Esosic
Generic Name
Esomeprazole 40 mg Capsule
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
Variant | Unit Price | Strip Price |
---|---|---|
esosic 40 mg capsule | ৳ 10.00 | ৳ 100.00 |
Description
Overview of the medicine
Esomeprazole is a proton pump inhibitor (PPI) that decreases the amount of acid produced in the stomach. It is used to treat symptoms of gastroesophageal reflux disease (GERD), erosive esophagitis, and other conditions involving excessive stomach acid such as Zollinger-Ellison syndrome.
Uses & Indications
Dosage
Adults
Typically 20 mg or 40 mg once daily, depending on the condition. For erosive esophagitis, 20 or 40 mg once daily for 4 to 8 weeks. For GERD, 20 mg once daily for 4 weeks. For Zollinger-Ellison syndrome, initial dose 40 mg twice daily, adjusted as needed.
Elderly
No specific dose adjustment is required for elderly patients.
Renal_impairment
No dose adjustment is necessary for patients with renal impairment.
Hepatic_impairment
For patients with severe hepatic impairment, a maximum dose of 20 mg once daily should not be exceeded.
How to Take
Administer orally at least one hour before a meal. Capsules should be swallowed whole; do not chew or crush. For patients who have difficulty swallowing, capsules may be opened and the pellets mixed with a small amount of water or soft food (e.g., apple sauce).
Mechanism of Action
Esomeprazole is a proton pump inhibitor that works by irreversibly binding to and inhibiting the H+/K+-ATPase enzyme system (the proton pump) found on the secretory surface of the gastric parietal cells. This action blocks the final step in gastric acid secretion, thereby reducing stomach acid levels.
Pharmacokinetics
Onset
Within 1 hour
Excretion
Approximately 80% excreted in the urine and 20% in the feces as metabolites.
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 dosing.
Metabolism
Extensively metabolized in the liver by the cytochrome P450 (CYP) system, primarily by CYP2C19 and CYP3A4, to inactive metabolites.
Side Effects
Contraindications
- Known hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation.
- Concomitant use with nelfinavir.
Drug Interactions
Digoxin
May increase digoxin exposure.
Warfarin
May increase INR and prothrombin time, requiring monitoring.
Tacrolimus
May increase plasma concentrations of tacrolimus.
Clopidogrel
May reduce the antiplatelet effect of clopidogrel (clinical significance debated, but caution advised).
Methotrexate
May increase and prolong plasma levels of methotrexate and/or its metabolite, possibly leading to toxicity. Consider temporary withdrawal of esomeprazole or dose reduction of methotrexate.
Nelfinavir, Atazanavir
Decreases plasma levels of nelfinavir and atazanavir, potentially reducing their antiviral effect. Concomitant use with nelfinavir is contraindicated.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Limited experience with overdose. Symptoms may include gastrointestinal disturbances, fatigue, headache. Management is symptomatic and supportive. Esomeprazole is extensively protein bound and not readily dialyzable.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether esomeprazole is excreted in human milk. A decision should be made whether to discontinue nursing or to discontinue 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
May increase digoxin exposure.
Warfarin
May increase INR and prothrombin time, requiring monitoring.
Tacrolimus
May increase plasma concentrations of tacrolimus.
Clopidogrel
May reduce the antiplatelet effect of clopidogrel (clinical significance debated, but caution advised).
Methotrexate
May increase and prolong plasma levels of methotrexate and/or its metabolite, possibly leading to toxicity. Consider temporary withdrawal of esomeprazole or dose reduction of methotrexate.
Nelfinavir, Atazanavir
Decreases plasma levels of nelfinavir and atazanavir, potentially reducing their antiviral effect. Concomitant use with nelfinavir is contraindicated.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Limited experience with overdose. Symptoms may include gastrointestinal disturbances, fatigue, headache. Management is symptomatic and supportive. Esomeprazole is extensively protein bound and not readily dialyzable.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether esomeprazole is excreted in human milk. A decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months
Availability
Available in pharmacies and hospitals
Approval Status
Approved
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, including studies comparing it with other PPIs and placebo.
Lab Monitoring
- Consider monitoring magnesium levels in patients expected to be on prolonged treatment or who take esomeprazole with other drugs known to cause hypomagnesemia.
- Liver function tests in patients with severe hepatic impairment.
Doctor Notes
- Ensure proper diagnosis before initiating PPI therapy to rule out underlying malignancy, especially in patients with alarm symptoms.
- Use the lowest effective dose for the shortest duration necessary to achieve treatment goals.
- Monitor for potential long-term adverse effects, such as hypomagnesemia, bone fractures, and C. difficile infection, especially in high-risk patients.
- Review the need for continued PPI therapy periodically.
Patient Guidelines
- Take exactly as prescribed by your doctor, usually once daily before a meal.
- Do not crush, chew, or open the capsule; swallow it whole.
- Report any severe or persistent side effects to your doctor.
- Inform your doctor about all other medications you are taking.
- Prolonged use may lead to vitamin B12 deficiency and increased risk of bone fractures; discuss these risks with your doctor.
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 resume your regular dosing schedule. Do not take two doses at once.
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, which could impair these abilities. Patients should be aware of how they react to the medication before driving or operating machinery.
Lifestyle Advice
- Avoid foods and drinks that trigger your acid reflux symptoms, such as fatty foods, spicy foods, caffeine, and alcohol.
- Quit smoking, as it can worsen GERD symptoms.
- Maintain a healthy weight.
- Eat smaller, more frequent meals.
- Avoid lying down immediately after eating.
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