Algita-D
Generic Name
algita-d-500-mg-tablet
Manufacturer
Square Pharmaceuticals PLC
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| algita d 500 mg tablet | ৳ 11.00 | ৳ 110.00 |
Description
Overview of the medicine
Algita-D 500 mg tablet is a combination medication primarily used to treat gastroesophageal reflux disease (GERD), peptic ulcers, and conditions associated with nausea and vomiting. It combines a proton pump inhibitor (PPI), Esomeprazole, with a prokinetic agent, Domperidone. Esomeprazole reduces stomach acid production, while Domperidone helps in accelerating gastric emptying and preventing reflux. The '500 mg' in the formulation name is highly unusual for standard Esomeprazole and Domperidone combinations, which typically specify strengths like Esomeprazole 20mg/40mg and Domperidone 10mg/30mg. This specific strength might indicate a unique formulation or is used as a generic identifier.
Uses & Indications
Dosage
Adults
Typically one tablet daily before breakfast. The specific dosage (e.g., Esomeprazole 40mg + Domperidone 30mg MR) should be determined by a physician based on patient condition.
Elderly
No specific dose adjustment for elderly patients is generally needed, but caution should be exercised in those with renal or hepatic impairment.
Renal_impairment
For severe renal impairment (creatinine clearance < 30 ml/min), the frequency of Domperidone administration should be reduced (e.g., once or twice daily instead of three times daily). No dose adjustment required for Esomeprazole in renal impairment.
How to Take
Take the tablet orally, preferably 30-60 minutes before a meal. Swallow the tablet whole with water; do not chew, crush, or break it.
Mechanism of Action
Esomeprazole blocks the H+/K+-ATPase enzyme system (proton pump) in gastric parietal cells, leading to a sustained reduction in gastric acid secretion. Domperidone is a peripheral dopamine D2 receptor antagonist, which increases esophageal and gastric motility, enhances gastric emptying, and has antiemetic effects by blocking dopamine receptors in the chemoreceptor trigger zone (CTZ).
Pharmacokinetics
Onset
Esomeprazole: Within 1 hour. Domperidone: 30-60 minutes.
Excretion
Esomeprazole: Approximately 80% is excreted in the urine and 20% in the feces. Domperidone: Approximately 66% is excreted in the feces and 33% in the urine, mainly as metabolites.
Half life
Esomeprazole: Approximately 1-1.5 hours. Domperidone: 7-9 hours (longer in severe renal impairment).
Absorption
Esomeprazole is rapidly absorbed after oral administration, with systemic bioavailability increasing to approximately 90% after repeated dosing. Domperidone is rapidly absorbed from the gastrointestinal tract, but undergoes extensive first-pass metabolism resulting in a low oral bioavailability of about 15%.
Metabolism
Esomeprazole is extensively metabolized in the liver by the cytochrome P450 enzyme system, mainly by CYP2C19 and CYP3A4. Domperidone is extensively metabolized in the liver by CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to Esomeprazole, Domperidone, or any excipients
- Known prolongation of QT interval or history of cardiac disease (e.g., congestive heart failure)
- Moderate to severe hepatic impairment (for Domperidone)
- Prolactin-releasing pituitary tumor (prolactinoma)
- Concomitant use with potent CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, clarithromycin)
- Conditions where gastrointestinal stimulation might be harmful (e.g., GI hemorrhage, mechanical obstruction, perforation)
Drug Interactions
Warfarin
Concomitant use with Esomeprazole may increase INR and prothrombin time, requiring monitoring.
Clopidogrel
Esomeprazole (and other PPIs) may reduce the antiplatelet effect of clopidogrel by inhibiting CYP2C19. Consider alternative antiplatelet therapy.
Methotrexate
PPIs may increase serum methotrexate levels, particularly with high-dose methotrexate. Monitor carefully.
Antacids/Sucralfate
May reduce the absorption of Esomeprazole. Administer at least 2 hours apart.
QT-prolonging drugs (e.g., some antipsychotics, antiarrhythmics)
Increased risk of QT prolongation and cardiac arrhythmias with Domperidone. Concomitant use should be avoided or used with extreme caution.
Potent CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, clarithromycin)
Can significantly increase Domperidone plasma concentrations, increasing the risk of QT prolongation and cardiac adverse events. Concomitant use is contraindicated.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, disorientation, tachycardia, and extrapyramidal reactions (for Domperidone); and drowsiness, blurred vision, flushing, and headache (for Esomeprazole). Management is symptomatic and supportive. Gastric lavage and activated charcoal may be considered. ECG monitoring is essential in Domperidone overdose due to the risk of QT prolongation and cardiac arrhythmias.
Pregnancy & Lactation
Use during pregnancy only if clearly needed and the potential benefits outweigh the potential risks, as adequate human data are limited. Both Esomeprazole and Domperidone are excreted in breast milk in small amounts; potential risk to the breastfed infant (especially cardiac effects for Domperidone). Not recommended during breastfeeding unless considered essential by a physician.
Side Effects
Contraindications
- Hypersensitivity to Esomeprazole, Domperidone, or any excipients
- Known prolongation of QT interval or history of cardiac disease (e.g., congestive heart failure)
- Moderate to severe hepatic impairment (for Domperidone)
- Prolactin-releasing pituitary tumor (prolactinoma)
- Concomitant use with potent CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, clarithromycin)
- Conditions where gastrointestinal stimulation might be harmful (e.g., GI hemorrhage, mechanical obstruction, perforation)
Drug Interactions
Warfarin
Concomitant use with Esomeprazole may increase INR and prothrombin time, requiring monitoring.
Clopidogrel
Esomeprazole (and other PPIs) may reduce the antiplatelet effect of clopidogrel by inhibiting CYP2C19. Consider alternative antiplatelet therapy.
Methotrexate
PPIs may increase serum methotrexate levels, particularly with high-dose methotrexate. Monitor carefully.
Antacids/Sucralfate
May reduce the absorption of Esomeprazole. Administer at least 2 hours apart.
QT-prolonging drugs (e.g., some antipsychotics, antiarrhythmics)
Increased risk of QT prolongation and cardiac arrhythmias with Domperidone. Concomitant use should be avoided or used with extreme caution.
Potent CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, clarithromycin)
Can significantly increase Domperidone plasma concentrations, increasing the risk of QT prolongation and cardiac adverse events. Concomitant use is contraindicated.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, disorientation, tachycardia, and extrapyramidal reactions (for Domperidone); and drowsiness, blurred vision, flushing, and headache (for Esomeprazole). Management is symptomatic and supportive. Gastric lavage and activated charcoal may be considered. ECG monitoring is essential in Domperidone overdose due to the risk of QT prolongation and cardiac arrhythmias.
Pregnancy & Lactation
Use during pregnancy only if clearly needed and the potential benefits outweigh the potential risks, as adequate human data are limited. Both Esomeprazole and Domperidone are excreted in breast milk in small amounts; potential risk to the breastfed infant (especially cardiac effects for Domperidone). Not recommended during breastfeeding unless considered essential by a physician.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from the date of manufacture.
Availability
Pharmacies, Hospitals
Approval Status
DGDA Approved
Patent Status
Off-patent
Clinical Trials
Clinical studies have demonstrated the efficacy and safety of Esomeprazole and Domperidone for their respective indications, both individually and in various combination formulations for the management of GERD, dyspepsia, and related motility disorders.
Lab Monitoring
- For long-term PPI use: Monitor Vitamin B12 levels periodically.
- For long-term PPI use: Monitor Magnesium levels, especially in patients on diuretics or other hypomagnesemia-inducing drugs.
- For Domperidone use: ECG monitoring is recommended for patients with cardiac risk factors or those taking other QT-prolonging drugs.
Doctor Notes
- Carefully assess patient history for cardiac risk factors, including QT prolongation, before initiating Domperidone.
- Advise patients on lifestyle modifications as an adjunct to pharmacotherapy for GERD.
- Periodically review the necessity and duration of PPI therapy to minimize long-term risks.
- Be aware of potential drug interactions, especially with CYP3A4 inhibitors and QT-prolonging agents.
Patient Guidelines
- Take this medicine exactly as prescribed by your doctor.
- Swallow the tablet whole with water, do not chew, crush, or break it.
- Preferably take it 30-60 minutes before meals for best results.
- Inform your doctor about all your medical conditions, especially heart problems, and all other medicines you are taking.
- Report any unusual symptoms like palpitations, dizziness, or muscle spasms immediately to your doctor.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine may cause dizziness or somnolence (drowsiness). If you experience these effects, avoid driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Avoid trigger foods such as spicy, fatty, acidic foods, caffeine, chocolate, and peppermint.
- Eat smaller, more frequent meals instead of large ones.
- Avoid lying down immediately after eating; wait at least 2-3 hours.
- Elevate the head of your bed to reduce nighttime reflux.
- Quit smoking and reduce alcohol consumption, as these can worsen GERD symptoms.
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