From the Research
Esomeprazole dosing for neonates is typically 0.5 mg/kg once daily, as this dose has been shown to be effective in reducing esophageal acid exposure and the number of acidic reflux events in neonates 1. For premature neonates and those under 1 month of age, this dose is generally recommended to start. The medication should be administered at least 1 hour before a feeding, preferably in the morning. For neonates who cannot swallow capsules, the contents can be mixed with a small amount of water and administered via an oral syringe or feeding tube. Some key points to consider when administering esomeprazole to neonates include:
- Treatment duration should be limited to the shortest time necessary to control symptoms, typically 4-8 weeks, with reassessment of the need for continued therapy.
- Esomeprazole works by inhibiting the proton pump in gastric parietal cells, reducing acid production in the stomach, making it effective for treating gastroesophageal reflux disease (GERD) and related conditions in neonates.
- However, long-term use should be approached cautiously due to potential risks including increased susceptibility to infections, altered gut microbiome, and possible effects on nutrient absorption.
- Regular monitoring for adverse effects and periodic attempts to discontinue therapy are recommended, as seen in studies such as 2 and 1. It's also important to note that the pharmacokinetics of esomeprazole in neonates may be different from those in older children and adults, and the dose may need to be adjusted accordingly, as suggested by studies like 3 and 4. Overall, the use of esomeprazole in neonates should be carefully considered and monitored to ensure the best possible outcomes for these patients.