Overview of Esomeprazole (NexIUM®) for Canines and Felines
- Esomeprazole, commonly known by the brand name Nexium®, is used in the treatment and prevention of stomach (gastric) and intestinal ulcers in dogs and cats. This is a commonly used human medication but there are few studies about its use in veterinary medicine.
- Other drugs in this class are more commonly used such as Omeprazole (Prilosec®). To avoid mistakes or confusion, please note the similarity between the names of these two different drugs – Omeprazole and ESometrazole.
- Esomeprazole is one of the newest drugs used in the treatment of ulcers and heartburn (acid reflux from the stomach) belonging to a class of drugs called proton pump inhibitors. Esomeprazole is such a drug and has been used for the treatment and prevention of stomach ulcers.
- Esomeprazole inhibits the movement of hydrogen ions which are constituents of hydrochloric stomach acid. Through this effect, esomeprazole blocks acid secretion in the stomach that creates a more favorable stomach pH to allow ulcers to heal.
- The duration of effect for esomeprazole is 24 hours.
- Esomeprazole is available without a prescription in low does oral forms. It is recommended that you not administer any medication unless under the supervision and guidance of a veterinarian.
- This drug is not approved for use in animals by the Food and Drug Administration but it is prescribed legally by veterinarians as an extra-label drug.
Brand Names and Other Names of Esomeprazole
- This drug is registered for use in humans only.
- Human formulations:
- Esomeprazole Magnesium Oral Delayed-Release Capsules
- Magnesium Powder for Oral Delayed-Release Suspension NexIUM®
- Esomeprazole Sodium for Injection
- Veterinary formulations: None
Uses of Esomeprazole for Dogs and Cats
- Esomeprazole can be used in the treatment and prevention of stomach (gastric) and intestinal ulcers.
- Esomeprazole promotes ulcer healing in animals with ulcers or erosions (shallow depressions in the stomach lining).
- Esomeprazole may be useful in the treatment of ulcers caused by ulcerogenic drugs such steroids (such as prednisone or dexamethasone) or non-steroidal anti-inflammatory drugs (commonly abbreviated as NSAID which includes aspirin, carprofen (Rimadyl), meloxicam, deracoxib (Deramaxx) and many more.
- Another use of Esomeprazole is for the management of acid reflux disease. Esomeprazole reduces injury to the esophagus (food tube) caused by the movement of stomach acid from the stomach into the esophagus.
Precautions and Side Effects
- While generally safe and effective when prescribed by a veterinarian, Esomeprazole can cause side effects in some animals.
- Esomeprazole should not be used in animals with known hypersensitivity or allergy to the drug.
- Esomeprazole should be used with caution in animals with liver disease. Lower doses may be used in pets with severe liver disease.
- Esomeprazole may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with esomeprazole. Such drugs include diazepam, cyclosporine, digoxin, rifampin, ketoconazole, itraconazole, clarithromycin, sucralfate, warfarin, diuretics, oral iron, mycophenolate, methotrexate, and ampicillin.
- Esomeprazole has not been approved for use in breeding, nursing, or lactating dogs.
- Adverse reactions to esomeprazole are uncommon as long as recommended doses are administered. Occasionally, some animals develop nausea, vomiting, flatulence, anorexia, diarrhea, urinary tract infections and/or central nervous system disturbances.
- Here is some information about if your dog accidentally eats Nexium and you are worried about potential overdose.
How Esomeprazole Is Supplied
- Esomeprazole Magnesium is supplied as Oral Delayed-Release Capsules in sizes of 20 mg and 40 mg.
- Esomeprazole Magnesium Powder for Oral Delayed-Release Suspension in 2.5, 5, 10, 20, and 40 mg packets.
- Esomeprazole Sodium is available for Injection: 20 & 40 mg.
Dosing Information of Esomeprazole for Dogs and Cats
- Medication should never be administered without first consulting your veterinarian.
- Oral doses should be given on an empty stomach or at least one hour before eating.
- The dose of oral Esomeprazole administered to dogs and cats is 0.25 to 0.75 mg per pound (0.5 to 1.5 mg/kg) every 24 hours or once daily.
- The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse or prevent the development of resistance.
References and Resources
- ASPCA Pet Poison Hotline
- Current Veterinary Therapy XV, Bonagura and Twedt
- Pet Poison Helpline
- Plumb’s Veterinary Handbook by Donald C. Plumb, 8th Edition
- Textbook of Veterinary Internal Medicine, Ettinger & Felman
- Videla, R., et al.. Effects of Intravenously Administered Esomeprazole Sodium on Gastric Juice pH in Adult Female Horses. Journal of Veterinary Internal Medicine. 2011.
- Zacuto, A. C., et al. The Influence of Esomeprazole and Cisapride on Gastroesophageal Reflux During Anesthesia in Dogs. Journal of Veterinary Internal Medicine. 2012.