Medicine Information

Esoral

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

Powder for Oral Suspension20 mgProton Pump Inhibitor (PPI)ATC: A02BC05

Generic Name

Esomeprazole

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
esoral 20 mg powder	৳ 7.00	N/A

Description

Overview of the medicine

Esomeprazole is a proton pump inhibitor (PPI) that reduces the amount of acid produced in the stomach. It is used to treat conditions such as gastroesophageal reflux disease (GERD), stomach ulcers, and to prevent NSAID-associated ulcers. The 20 mg powder form is often suitable for patients who have difficulty swallowing tablets.

Uses & Indications

Treatment of gastroesophageal reflux disease (GERD) including erosive esophagitis.

Maintenance of healing of erosive esophagitis.

Symptomatic treatment of non-erosive reflux disease.

Eradication of Helicobacter pylori (in combination with antibiotics) for healing of H. pylori-associated duodenal ulcers.

Prevention of gastric ulcers associated with NSAID therapy in at-risk patients.

Treatment of Zollinger-Ellison Syndrome and other pathological hypersecretory conditions.

Dosage

Adults

For GERD: 20 mg or 40 mg once daily for 4-8 weeks. For H. pylori eradication: 20 mg twice daily for 10 days (in combination). For NSAID-associated ulcers prevention: 20 mg once daily. Mix contents of one sachet with 15 mL of water, stir and drink immediately. Do not crush or chew.

Elderly

No dosage adjustment is generally required. However, caution is advised due to potential age-related decrease in renal or hepatic function.

Renal_impairment

No dosage adjustment is necessary for patients with impaired renal function. However, caution should be exercised in severe cases.

How to Take

Empty the contents of one sachet into a glass containing 15 mL (1 tablespoon) of water. Stir the mixture well and drink immediately. Do not crush or chew the granules. Take at least 30-60 minutes before a meal, preferably in the morning.

Mechanism of Action

Esomeprazole is an S-isomer of omeprazole. It is a proton pump inhibitor that specifically inhibits the H+/K+-ATPase enzyme system (the proton pump) at the secretory surface of the gastric parietal cells. This action blocks the final step in acid production, leading to a profound and long-lasting reduction in gastric acid secretion.

Pharmacokinetics

Onset

Acid inhibition starts within 1 hour.

Excretion

Approximately 80% of the dose is excreted as metabolites in the urine, and the remainder in the feces.

Half life

Plasma elimination half-life is approximately 1.5 hours.

Absorption

Rapidly absorbed after oral administration. Bioavailability is approximately 60% after a single 20 mg dose, increasing to 68% after repeated daily dosing.

Metabolism

Extensively metabolized in the liver by the cytochrome P450 system, primarily by CYP2C19 and CYP3A4.

Side Effects

Contraindications

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

Drug Interactions

Digoxin

Increased digoxin levels, monitor digoxin concentrations.

Warfarin

Increased INR/prothrombin time, monitor carefully.

Clopidogrel

Reduced antiplatelet effect of clopidogrel due to CYP2C19 inhibition.

Methotrexate

Increased methotrexate levels, especially with high doses; monitor for toxicity.

Nelfinavir, Atazanavir

Reduced plasma concentrations of antiretrovirals, avoid concomitant use.

Iron salts, Ketoconazole, Itraconazole

Reduced absorption of drugs whose bioavailability is pH-dependent.

Storage

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

Overdose

Limited experience with overdose. Symptoms may include drowsiness, tachycardia, nausea, headache, diarrhea. In case of overdose, discontinue the drug and administer symptomatic and supportive treatment.

Pregnancy & Lactation

Pregnancy Category B. Studies in animals have not shown harm to the fetus. However, use during pregnancy only if clearly needed and potential benefits outweigh risks. Esomeprazole is excreted in human breast milk; a decision should be made whether to discontinue nursing or the drug, taking into account the importance of the drug to the mother.

Side Effects

Contraindications

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

Drug Interactions

Digoxin

Increased digoxin levels, monitor digoxin concentrations.

Warfarin

Increased INR/prothrombin time, monitor carefully.

Clopidogrel

Reduced antiplatelet effect of clopidogrel due to CYP2C19 inhibition.

Methotrexate

Increased methotrexate levels, especially with high doses; monitor for toxicity.

Nelfinavir, Atazanavir

Reduced plasma concentrations of antiretrovirals, avoid concomitant use.

Iron salts, Ketoconazole, Itraconazole

Reduced absorption of drugs whose bioavailability is pH-dependent.

Storage

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

Overdose

Pregnancy & Lactation

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

Box of 10 sachetsBox of 20 sachetsBox of 30 sachets

Shelf Life

Typically 24-36 months from manufacturing date.

Availability

Available in pharmacies nationwide

Approval Status

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

Patent Status

Generics available; original patent expired

WHO Essential Medicine

Yes

Clinical Trials

Esomeprazole has undergone extensive clinical trials demonstrating its efficacy and safety in various acid-related disorders. Studies have shown its superiority over other PPIs in some specific conditions.

Lab Monitoring

Magnesium levels (for long-term use)
Chromogranin A (CgA) levels (may increase with PPIs and interfere with neuroendocrine tumor diagnosis)

Doctor Notes

Educate patients on proper administration of the powder for oral suspension.
Consider lowest effective dose and shortest duration for PPI therapy, especially for long-term use.
Monitor for potential drug interactions, particularly with clopidogrel and methotrexate.
Advise patients to report any new or worsening symptoms, including severe diarrhea, bone pain, or muscle weakness.

Patient Guidelines

Take Esoral 20 mg powder as directed by your doctor, usually once daily before a meal.
Mix the powder with water and drink immediately; do not chew the granules.
Inform your doctor about all medications you are taking, including over-the-counter drugs and herbal supplements.
Do not stop taking the medicine abruptly without consulting your doctor, even if your symptoms improve.

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 take a double dose to make up for a missed one.

Driving Precautions

Esomeprazole may cause dizziness or visual disturbances in some patients. If you experience these effects, avoid driving or operating machinery.

Lifestyle Advice

Avoid foods and drinks that trigger your heartburn or reflux symptoms (e.g., spicy foods, fatty foods, caffeine, alcohol, carbonated drinks).
Eat smaller, more frequent meals. Avoid eating close to bedtime.
Elevate the head of your bed to reduce nighttime reflux.