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esomeprazole

esomeprazole
Brand names: NexIUM
Form Strength
POWDER FOR RECONSTITUTION, DELAYED RELEASE, ORAL 40 mg
Display Proton-pump Inhibitors Class: 562836
Medication comments:

Per policy, orders for these non-formulary agents will be changed to formulary equivalents.  
Non-Formulary Agent Formulary Equivalent
esomeprazole (NexIUM) 20-40 mg IV pantoprazole (Protonix) 40 mg IV at same frequency
(see policy in the event of drug shortages.)
esomeprazole (NexIUM) 20-40 mg PO pantoprazole (Protonix) 40 mg PO at same frequency (esomeprazole (NexIUM) 40 mg packets if patient receives medication through a tube)
esomeprazole (NexIUM) for pediatric patients esomeprazole (NexIUM) granules - mix 40 mg packet with 15 ml distilled water = 40 mg/15ml final concentration. One hour expiration, all doses to be prepared in pharmacy. Dosing: refer to Lexicomp Online Search or other reference.
Per policy, these drugs may be converted from IV to PO in patients who meet criteria.  
esomeprazole(NexIUM) may convert from IV to PO on a mg-to-mg basis.
2023 American Geriatrics Society Beers Criteria® for potentially inappropriate medication use in older adults.
Medication: esomeprazole (NexIUM)
Criteria 1: Potentially inappropriate medication use in older adults. (Table 2)
Drug(s) proton-pump inhibitors
Rationale Risk of C. difficile infection, pneumonia, GI malignancies, bone loss, and fractures.
Recommendation Avoid scheduled use for >8 weeks unless for high-risk patients (e.g., oral corticosteroids or chronic NSAID use), erosive esophagitis, Barrett's esophagitis, pathologic hypersecretory condition, or demonstrated need for maintenance treatment (e.g., because of failure of drug discontinuation trial or H2-receptor antagonists).
 Quality of evidence: C. difficile, bone loss, and fractures: High
Pneumonia and GI malignancies: Moderate, Strength of Recommendation: Strong
Last updated: Sep. 19, 2025
UpToDate Lexidrug

Pharmacy Contact Info:

Main Inpatient Pharmacy: ext 4599, 3503
Fax: 704-878-7283

Director of Pharmacy - Randi Raynor, PharmD: ext 4501
Clinical Coordinator - Laura Rollings, PharmD: ext 4597
Pharmacy Informaticist - Stephen Pringle, PharmD: ext 7645
Pharmacy Technician Supervisor - Amy Wingler, CPhT: ext 7385
Pharmacy Automation Coordinator (Omnicell) - Melissa Fulford, CPhT: ext 3556



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