Esozol
Generic Name
Esomeprazole 20 mg
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| esozol 20 mg capsule | ৳ 7.00 | ৳ 70.00 |
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 gastroesophageal reflux disease (GERD), erosive esophagitis, Zollinger-Ellison syndrome, and other conditions involving excessive stomach acid.
Uses & Indications
Dosage
Adults
For GERD with erosive esophagitis: 20 mg or 40 mg once daily for 4 to 8 weeks. For maintenance: 20 mg once daily. For symptomatic GERD: 20 mg once daily for 4 weeks. For H. pylori eradication: 20 mg twice daily for 10 days (with appropriate antibiotics). For Zollinger-Ellison syndrome: Initial dose of 40 mg twice daily, adjusted as needed.
Elderly
No specific dosage adjustment is generally required. However, caution should be exercised in elderly patients with severe hepatic impairment.
Renal_impairment
No dosage adjustment is necessary for patients with renal impairment.
How to Take
Take Esozol capsules orally at least one hour before a meal. Swallow the capsule whole with water; do not chew, crush, or open the capsule.
Mechanism of Action
Esomeprazole works by irreversibly blocking the proton pumps (H+/K+-ATPase) in the gastric parietal cells. This action significantly reduces gastric acid secretion, providing relief from acid-related symptoms and promoting healing of acid-induced damage.
Pharmacokinetics
Onset
Acid suppression begins within 1 hour after oral administration. Maximal effects typically occur within 3-5 days of continuous daily dosing.
Excretion
Metabolites are excreted primarily through urine (approximately 80%) and feces (approximately 20%). Less than 1% of the parent drug is excreted unchanged in urine.
Half life
Approximately 1-1.5 hours in healthy individuals, but the duration of acid suppression is much longer due to irreversible binding to the proton pump.
Absorption
Rapidly absorbed after oral administration. Bioavailability increases with repeated dosing, reaching approximately 64% after a single 40 mg dose and 89% after repeated once-daily dosing.
Metabolism
Extensively metabolized in the liver by the cytochrome P450 enzyme system, primarily by CYP2C19 and CYP3A4. CYP2C19 exhibits polymorphism, leading to different metabolic rates.
Side Effects
Contraindications
- Known hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation.
- Concomitant use with nelfinavir (an antiretroviral drug).
Drug Interactions
Digoxin
Increased systemic exposure to digoxin. Monitor digoxin levels.
Diazepam
Reduced clearance and prolonged half-life of diazepam.
Warfarin
Increased INR and prothrombin time; monitor patients for bleeding.
Clopidogrel
Reduced antiplatelet effect of clopidogrel due to inhibition of CYP2C19.
Methotrexate
Possible increased serum methotrexate levels. Consider temporary withdrawal of esomeprazole.
Nelfinavir/Atazanavir
Significantly reduced plasma concentrations of antiretroviral drugs, leading to loss of therapeutic effect and development of resistance. Concomitant use is not recommended.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Experience with esomeprazole overdose is limited. Symptoms observed in cases of overdose are generally mild and reversible (e.g., gastrointestinal symptoms, fatigue). Treatment should be symptomatic and supportive. Esomeprazole is highly protein-bound and not readily dialyzable.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Esomeprazole is excreted in human milk; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Known hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation.
- Concomitant use with nelfinavir (an antiretroviral drug).
Drug Interactions
Digoxin
Increased systemic exposure to digoxin. Monitor digoxin levels.
Diazepam
Reduced clearance and prolonged half-life of diazepam.
Warfarin
Increased INR and prothrombin time; monitor patients for bleeding.
Clopidogrel
Reduced antiplatelet effect of clopidogrel due to inhibition of CYP2C19.
Methotrexate
Possible increased serum methotrexate levels. Consider temporary withdrawal of esomeprazole.
Nelfinavir/Atazanavir
Significantly reduced plasma concentrations of antiretroviral drugs, leading to loss of therapeutic effect and development of resistance. Concomitant use is not recommended.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Experience with esomeprazole overdose is limited. Symptoms observed in cases of overdose are generally mild and reversible (e.g., gastrointestinal symptoms, fatigue). Treatment should be symptomatic and supportive. Esomeprazole is highly protein-bound and not readily dialyzable.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. 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
24 months from the date of manufacture.
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory authorities worldwide (e.g., FDA, DGDA)
Patent Status
Generic available, original patent expired
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of esomeprazole in the treatment of GERD, erosive esophagitis, H. pylori eradication, and other acid-related disorders across various patient populations.
Lab Monitoring
- Serum magnesium levels (especially with prolonged use or with other drugs that can cause hypomagnesemia).
- Vitamin B12 levels (for long-term use, as PPIs can impair absorption).
Doctor Notes
- Prioritize using the lowest effective dose for the shortest duration necessary to achieve therapeutic goals, especially for conditions not requiring long-term maintenance.
- Monitor patients on long-term esomeprazole therapy for potential risks like hypomagnesemia, vitamin B12 deficiency, and C. difficile infection.
- Consider drug interactions, particularly with clopidogrel and certain antiretrovirals. Avoid concomitant use with nelfinavir.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not chew, crush, or open the capsule; swallow it whole.
- Take it at least one hour before a meal.
- Do not stop taking the medicine abruptly without consulting your doctor, even if you feel better.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
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 continue with 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 side effects, avoid driving or operating machinery.
Lifestyle Advice
- Avoid foods and beverages that trigger your acid reflux symptoms, such as spicy, fatty, acidic foods, caffeine, and alcohol.
- Eat smaller, more frequent meals.
- Do not lie down for at least 3 hours after eating.
- Elevate the head of your bed by 6-8 inches if you experience nighttime heartburn.
- Maintain a healthy weight and quit smoking.
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