esoral
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 40 mg injection | ৳ 90.00 | N/A |
Description
Overview of the medicine
Esomeprazole is a proton pump inhibitor (PPI) that reduces gastric acid secretion. It is used to treat conditions such as gastroesophageal reflux disease (GERD), erosive esophagitis, and Zollinger-Ellison syndrome, especially when oral administration is not feasible.
Uses & Indications
Dosage
Adults
40 mg once daily by intravenous injection (over at least 3 minutes) or infusion (over 10-30 minutes). For Zollinger-Ellison Syndrome, initial dose is 80 mg, then 80 mg twice daily. For acute bleeding, 80 mg bolus followed by 8 mg/hour infusion for 72 hours.
Elderly
No dosage adjustment is generally required, but caution is advised in patients with severe hepatic impairment.
Renal_impairment
No dosage adjustment is required in patients with renal impairment.
How to Take
For intravenous use only. Administer as an injection over at least 3 minutes or as an intravenous infusion over 10-30 minutes. Reconstitute the powder for injection with the provided solvent or appropriate diluent before use.
Mechanism of Action
Esomeprazole selectively and irreversibly inhibits the H+/K+-ATPase (proton pump) in the gastric parietal cells, thereby reducing gastric acid secretion.
Pharmacokinetics
Onset
Acid secretion inhibition occurs within one hour of administration.
Excretion
Approximately 80% is excreted as metabolites in the urine and 20% in the feces.
Half life
Approximately 1.5 hours.
Absorption
Rapidly absorbed after intravenous administration, with peak plasma concentration reached within minutes.
Metabolism
Extensively metabolized in the liver by the cytochrome P450 (CYP) system, primarily via CYP2C19 and CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation.
- Concomitant use with nelfinavir (due to significant reduction in nelfinavir plasma levels).
Drug Interactions
Diazepam
May decrease clearance of diazepam (metabolized by CYP2C19).
Warfarin
Reported increases in INR and prothrombin time with concomitant use, requiring monitoring.
Clopidogrel
May reduce the antiplatelet effect of clopidogrel.
Methotrexate
May increase methotrexate plasma levels, potentially leading to toxicity.
Nelfinavir/Atazanavir
Reduced plasma concentrations, potentially leading to loss of antiviral effect.
Storage
Store below 25-30°C, protected from light and moisture. Keep out of reach of children. Reconstituted solution should be used within 6 hours at room temperature or 24 hours if refrigerated.
Overdose
Limited experience with overdose. Symptoms may include gastrointestinal disturbances and weakness. Management is symptomatic and supportive.
Pregnancy & Lactation
Pregnancy Category B. Use during pregnancy only if clearly needed and the potential benefits outweigh the potential risks. Esomeprazole is excreted in human milk; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation.
- Concomitant use with nelfinavir (due to significant reduction in nelfinavir plasma levels).
Drug Interactions
Diazepam
May decrease clearance of diazepam (metabolized by CYP2C19).
Warfarin
Reported increases in INR and prothrombin time with concomitant use, requiring monitoring.
Clopidogrel
May reduce the antiplatelet effect of clopidogrel.
Methotrexate
May increase methotrexate plasma levels, potentially leading to toxicity.
Nelfinavir/Atazanavir
Reduced plasma concentrations, potentially leading to loss of antiviral effect.
Storage
Store below 25-30°C, protected from light and moisture. Keep out of reach of children. Reconstituted solution should be used within 6 hours at room temperature or 24 hours if refrigerated.
Overdose
Limited experience with overdose. Symptoms may include gastrointestinal disturbances and weakness. Management is symptomatic and supportive.
Pregnancy & Lactation
Pregnancy Category B. Use during pregnancy only if clearly needed and the potential benefits outweigh the potential risks. Esomeprazole is excreted in human milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 3 years from the manufacturing date when stored correctly. Refer to the specific product packaging for exact details.
Availability
Available in pharmacies and hospitals
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Patent expired (generic versions available)
WHO Essential Medicine
YesClinical Trials
Esomeprazole has undergone extensive clinical trials demonstrating its efficacy and safety in various acid-related disorders. Studies have compared its intravenous form to oral PPIs and other intravenous acid suppressants.
Lab Monitoring
- Magnesium levels (for long-term use, especially in patients on diuretics or other magnesium-depleting drugs).
- Liver function tests (in patients with hepatic impairment).
Doctor Notes
- Consider step-down therapy from IV to oral PPI as soon as feasible.
- Monitor patients for long-term risks associated with PPI use, especially hypomagnesemia and bone health.
- Assess for potential drug interactions, particularly with clopidogrel, nelfinavir, and methotrexate.
Patient Guidelines
- Follow your doctor's instructions regarding dosage and administration.
- Report any unusual side effects or symptoms immediately to your doctor.
- This injection is usually for short-term treatment or when oral medication is not possible.
Missed Dose Advice
If a dose is missed, administer it as soon as remembered. If it is close to the time for the next scheduled dose, skip the missed dose and continue with the regular dosing schedule. Do not administer a double dose to make up for a missed one.
Driving Precautions
Esomeprazole may cause dizziness or visual disturbances. Patients should be advised to exercise caution when driving or operating machinery if they experience such effects.
Lifestyle Advice
- Avoid spicy and fatty foods, alcohol, and smoking to help manage acid-related symptoms.
- Maintain a healthy weight.
- Elevate the head of your bed if suffering from GERD.
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