Esomeprazole: English spelling of Esomeprazol
Esomeprazole is the English spelling of the active ingredient Esomeprazol, which is designated as such in international medical literature and on English-language package inserts. In German medical terminology and in German pharmacies, the correct spelling is Esomeprazol. Both spellings refer to the same active ingredient and are used synonymously in practice. This page is intended for patients who have found the term Esomeprazole in English-language sources or on imported preparations and are seeking information.
Esomeprazole is a proton pump inhibitor (PPI) from the group of benzimidazoles and is among the most frequently prescribed gastric acid blockers worldwide. In Germany, Esomeprazole has been approved since 2001 and is available in various strengths both as a prescription medication and in lower doses as an over-the-counter (OTC) product. Well-known brand names containing Esomeprazole include Nexium, Esomep, and numerous generics. For detailed information on the active ingredient profile, indications, dosage, side effects, and drug interactions, see our Esomeprazol main page.
Definition
Esomeprazole corresponds to English nomenclature and is used in English-language publications, international package inserts, and original preparations. In Germany, the correct spelling is Esomeprazol, and patients usually encounter the form Esomeprazole on imported preparations or in English-language sources.
Pharmacologically, Esomeprazole is the pharmacologically active S isomer of Omeprazole. While Omeprazole exists as a racemate composed of S and R isomers, Esomeprazole contains exclusively the S isomer, which leads to improved pharmacokinetics with longer duration of action and stronger acid suppression. This chiral purity distinguishes Esomeprazole from Omeprazole pharmacologically. More information on the main page for Esomeprazole.
Mechanism of action
Esomeprazole irreversibly blocks the H+ K+ ATPase (proton pump) of the parietal cells in the stomach. This proton pump is responsible for gastric acid secretion. Esomeprazole is a prodrug that is activated in the acidic environment of parietal cells and binds covalently to the proton pump. This leads to long-term inhibition of acid secretion until new proton pumps are synthesized, which takes approximately 1 to 2 days. For more details on the mechanism of action, see the Esomeprazol main page.
Indications
- Gastroesophageal reflux disease (GERD) with heartburn, reflux esophagitis, and healing of mucosal damage
- Gastric and duodenal ulcer in acute therapy and recurrence prophylaxis
- Helicobacter pylori eradication in combination with antibiotics (triple or quadruple therapy)
- NSAID associated gastric protection in patients at risk for gastric ulcers while taking pain relievers
- Zollinger Ellison syndrome and other hypersecretory conditions
Dosage and administration
GERD and reflux esophagitis in adults: 20 to 40 mg once daily orally, typically for 4 to 8 weeks.
Maintenance therapy after reflux esophagitis: 20 mg once daily.
Helicobacter pylori eradication: 20 mg twice daily in combination with Amoxicillin and Clarithromycin or Bismuth-based regimen, typically 7 to 14 days.
NSAID gastric protection: 20 mg once daily.
Zollinger Ellison syndrome: 40 to 80 mg per day, in individual cases higher doses, divided into two single doses.
Administration: Take tablets whole with water, approximately 30 to 60 minutes before a meal, ideally before breakfast. If swallowing is difficult, the tablet may be dissolved in water.
Renal insufficiency: dose adjustment usually not required. Hepatic insufficiency: in case of severe impairment, reduce dose to 20 mg per day.
Side effects
Common: Headache, abdominal pain, diarrhea, constipation, nausea, vomiting, bloating.
Uncommon: Skin rash, pruritus, dermatitis, dizziness, dry mouth, sleep disturbances, weight changes.
Rare: Hyponatremia, hypomagnesemia (especially with long-term use), vitamin B12 deficiency, elevated liver values, taste disturbances, visual disturbances, confusion (especially in elderly patients), bone fractures (especially hip, vertebral, and wrist fractures, risk increased with prolonged use).
Very rare: Severe skin reactions such as Stevens Johnson syndrome, acute interstitial nephritis, hepatotoxicity, pancreatitis, microscopic colitis, collagenous colitis, subacute cutaneous lupus erythematosus (SCLE).
For more details on side effects, see the Esomeprazol main page.
Drug interactions
- Clopidogrel: Reduction of antithrombotic effect due to CYP2C19 inhibition, avoid combination if possible, consider alternative PPI.
- High-dose Methotrexate: Increased Methotrexate levels, use caution and possibly pause PPI.
- HIV therapeutics: PPIs may reduce absorption of Atazanavir and Nelfinavir, combination contraindicated.
- Ketoconazole, Itraconazole: Reduced absorption due to increased pH, consider alternative antifungals.
- Diazepam, Phenytoin, Warfarin, Citalopram: Increased levels due to CYP2C19 inhibition.
- Iron preparations, Vitamin B12: Reduced absorption with long-term PPI use.
Special notes
Pregnancy: Possible with strict indication at low dose. Breast-feeding: Limited data, individual assessment required.
Children: Approved from 1 year of age in age-appropriate dosage.
Long-term use: Regular re-evaluation of indication is recommended because prolonged use carries risks such as hypomagnesemia, vitamin B12 deficiency, increased risk of Clostridium difficile infection and pneumonia, and increased fracture risk.
If symptoms worsen or new warning symptoms such as weight loss, difficulty swallowing, vomiting blood, or tarry stools appear, medical evaluation is necessary.
For Helicobacter pylori eradication: Treatment adherence is important because inadequate intake promotes the development of resistance.
Ability to drive: Generally not impaired, use caution if dizziness or visual disturbances occur.
You might also be interested in
- Esomeprazol, main page for this active ingredient
- Omeprazol, racemic precursor of Esomeprazol
- Pantoprazol, another PPI with similar indications
- Lansoprazol, another PPI
- Ranitidine, H2 blocker (no longer available)
Frequently asked questions
Is Esomeprazole the same as Esomeprazol?
Yes, Esomeprazole is just the English spelling of Esomeprazol. Pharmacologically, it is the identical substance with the same effect, same indications, and same side effects. In English-language sources and on imported preparations, the form Esomeprazole is used, in Germany Esomeprazol.
What is the difference between Esomeprazol and Omeprazol?
Omeprazol is a racemate, which is a mixture of two enantiomers (S and R isomers). Esomeprazol is the pure S isomer of Omeprazol. Pharmacokinetically, Esomeprazol has slightly longer duration of action and somewhat stronger acid suppression at comparable doses. Clinically, however, both substances are very similarly effective, and the differences in practice are often minor.
Which spelling is correct in Germany?
In German pharmacies and German medical terminology, Esomeprazol is the correct spelling. On package inserts and in the Red List, this form is consistently used. Patients usually encounter Esomeprazole on imported preparations or in English-language sources.
Where can I find detailed information about this active ingredient?
For detailed information on mechanism of action, indications, dosage, side effects, drug interactions, and notes, see our main page for Esomeprazol. This page contains the comprehensive main page with all aspects of the active ingredient.
Sources
- Gelbe Liste, Esomeprazol active ingredient profile
- BfArM, Federal Institute for Drugs and Medical Devices
- German Society for Gastroenterology, Digestive and Metabolic Diseases
- AWMF S2k guideline on gastroesophageal reflux disease and Helicobacter pylori
Legal notices and disclaimer
The information provided on this page is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment recommendation. It does not replace the advice of a licensed physician or pharmacist. All information is based on specialist information published at the time of preparation and recognized scientific sources; the current specialist information from the manufacturer is always authoritative. Sanoliste assumes no liability for completeness, currency, or accuracy of the information presented. In a medical emergency, call the emergency number 112.