Esomeprazole Dosing Guidelines for Pediatric Patients

Introduction to Esomeprazole Dosing

• The American Academy of Pediatrics recommends esomeprazole dosing for children aged 1-11 years with GERD at 10 mg once daily for those weighing 10 to <20 kg and 20 mg once daily for those weighing ≥20 kg 1

Weight-Based Dosing for GERD and Erosive Esophagitis

• For children with GERD, weighing 10 to <20 kg, the recommended dose is 10 mg once daily 1
• For children with GERD, weighing ≥20 kg, the recommended dose is 20 mg once daily 1

Dosing for Eosinophilic Esophagitis

• For children with eosinophilic esophagitis, the initial treatment dose is 1 mg/kg twice daily (maximum 40 mg twice daily) 1
• For children with eosinophilic esophagitis, the maintenance therapy dose is 1 mg/kg/day (maximum 40 mg/day) 1
• The twice-daily regimen at 1 mg/kg provides the anti-inflammatory effects needed beyond simple acid suppression, as supported by evidence from the Gut journal 2

Administration Instructions

• For children unable to swallow capsules, the pellets can be mixed with applesauce for oral administration 1
• Administering esomeprazole approximately 30 minutes before meals is recommended for optimal acid suppression 3

Safety Profile

• Long-term use of esomeprazole exceeding 2.5 years may cause enterochromaffin cell hyperplasia in up to 50% of children 1