Esomeprazole

Usage in Neonatal age group

GERD

Routine use is not recommended in preterm neonates 

Term and preterm neonates: Oral: 0.5 mg/kg/dose once daily. 

DURATION of therapy in symptomatic GERD : 

Guidelines recommend a 4 to 8 week treatment course; if improvement seen after 4 to 8 

weeks, consider possible wean; if no response after 4 to 8 weeks, re-evaluate diagnosis and consider referral to  a Pediatric GI specialist 

Pediatric age group

Erosive esophagitis associated with GERD:

Infants:

3 to 5 kg: 2.5 mg once daily for up to 6 weeks.

>5 to 7.5 kg: 5 mg once daily for up to 6 weeks.

>7.5 kg: 10 mg once daily for up to 6 weeks.

Children 1 to 11 years:

<20 kg: 10 mg once daily for 8 weeks.

≥20 kg: 10 or 20 mg once daily for 8 weeks.

Children ≥12 years and Adolescents: 20 to 40 mg once daily for 4 to 8 weeks.

Weight-based dosing: Infants, Children, and Adolescents: Oral: 0.7 to 3.3 mg/kg/day  maximum dose: 40 mg/dose.

Discontinuation of therapy: A step-down approach in order to avoid worsening or rebound symptoms. Decrease the dose by 50% over 2 to 4 weeks. If the patient is already on the lowest possible dose, alternate day therapy may be considered. 

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