Does Nexium Come as a Liquid?
Yes, Nexium (esomeprazole) is available as a liquid formulation called "delayed-release oral suspension" that comes in individual packets (sachets) containing granules that are mixed with water to create a suspension. 11
Available Liquid Formulations
The FDA-approved Nexium for delayed-release oral suspension is available in the following packet strengths 1:
- 2.5 mg
- 5 mg
- 10 mg
- 20 mg
- 40 mg
Each packet contains enteric-coated granules (the same type used in the capsules) plus inactive granules that are mixed with water to form a suspension 1.
How to Prepare the Liquid
The preparation is straightforward 1:
- For 2.5 mg or 5 mg doses: Mix with 5 mL of water
- For 10 mg, 20 mg, or 40 mg doses: Mix with 15 mL of water
- Reconstitution time: 2 minutes with water
- Stability: Must be used within 30 minutes after mixing
- Leave mixture for 2-3 minutes to thicken before administering
Administration Options
The liquid formulation can be given 11:
- Orally (by mouth or with oral syringe for young children)
- Via nasogastric tube (French size 6 or larger)
- Via gastric tube
Research confirms that nasogastric tube administration provides bioavailability similar to oral dosing with intact capsules 2, and the packet formulation is bioequivalent to both capsule and tablet forms 3.
Clinical Context
This liquid formulation was specifically developed for patients who have difficulty swallowing 3. The pediatric guideline notes that esomeprazole is FDA-indicated for ages 1-17 years, and the availability of different formulations (including the ability to sprinkle capsule contents or use the suspension) makes dosing feasible across age groups 4.
Important caveat: The suspension must be prepared fresh each time and used within 30 minutes, as the enteric-coated granules are designed to protect the drug from degradation in acidic environments 11.