Medicine Information

Esoral

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

Capsule40 mgProton Pump Inhibitor (PPI)ATC: A02BC05

Generic Name

Esomeprazole

Manufacturer

Incepta Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
esoral 40 mg capsule	৳ 10.00	৳ 100.00

Description

Overview of the medicine

Esoral 40 mg Capsule is a proton pump inhibitor used to treat conditions where there is too much acid in the stomach, such as gastroesophageal reflux disease (GERD), erosive esophagitis, and Zollinger-Ellison syndrome. It works by reducing the amount of acid produced in the stomach.

Uses & Indications

Gastroesophageal Reflux Disease (GERD)

Erosive Esophagitis

Healing of Gastric Ulcers

Zollinger-Ellison Syndrome

Prevention of NSAID-associated gastric ulcers

Dosage

Adults

GERD: 20-40 mg once daily for 4-8 weeks. Erosive Esophagitis: 20-40 mg once daily for 4-8 weeks. Zollinger-Ellison Syndrome: Initial dose 40 mg twice daily, adjusted as needed.

Elderly

No dosage adjustment generally required, but caution is advised.

Renal_impairment

No dosage adjustment required for mild to moderate renal impairment. For severe impairment, caution is advised.

How to Take

Take Esoral 40 mg Capsule whole, with water, at least one hour before a meal, preferably in the morning. Do not chew or crush the capsule.

Mechanism of Action

Esomeprazole is a proton pump inhibitor that specifically inhibits the H+/K+-ATPase (proton pump) in the gastric parietal cells. This irreversible inhibition reduces gastric acid secretion by blocking the final step in acid production.

Pharmacokinetics

Onset

Within 1 hour

Excretion

Eliminated mainly in the urine (about 80%) and feces (about 20%) as metabolites. Less than 1% is excreted unchanged.

Half life

Approximately 1-1.5 hours

Absorption

Rapidly absorbed after oral administration, peak plasma concentrations occur in 1-2 hours. Bioavailability is about 64% after a single 40 mg dose, increasing to 89% after repeated once-daily administration.

Metabolism

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

Side Effects

Contraindications

Hypersensitivity to esomeprazole or any components of the formulation or to other substituted benzimidazoles.
Concomitant use with nelfinavir.

Drug Interactions

Digoxin

Increased absorption of digoxin, especially in patients taking high doses. Monitor digoxin levels.

Warfarin

Increased INR and prothrombin time, monitor carefully.

Clopidogrel

Esomeprazole can reduce the antiplatelet effect of clopidogrel, potentially increasing the risk of thrombotic events. Avoid concomitant use or consider alternative antiplatelet therapy.

Methotrexate

Increased plasma levels of methotrexate, particularly with high doses. Monitor for toxicity.

Nelfinavir/Atazanavir

Reduced plasma concentrations of nelfinavir and atazanavir, leading to loss of therapeutic effect and potential resistance. Concomitant use is contraindicated.

Storage

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

Overdose

Symptoms of overdose may include drowsiness, tachycardia, nausea, abdominal pain, and diarrhea. Treatment is symptomatic and supportive. Esomeprazole is highly protein-bound and not readily dialyzable.

Pregnancy & Lactation

Pregnancy Category B. Studies in animals have shown no evidence of harm to the fetus, but there are no adequate and well-controlled studies in pregnant women. Use only if clearly needed. It is unknown if esomeprazole is excreted in human milk. Caution should be exercised when administered to a nursing woman.

Side Effects

Contraindications

Hypersensitivity to esomeprazole or any components of the formulation or to other substituted benzimidazoles.
Concomitant use with nelfinavir.

Drug Interactions

Digoxin

Increased absorption of digoxin, especially in patients taking high doses. Monitor digoxin levels.

Warfarin

Increased INR and prothrombin time, monitor carefully.

Clopidogrel

Esomeprazole can reduce the antiplatelet effect of clopidogrel, potentially increasing the risk of thrombotic events. Avoid concomitant use or consider alternative antiplatelet therapy.

Methotrexate

Increased plasma levels of methotrexate, particularly with high doses. Monitor for toxicity.

Nelfinavir/Atazanavir

Reduced plasma concentrations of nelfinavir and atazanavir, leading to loss of therapeutic effect and potential resistance. Concomitant use is contraindicated.

Storage

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

Overdose

Pregnancy & Lactation

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 capsules per box30 capsules per box

Shelf Life

Typically 24-36 months from manufacturing date

Availability

Pharmacies, Hospitals

Approval Status

Approved by FDA (US) and DGDA (Bangladesh)

Patent Status

Off-patent (generic versions available)

WHO Essential Medicine

Yes

Clinical Trials

Extensive clinical trials have demonstrated esomeprazole's efficacy and safety in acid-related disorders. Ongoing research focuses on long-term safety and specific patient populations.

Lab Monitoring

No routine lab monitoring is generally required. However, for long-term use (over a year), monitoring of serum magnesium levels is recommended, especially in patients taking other drugs that can cause hypomagnesemia.

Doctor Notes

Consider lowest effective dose for shortest duration possible.
Monitor magnesium levels in patients on long-term therapy or concomitant diuretics.
Counsel patients on potential long-term risks, especially bone fractures and *C. difficile* infection.

Patient Guidelines

Take the capsule whole; do not chew or crush it.
Take it at least one hour before a meal.
Inform your doctor about all other medications you are taking.
Report any new or worsening symptoms to your doctor immediately.

Missed Dose Advice

If a dose is missed, take it 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 generally has no or negligible influence on the ability to drive or use machines. However, some side effects like dizziness or visual disturbances may occur; if affected, patients should avoid driving or operating machinery.