Peptic ulcer bleeding following therapeutic endoscopy: a new indication for intravenous esomeprazole

Intravenous (IV) administration of the esomeprazole is a faster way to achieve gastric acid suppression than oral administration of the same agent. Peak suppression following IV administration occurs within hours compared with several days following oral administration. Thus, the IV administration route offers a faster onset of gastric suppression, achievement of intragastric pH closer to target levels, and better bioavailability. Treatment of peptic ulcer bleeding is the newest indication for the IV formulation of esomeprazole. The drug is effective in preventing rebleeds following endoscopic treatment when administered within 24 hours of the procedure as an 80-mg bolus followed by an IV infusion for 72 hours. What remains to be seen is whether oral therapy can be substituted for all, or part, of the 72-hour IV infusion and whether the patient can be discharged from the hospital sooner with similar outcomes.