Medicine Information

Esogap

Name: Esogap
Brand: Esogap
Rating: 4.5 (117 reviews)

Tablet40 mgProton Pump Inhibitor (PPI), AntiulcerantATC: A02BC05

Generic Name

Esomeprazole 40 mg Tablet

Manufacturer

Example Pharmaceutical Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
esogap 40 mg tablet	৳ 8.00	৳ 80.00

Description

Overview of the medicine

Esogap 40 mg Tablet contains Esomeprazole, a proton pump inhibitor used to reduce stomach acid production. It is prescribed for conditions like gastroesophageal reflux disease (GERD), peptic ulcers, and Zollinger-Ellison syndrome.

Uses & Indications

Gastroesophageal Reflux Disease (GERD)

Erosive Esophagitis healing and maintenance

Symptomatic GERD

Zollinger-Ellison Syndrome

Prevention of NSAID-associated gastric ulcers

H. pylori eradication (in combination therapy)

Dosage

Adults

For Erosive Esophagitis: 20 mg or 40 mg once daily for 4-8 weeks. For GERD symptoms: 20 mg once daily for 4 weeks. For Zollinger-Ellison Syndrome: Initial dose 40 mg twice daily, adjusted as needed. For H. pylori eradication: 40 mg once daily with antibiotics for 10 days.

Elderly

No specific dose adjustment is necessary, but caution is advised in elderly patients with severe hepatic impairment.

Renal_impairment

No dose adjustment is necessary for patients with renal impairment.

How to Take

Swallow the tablet whole with a glass of water, at least one hour before a meal. Do not chew or crush. If difficulty swallowing, disperse in water.

Mechanism of Action

Esomeprazole is an S-isomer of omeprazole and a proton pump inhibitor. It reduces gastric acid secretion by specifically inhibiting the H+/K+-ATPase (proton pump) in the gastric parietal cells. This inhibition is dose-dependent and irreversible, leading to a profound and prolonged reduction of gastric acid secretion.

Pharmacokinetics

Onset

Within 1 hour (acid secretion inhibition)

Excretion

Primarily excreted in the urine (approximately 80%) as metabolites, and to a lesser extent in the feces (approximately 20%).

Half life

Approximately 1-1.5 hours

Absorption

Rapidly absorbed after oral administration. Peak plasma concentrations reached within 1-2 hours. Bioavailability is approximately 64% after a single 40 mg dose, increasing to 89% with repeated once-daily administration.

Metabolism

Extensively metabolized in the liver by the cytochrome P450 (CYP) enzyme system, primarily by CYP2C19 and CYP3A4. Metabolites are inactive.

Side Effects

Contraindications

Hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation.
Concomitant use with nelfinavir.

Drug Interactions

Digoxin

Increased plasma levels of digoxin, monitor closely.

Warfarin

Increased INR and prothrombin time, monitor closely.

Clopidogrel

Reduced effectiveness of clopidogrel (CYP2C19 inhibition), consider alternative antiplatelet therapy.

Methotrexate

Increased plasma levels of methotrexate, especially with high doses.

Nelfinavir, Atazanavir

Decreased plasma levels of antiretroviral drugs, avoid co-administration.

Diazepam, Citalopram, Imipramine, Phenytoin

May increase exposure to these drugs metabolized by CYP2C19.

Storage

Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.

Overdose

Symptoms of overdose are generally mild and include drowsiness, confusion, blurred vision, tachycardia, nausea, sweating, headache, dry mouth, and other gastrointestinal disturbances. Treatment is symptomatic and supportive.

Pregnancy & Lactation

Pregnancy Category B. Studies in animals have not shown harm, but adequate human studies are lacking. Use only if clearly needed. Excretion in human milk is unknown, use with caution.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets (1x10 blister)20 tablets (2x10 blister)

Shelf Life

Typically 2-3 years from manufacturing date

Availability

Pharmacies, Hospitals

Approval Status

Approved by regulatory bodies (e.g., FDA, DGDA)

Patent Status

Generics available, patent expired for original formulation

WHO Essential Medicine

Yes

Clinical Trials

Extensive clinical trials have demonstrated esomeprazole's efficacy and safety in various acid-related disorders. Ongoing research continues to explore new applications and formulations.

Lab Monitoring

Magnesium levels (if long-term use or with diuretics)
Chromogranin A (CgA) levels (can interfere with neuroendocrine tumor diagnosis)

Doctor Notes

Consider bone density screening for long-term users.
Assess magnesium levels periodically.
Review necessity of continued PPI therapy regularly.
Educate patients on potential risks of long-term use.

Patient Guidelines

Take as directed by your doctor.
Do not stop taking the medicine suddenly without consulting your doctor.
Report any severe or persistent side effects.
Inform your doctor about all other medications you are taking.

Missed Dose Advice

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

Driving Precautions

Esomeprazole is generally not expected to affect the ability to drive or operate machinery. However, some side effects like dizziness or blurred vision may occur rarely, in which case caution should be exercised.