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Intravenous Dilution Guidelines

esomeprazole sodium - Nexium ®

The authors make no claims of the accuracy of the information contained herein; and these suggested doses and/or guidelines are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this document shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.    PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.

Usual Diluents

NS , D5W

Standard Dilutions   [Amount of drug] [Infusion volume] [Infusion rate]

[ 20 mg ] [ 50 ml ] [ 10 to 30 min]
[ 40 mg ] [ 50 ml ] [ 10 to 30 min ]
(Dilute each vial with 5 ml NS)

Label: Do not refrigerate.

Stability / Miscellaneous

Stability data:

Drug Stability
Refrigerated
Stability
Room Temp.
Reconstituted
Vial/Powder
Notes P-Insert
Updated
Esomeprazole - Nexium   Store at 20° to 25°C (68° to 77°F).  The reconstituted solution of esomeprazole sodium for injection should be stored at room temperature up to 30°C (86°F) and administered within 12 hours after reconstitution. (Administer within 6 hours if 5% Dextrose Injection is used after reconstitution). No refrigeration is required Powder Protect from light. Store in carton until time of use.

Following reconstitution and administration, discard any unused portion of esomeprazole solution.
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INDICATIONS
: NEXIUM I.V. for Injection is indicated for the short-term treatment (up to 10 days) of GERD patients with a history of erosive esophagitis as an alternative to oral therapy in patients when therapy with NEXIUM Delayed-Release Capsules is not possible or appropriate.

DOSAGE AND ADMINISTRATION:
GERD with a history of Erosive Esophagitis: The recommended adult dose is either 20 or 40 mg esomeprazole given once daily by intravenous injection (no less than 3 minutes) or intravenous infusion (10 to 30 minutes). NEXIUM I.V. for Injection should not be administered concomitantly with any other medications through the same intravenous site and or tubing. The intravenous line should always be flushed with either 0.9% Sodium Chloride Injection, Lactated Ringer’s Injection, or 5% Dextrose Injection, both prior to and after administration. Safety and efficacy of NEXIUM I.V. for Injection as a treatment of GERD patients with a history of erosive esophagitis for more than 10 days have not been demonstrated.

Renal Insufficiency
The pharmacokinetics of esomeprazole in patients with renal impairment are not expected to be altered relative to healthy volunteers as less than 1% of esomeprazole is excreted unchanged in urine.

Preparations for use:
No refrigeration is required. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

IV Injection: The freeze-dried powder should be reconstituted with 5 mL of 0.9% Sodium Chloride Injection, USP. Withdraw 5 mL of the reconstituted solution and administer as an intravenous injection over no less than 3 minutes. The reconstituted solution should be stored at room temperature up to 30°C (86°F) and administered within 12 hours after reconstitution.

Intravenous Infusion (20 or 40 mg) over 10 to 30 minutes: A solution for intravenous infusion is prepared by first reconstituting the contents of one vial with 5 mL of 0.9% Sodium Chloride Injection, Lactated Ringer’s Injection, or 5% Dextrose Injection, and further diluting the resulting solution to a final volume of 50 mL. The solution (admixture) should be administered as an intravenous infusion over a period of 10 to 30 minutes. The admixture should be stored at room temperature up to 30°C (86°F) and should be administered within the designated time period as listed in the Table below.

Diluent

Administer within:

5% Dextrose Injection, USP

6 hours

Lactated Ringer’s Injection, USP

12 hours

0.9% Sodium Chloride Injection, USP

12 hours



Storage:
Store at 25°C (77°F); excursions permitted to 15°-30°C (59°-86°F). Protect from light. Store in carton until time of use.

HOW SUPPLIED:
NEXIUM I.V. for Injection is supplied as a freeze-dried powder containing 20 mg or 40 mg of esomeprazole per single-use vial.


Source: Nexium (package insert). Willmington, DE: AstraZeneca LP; April 2007. http://www.astrazeneca-us.com/pi/nexium_iv.pdf
Disclaimer
The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.  PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.
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