When This Medicine Should Not Be Used:
This medicine is not right for everyone. You should not receive it if you had an allergic reaction to esomeprazole or similar medicines.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• A nurse or other health provider will give you this medicine.
• Your doctor will give you a few doses of this medicine until your condition improves, and then switch you to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how esomeprazole works. Tell your doctor if you are using any of the following:
  
  • Atazanavir, cilostazol, digoxin, erlotinib, ketoconazole, methotrexate, mycophenolate mofetil, nelfinavir, rifampin, saquinavir, St John's wort, tacrolimus, voriconazole
  • Blood thinner (such as clopidogrel or warfarin)
  • Diuretic (water pill)
  • Iron supplements

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have liver disease or osteoporosis.
• This medicine may cause the following problems:
  
  • Kidney problems
  • Broken bones in the hip, wrist, or spine
  • Low magnesium levels in the blood
• This medicine can cause diarrhea. Call your doctor if the diarrhea becomes severe, does not stop, or is bloody. Do not take any medicine to stop diarrhea until you have talked to your doctor. Diarrhea can occur 2 months or more after you stop taking this medicine.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, red skin rash
• Fast, slow, pounding, or uneven heartbeat
• Fever, joint pain, swelling in your body, unusual weight gain, changes in how much or how often you urinate
• Seizures, dizziness, muscle spasms, muscle cramps or twitching
• Severe diarrhea that does not go away, fever
• Stomach pain, nausea, vomiting, weight loss

If you notice these less serious side effects, talk with your doctor:

• Gas
• Headache
• Redness, pain, itching, swelling, or a lump under your skin where the needle is placed

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088