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►•least f«ad :n i SBrnaurf-caretoity aad then M your doctor afecat MfXtUM Ho advertisement tan proerdf in tie
n‘»rw»tHttMe(t?d in prescr oe a «tv| To* n»<efl»seme« lots not u«e tie puce of careful discussions wiffc your doctor
Qp-i *ojr decor lus tne t« »enjn Itie nsis mo Benefits ol a prescription drug for you
NEXIUM* (esomeprazoie magnesium)
20-mg, 40-mg Delay ed-Release Capsules
M» SUMMAIIY Boon prescnttng NEXIUM own see M PrekcnDmg tnfomwoo MDtCAIIONS AND USAGE NEXIUM s Mated
for tfK shon-wrtr traitment (4 to 8 wwks) n the hm«ng ano symptorrutK feso*ut«y» o< dagnosticjity esopnagrtis thermite,
nano of fyinotom rawkrtior M heakng of erosiw esopiraguis icontroked studies do nrt emend beyond 6 months). jnd lor the tnatmeni of
fwrthuni iffl other symotoms assocolad Nth G6 a C CONntAt4DtCAnONS NEXIUM sconbvidratbdKDnents win know hyorsen.
vtwxyuaaycofnpaiwntcttMlormuaaonoriosubstßuwdtannmdanitts PKCAUTIONS Symotonutic -csDonse so merapy antn NBxiUM
Ms -a oredude M ore*™ of gone masgiwcy Atraoktc gens bus bun voted xasnmi n gstnc axons »ws tram warns
™* longNm wet onspraals. of •Kelt NEXHJM is an enmomei hforaaiwi for Miwnfs NEXIUM Dereyeo-Retase Gvsules should
MsnaooKl «*oae an) Man (Wst one hour Mon meels Foi omits vduhMtkfflcuNyswiinwiigapsutemtilNsooon of aootesuuce
cantNaddsfltoansnsMyMHanjthsffEXiUMDsiaM-ffslaasiCapsuiscarf aownsa am aw outlets oreMy emptw onto ms miesuuce
Tl» pests soouM M mood sum 0* wwsiuce and Own ssatoml mmsMafi The seoHauce used sMmo not H M and snoulo bs soil
enough to ee svrairowed without chewing The octets stioufd oofbechewed or crushed fa oefletiooresauce mature shoufa not a stonO for
Mon iiso Antaoits imy a used iMs taking NEXUS Drag Mansdiom Esomeonnie a extensively meaMMd * to kwr Oy CYP2CI9
anOCXP3M m reromdvi wwstuJes bare shown thHesomeorecoif dm* Hofy to rt«rtC'lT , slA2.2« 2C9 206 2EI and3A4 Nocknoiy
-efovanf meiacaoits with drugs mstaoofeso a iaso CVF* eroymes would a exoected Drag rtnehon states nave shown that esomeonroif
don not haw any ctmscaSy sigmhcare eitndmni with gtenysom. raaftarin. oundna. clantfiroanyon oi amoncitei Posi-raaftamg icffotts of
etianges m orothrombm measjies have Deen rscsnsO anong wants on concornfam wartarei ano esomeoraroie thereby increases« M and
OfMombn hme may Wd to aonomaf DWdhig and iren otatn Raoents mateo with grown pun; mtabdors wd warfarin conconwanby may
nooo to Do monooraO lor nersasos m INR and DnxhromOm time fsomeorarow may potamsaDy mtertere wdh CYPZCI9 ta maiot esonegraroie
ffOtaMangonayta Coddmuiisdmidesonwram 30 mg and daeeoam. a CXTTOBsudstraie, resulted ma 45% decrease ncWranceol
Satopant increased plasma lot Mot Otatcoam wore obscired 12 hours allot Oosaig and ononis Horn* attnat time the glasnia lewis ol
diaiipam mis DolwrlficthoraQMic nerval and Hus ttys onoradionaunMafy to (tool cane* rslovanco Esomeeraffl* inhibits gash* aw
secrebra Tharelore esomeoramm*etertmwtttheabcixgMoldragswhngasbxo* danangosantdeleininantofbioavailabiktyitg
SatoconaiM. iron sans and dtgoxm) Coadnwustrahon ot ore cootraceobves. marapam ohenytom organon Ad not ssem to cargo me
pttatmacokaWc grate ot tsomoptaa* Cnttniugonoiii, MnOrn—iii. Nnpownrenl ot Fortuity ta carcinogenic goiontiai ot
esomepraafi was assessed using omoptaaote states in h»24-mon* or* caronogencrty studies n rets omesirva* a oety dosos of 17.3 4,
13.1.44 0 and 140 6 mgSgtPay (aboa 07a 57 Pnas Ha human doss a2O mgfflay expressed on a body satace ana Pass) Adduced gastnc
EClcedcaroaoids a a dosf-relMd manner a bodi male and female rats mo rodence of trss effect was marked* «iglw m Nina* rats wracf
had isgnr Mood imts ot onopraa* Gastnc canmds seldom ocw m mo umroaleo r* in addition Ea cal hyootplasia ns present m all
treated groups ol noth sees hi MotmeestaMs loniale tats aero heated ootti 13 «mg otmptatoM»day|atiM 5 6 tunes mo human oose
on a hody surface araahasis I la 1 year then tdonddlpr an adtNonal year anliout the drag Ho caronods note seen at mesa rats Unwesseo
nMnca ot treatment-ntated Ea cel hyporplasu «s opstrw) n the end a 1 year 194\ treated re 19% controls) By the second year me
ddterence bahuoen heated and cprarat rats was much sntader |4C\rs 26%) but shl showed more hyperplasia <n the treated group Gastnc adeno
carcinoma nas seen dm rat (2%). No sender tianor <OOIOOOIO mats or lemale rats treated tor 2 years For ms sham ot rat no srmto tumor
has been noted twtoncaly bid a trndng motring only m tumor srhlhcud to interpret A/Street mouse carcmogerecrty study olomeptame
did not sheer nereased tianor ocomence Out the study nas not condusivi Esomeprarote nas nagatnem the Ames mutabon test.® the nnw
rat bM matron cal chromosome aberrabon lest and the n mo mouse ncranucltus test Esomeptatoie hoomr. ms positne it tha at mo
human tympnocyle chromcdome abenaon test Omspritole nas potrbve n me in ntro human tymphocyte chromosome aberrebon test, the m
mo mouse bone matron cel chromosome aberration test and the at mo mouse micronucleus lest The potential ettects ot esomeprarole on
fertility and reproduce performance mre assessed usatgomepiaioia shapes Omeprso* atom doses up to t3Bmg»gidaym rats (about 56
bmes the human dM on a body surface area basis) ms lound to hare no effect on reproductive performance ot parental ammals Pregnancy
rmotmcl Sects Pregnancy GamgoryS Teratology studies hare been performed ntals at oral doses up to 260 mgikg/day (atoms? times me
tnnnan dose on a body suttace area bass) and at rabbdsl oral doses up to 66 mghgoayiaooul 35 bmes the human dose on a body surface area
basrst and nava revealed no evidence of anpared lenday or harm to the letus M to isomepranle Thereare.honever.noadequateandnel
controdedstiahes at pregnam noman Because animal reproduction studies are not ahvays predrctive ol human response this drug should be used
during pregnancy only 4 dearly needed Teratology studies condoned mthomeprattue* rats at oral doses up to 138 mgdigrday {about 56 omes
the human dose on a body surface area bass) and at rabbits at doses«to 69 mgAgrday about 56 lanes the human dose on a bod* surface area
ban) did not drsdose any evidence lor a teratogenic potential ol oroepcaitae in redoes omepraaoli r a dose range ot 6 9 to 691 mgAgnsay
labout 55 to 56 omes the human dose on a body surface area taasas) produced dose-naled increases ei embryo-Mality. fetal resorptions and
pregnancy dnrugmms. In rats doseKemd embrro/M loaaaty and postnatal developmental toaauty vrere observed m oltspnng resuttaig bom
parents into Mh omepraMi at 13 6 to 136.0 mgiiigfday labout 5 6to 56 omes me human doses on a body surface area bass) Thereareno
adeem* and wiFeontroded studies « pregnant uomen Sporadic reports neve been received ot congenital aonoimalibes occumng at mtanis bom
to wmen who have received omepiatoie during piegnancy Nursing Mothers The excretion ol esomeptatoie mm* has nol been studied
Hoetnrer.omepranie concentrations Im been measured n breast mdh of a smmantodmnng oral admanstration 0126 mg Because esomeoratoie
is Wyto be excreted at human mdh. because ol the polenbal tor senous adverse reattonsm nursmg mtams from esomepraroie ano because ol
die potential tor tumongemerty shoem lor omeprasue m rat carantgemcity studies a deesron should be made nhether to dlscoimnui nursmg or
10 discortnua the ihug takmg mto account the rmportanca ol the drug to the mother Ndinlric Use Safety and eltectwness at pediatric patents
have not been estabhsned ADVERSE FACTIONS The safety of NEXMM was evaluated mover 10.000 patents ;agec 18-64 yuarslmctmcal
trials smruhmde including mar 7,400 pabeids n the United States and over 2.60 C patients in Europe and Canada. I>«r 2.900 paoents were treated
ntaxHerm studies lor up to 6-12 morons In general. NEXIUM nas uod foferaied n bom short- and long-term cancel trots The safety m the
treatment ot heating m erosive esoptages nas assessed ei lour landonuted comparative ctascat trials aahah included 1.240 wtents on NEXIUM
20 mg 2.434 pMids on ICOtAt 40 mg. and 3.008 pabonts on omepiatoie 20 mg daily The most treouently occumng adverse events (et%)m
al three groups *as headache (5 5.5 0. and 3.8. respectnaly) ano darrhea (no dmerena among me three grouosi Nausea haMence.abdtmina
pam. consbpahon and *y mourn occurred at sunder rates among patients takmg NEXIUM or omepratoie Additional adverse events that nere
reported as possibly or probably related to NEXIUM vnth an andenco < 1 % are hstad beknv by Body system Indy as a Mote eoootnen enlarged
ahertpe reaaon.astherea. bach pain, chest pam chest pam suostemaf tacrat edema penpherar edema, hot (lushes tahgue lever Vtdie disorder
ganaraaad edema leg edema, malaise, pam. ngors CtHimtaUr tnrshmg hypertensror tachycaroia fadocnee goner Sim,Mam
borne! uregmarty conswanon aggravated dyspepsia dysphagia dysplasia Gl eoigastnc pam. eructation esophageal OOTder beouem stools
gastroemenhs. Gl hemonhage Gl symKoms not omeranse specified hccup meiana mourn dsorder. pnarym disorder rectal disorder serum
gastnn increased tongue disorder tongue edema idcsrsbvf stomatitis vomiting Hearing earache bnnrtus Hemawogic anemia anemia
hypochromc. caracal lymphoadenopathy eprsians leuuocyloss. leukopenia. tnraenDocylooenia. Hepatic Ddnubmema hepatic function
abnormal SGOT increased. SGW increased ffatabalicMtHhaast giycosuna, hyperunceima nyponalreima increased ahahne phosphatase
mast marmn 812 deficiency vmght increase Mgl* decrease MuammiM: arthralgia arthritis aggravated arthrooatby cramps
hbromyaima syndrome hanuapotymyaigiartieumalica HervnieSyste»ftyriiia*lc. anore)aa. apathy apoeme mcreased contusion, depression
aggravated dininess hypartona. nervousness hypoesthesra rrnpotcnce msomma. rngrame mgrame aggravated, paresthesia sleep disorder,
somnolence tremor vertigo visual f*d Delect Aearadacffve dysmenonhei menstrual dsorder regents ttesoiramry asthma aggravated
coughmg dyspnea larynx edema pharyngns. tunits smusms Sim aadAppeadagas acne angioedema. dermablis pruntus. pruritus an. rash,
rash erythematous rash macutoorailar skmiollammabon svreatmg increased umcana Special Senear obbsmeda parosmia taste toss taste
perreision UragaMef. abnormal urn. aHummuna, cysbbs, dysbra, hmgN Section bematbna mcuinbon begaancy. monuase, gendai morel
as«.poiybna gnejltconiunctvrtis vseyiabnomH EndoscoK tmtlmgs M vuare regoneo as adveise events include duodenhs esophagsis
esoonageal stricture esoonageal meerabor esophageal rencas. gastnc idem gasmtis bema benign polyps 01 nodules Barrens esophagus ano
mucosa dscotorabon Tvm piacebiKontroiled sturaes were conducmcm 710 patents lot the beitmem of symptomatic gasboesopirageai renux
disease The mosl common adrerse events lhauere reported as possfOey or probaMymaM 10 NEXIUM mere dianbea |4.3%) beadache(3S%)
and abdommd pan 138%) Postmartehng Reports - There have been spontaneous reports ot adveise erents unth postmaikebng use ot
espmipraiole These reports have metudad rare cases ol anaphylactic reacDon and myalgia severe detmatoiogic reactions inamhng low
epmarmd nacrohysis (TEN. some lata) Stevens-Johnson syndroms, and eiytbema mutworme and pancreams Vary rarely hepaits mth or
wthout iiondice has bnen reported Other adrerse events not oPserred unth NEXIUM hut occumng with omepra2ole cat In hand in the
omeorafflle package insert ADVEME REACTtOM sector OVHtOOiAGC A single ora) dose otesomepratnie a 510 mgrtig (about 103 omes
tire human dost on a body sixtace area bass) was lettta to rets The mator signs ot acute toocity were reduced motor activity, changes m
respiratory troqwncy tremor, aaxia. and eneinuttemcJertcconvuSioos There hare boen some reports a oyeroosagewrthesomap'arole Reports
haw been nemo of oreroosage with omepratoie m humans Doses ranged up to 2.400 mg 1120 times the usua recommended drned dosei
Mandeaabons were nanane bid included contusion drowsiness, bkjned vsion tactiycanha. nausea, dapnoresis hushing headache ay mourn
and otbr adrerse reactions smidv to um seen a norma ctencaexpenence (see omenrazoie package msertAOVEItSEREACnUNS Nospechc
•“dote tor esomepran* s known SMctesomepratoiesnleiisireiyproMboimd «s not eapecteo to be removed by diatysis Intneewntot
oreTOosage bbebrwsnoiißMsymtnoindic and supportive As with the management ol any overdose, toe possokty ot muinole drag ngesbon
snadd be considered For cunent eitormaPOb on treatment a any drug onroose a crerMred Ragionaf Fhxsom Control Cantoc stwxjia Oe comsacM
Tetecnone numbers are Wed n the Physreans Desk Retaence iPDR) or loca tewnone book DOSAGE ANO ADMINISTRATION Please
she hut Rrescnbmg Intormacion tor recommended aduh dosages lot NEXIUM Forwbentswbohawanasogastnclubeaplace NEXIUM Desaycd
(taease Capsules can be opened and the witact granules emptied mto a 60 mL synnge and muted with 50 ml gl water Reoiace me ptunget and
sfiaka 0» ayrmgi ngorousty lor 15 saants. Hold the syrmgewdn the t* up and check lot granules remauvng mote bp Attach the syringe to a
nasogastric tuba and debwr the contants a tt» syringe through the nasogastric tuba mto die stomacn After admmistenng me granules me
nasogasbic tube should be hushed with addawid water Oorenadmimstei the pehelsd they bare dissolved or damegraM Tl» suspension must
be mi unmeduseh ilia DreoaWon Special Populoiiom In aduns no dosage amusements are necessary based on age gender or renal
rnsidhoency paoents w«b teoabc msulbcency no dosage adiustmentis necessary ei paoents with mild to moderate kwnmoairment ictuid
Ciasses A and B) tor gaoents with aerev met mpanment (Chid Fhrgb Class C) a dose a 20 mg a NEXIUM should not oe eroeeded
NEXIUM is a registered trademark a the AstraZeneca group a companies
©AstraZeneca 2004 Ajt ngbts reserved
DtstribuMd by AstraZeneca LP MfUrrangSon DE19650
Product a Franca /)
AstraZeneca
References:
Castell DO. Kahrilas PJ, Richter JE, el al. Esomeprazoie (40 mg)
compared with lansoprazole (30 mg) in the treatment of erosive esophagitis
Am J Gastroenterol. 2002:97:575-583.
Data on file. DA-NEX-37.
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“I’ve made this pie for family
and friends for 36 years. Many people say that they
haven’t heard of a German chocolate pie. Once they try
it, however, they usually want the recipe."
German Chocolate Pie
4 ounces German chocolate
1/4 cup butter
I and 1/2 cup sugar
3 tablespoons cornstarch
1/8 teaspoon salt
1 teaspoon vanilla
2 eggs, beaten
I and 1/2 cup evaporated
milk
I unbaked I O-inch pie crust
Topping:
I and 1/3 cup shredded
coconut
1/2 cup chopped pecans
Preheat oven to 375 degrees. In microwave,
melt chocolate and butter on a low setting in
a medium-size microwave-safe bowl. Stir sev
eral times during melting process to prevent
burning. When chocolate is melted, stir in
sugar, salt, vanilla, cornstarch and eggs until
well blended. Stir in evaporated milk until
smooth. Pour into pie shell. Mix coconut and
pecans together. Sprinkle them evenly over
the chocolate mixture. Use a knife to cut
through the coconut into the chocolate mix
ture in several places. Bake 45 to 50 minutes,
or until center is set
Tips From Our Test Kitchen:
The pie center puffs slightly and the top
begins to crack when it is done. If the crust
becomes too brown, place a piece of foil over
the top of the entire pie for the final 15 min
utes of baking. A dollup of whipped cream can
be added if desired.
Page 4
•American Profile
Janet Curtis
North Platte, Neb.