Esofour
Generic Name
Esomeprazole 40 mg tablet
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| esofour 40 mg tablet | ৳ 9.60 | ৳ 134.40 |
Description
Overview of the medicine
Esofour 40 mg Tablet is a proton pump inhibitor (PPI) used to treat various conditions involving excessive stomach acid production. It helps to reduce acid secretion in the stomach, providing relief from symptoms and promoting healing of acid-related damage.
Uses & Indications
Dosage
Adults
For erosive esophagitis: 20 mg or 40 mg once daily for 4 to 8 weeks. For GERD symptoms: 20 mg once daily for 4 weeks. For H. pylori eradication: 20 mg twice daily for 7-10 days (with antibiotics). For Zollinger-Ellison syndrome: Initial dose 40 mg twice daily, adjusted as needed.
Elderly
No specific dose adjustment is required for elderly patients, but caution is advised in those with severe hepatic impairment.
Renal_impairment
No dose adjustment is necessary for patients with impaired renal function.
How to Take
Take Esofour 40 mg Tablet orally, usually once daily, at least one hour before a meal. Swallow the tablet whole; do not crush, chew, or split it. If you have difficulty swallowing, some preparations can be dissolved in water (check specific product instructions).
Mechanism of Action
Esomeprazole selectively inhibits the H+/K+-ATPase proton pump on the secretory surface of the parietal cells in the stomach. This action blocks the final step in acid production, reducing both basal and stimulated acid secretion.
Pharmacokinetics
Onset
Acid inhibition occurs within 1 hour.
Excretion
Approximately 80% of metabolites are excreted in the urine and the remaining 20% in the feces.
Half life
Plasma elimination half-life is approximately 1.0-1.5 hours.
Absorption
Rapidly absorbed after oral administration, with peak plasma concentrations occurring within 1-2 hours. Bioavailability increases with repeated dosing.
Metabolism
Extensively metabolized in the liver by the cytochrome P450 (CYP) enzyme system, mainly CYP2C19 and CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to esomeprazole, other substituted benzimidazoles, or any component of the formulation.
- Concomitant use with nelfinavir.
Drug Interactions
Warfarin
Increased INR and prothrombin time have been reported, requiring monitoring.
Clopidogrel
Esomeprazole may reduce the antiplatelet effect of clopidogrel by inhibiting its metabolism to its active form.
Methotrexate
May increase methotrexate levels, especially with high doses.
Atazanavir, Nelfinavir
Reduced absorption and efficacy of these antiretroviral drugs due to increased gastric pH.
Diazepam, Citalopram, Phenytoin
May alter metabolism, potentially increasing levels of these drugs.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Experience with esomeprazole overdose is limited. Symptoms are generally mild and reversible. Management should be symptomatic and supportive. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Esomeprazole is excreted in human breast milk; therefore, use with caution in nursing mothers.
Side Effects
Contraindications
- Hypersensitivity to esomeprazole, other substituted benzimidazoles, or any component of the formulation.
- Concomitant use with nelfinavir.
Drug Interactions
Warfarin
Increased INR and prothrombin time have been reported, requiring monitoring.
Clopidogrel
Esomeprazole may reduce the antiplatelet effect of clopidogrel by inhibiting its metabolism to its active form.
Methotrexate
May increase methotrexate levels, especially with high doses.
Atazanavir, Nelfinavir
Reduced absorption and efficacy of these antiretroviral drugs due to increased gastric pH.
Diazepam, Citalopram, Phenytoin
May alter metabolism, potentially increasing levels of these drugs.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Experience with esomeprazole overdose is limited. Symptoms are generally mild and reversible. Management should be symptomatic and supportive. There is no specific antidote.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Esomeprazole is excreted in human breast milk; therefore, use with caution in nursing mothers.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from manufacturing date
Availability
Available in pharmacies and hospitals nationwide
Approval Status
Approved by Directorate General of Drug Administration (DGDA), Bangladesh
Patent Status
Generic version, off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of esomeprazole in various acid-related disorders, including GERD, erosive esophagitis healing, and H. pylori eradication. Studies support its superior acid suppression compared to some other PPIs.
Lab Monitoring
- Monitor serum magnesium levels periodically in patients expected to be on prolonged treatment or those taking other drugs that may cause hypomagnesemia.
- Monitor liver enzymes if there is clinical indication of hepatic dysfunction.
Doctor Notes
- Assess the need for long-term PPI therapy regularly; consider step-down or discontinuation if appropriate.
- Be aware of potential drug interactions, especially with clopidogrel and warfarin.
- Advise patients about potential long-term risks, including bone fractures and hypomagnesemia, and consider monitoring if necessary.
- Educate patients on proper administration (before meals, swallow whole).
Patient Guidelines
- Take the medication exactly as prescribed by your doctor.
- Swallow the tablet whole with water; do not crush, chew, or split it.
- Take it at least one hour before a meal.
- Continue taking the medication for the full prescribed duration, even if symptoms improve.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Esomeprazole generally does not affect the ability to drive or operate machinery. However, if you experience side effects like dizziness or visual disturbances, you should avoid driving or operating machinery.
Lifestyle Advice
- Avoid foods and drinks that trigger acid reflux, such as spicy, fatty, or acidic foods, caffeine, and alcohol.
- Quit smoking.
- Maintain a healthy weight.
- Avoid eating large meals close to bedtime.
- Elevate the head of your bed.
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