablets 14 pcs. 226 r Buy

Nexium tablets p.p. 20mg 28 pcs. 248 r Buy

Nexium 40 mg film-coated tablets 28 pcs. 387 r Buy

Nexium tablets p.p. 40mg 28 Pcs. 398 RUB Buy

Nexium 10 mg enteric coated pellets and granules for oral suspension 28 pcs. 1467 RUB Buy

Nexium pellets p.p. and granules for prig suspension. for internal approx. 10mg 28 pcs. 1902 RUB Buy

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Maria Kulkes Medical journalist About the author

Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!