Eshozol
Generic Name
Esomeprazole
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| esozol 40 mg capsule | ৳ 9.00 | ৳ 90.00 |
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 like gastroesophageal reflux disease (GERD), stomach ulcers, and Zollinger-Ellison syndrome.
Uses & Indications
Dosage
Adults
GERD (Erosive Esophagitis): 20 mg or 40 mg once daily for 4-8 weeks. GERD (Symptomatic): 20 mg once daily for 4 weeks. H. pylori eradication: 40 mg once daily (or 20 mg twice daily) for 7-10 days in combination with antibiotics. NSAID-associated ulcers: 20 mg once daily for 4-8 weeks. Zollinger-Ellison Syndrome: Initial dose 40 mg twice daily; adjust according to response.
Elderly
No dosage adjustment generally required.
Renal_impairment
No dosage adjustment required for mild to moderate impairment. Use with caution in severe renal impairment.
How to Take
Take Esomeprazole capsules at least one hour before a meal. Swallow the capsule whole with water; do not chew or crush. For patients who have difficulty swallowing, the capsule can be opened, and the pellets mixed with a small amount of water or fruit juice and swallowed immediately.
Mechanism of Action
Esomeprazole selectively and irreversibly inhibits the H+/K+-ATPase enzyme system (the proton pump) in the gastric parietal cells, thereby blocking the final step in gastric acid secretion. This leads to a dose-dependent inhibition of both basal and stimulated acid secretion.
Pharmacokinetics
Onset
Acid secretion inhibition starts within 1 hour.
Excretion
Metabolites are primarily excreted in urine (about 80%) and feces (about 20%).
Half life
Approximately 1.5 hours.
Absorption
Rapidly absorbed after oral administration, peak plasma levels occur within 1-2 hours. Bioavailability is about 64% after a single 40 mg dose, increasing to 89% with repeated once-daily dosing. Food delays and decreases absorption, but does not significantly affect the clinical efficacy of delayed-release formulations.
Metabolism
Extensively metabolized in the liver by the cytochrome P450 (CYP) enzyme system, primarily by CYP2C19 and CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation.
- Concomitant use with nelfinavir (an antiretroviral drug).
Drug Interactions
Warfarin
Increased INR and prothrombin time have been reported.
Clopidogrel
May reduce the antiplatelet effect of clopidogrel.
Methotrexate
May increase methotrexate levels, especially with high doses.
Diazepam/Citalopram
Esomeprazole may inhibit metabolism, increasing plasma concentrations.
Atazanavir/Nelfinavir
Significantly reduced plasma levels of these antiretrovirals.
Iron salts/Ketoconazole/Itraconazole
Esomeprazole may reduce absorption due to increased gastric pH.
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 confusion, drowsiness, blurred vision, tachycardia, nausea, sweating, flushing, headache, dry mouth, and other gastrointestinal disturbances. Treatment is symptomatic and supportive. Esomeprazole is not readily dialyzable.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Esomeprazole is likely excreted in human milk; caution should be exercised when administered to a nursing mother.
Side Effects
Contraindications
- Hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation.
- Concomitant use with nelfinavir (an antiretroviral drug).
Drug Interactions
Warfarin
Increased INR and prothrombin time have been reported.
Clopidogrel
May reduce the antiplatelet effect of clopidogrel.
Methotrexate
May increase methotrexate levels, especially with high doses.
Diazepam/Citalopram
Esomeprazole may inhibit metabolism, increasing plasma concentrations.
Atazanavir/Nelfinavir
Significantly reduced plasma levels of these antiretrovirals.
Iron salts/Ketoconazole/Itraconazole
Esomeprazole may reduce absorption due to increased gastric pH.
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 confusion, drowsiness, blurred vision, tachycardia, nausea, sweating, flushing, headache, dry mouth, and other gastrointestinal disturbances. Treatment is symptomatic and supportive. Esomeprazole is not readily dialyzable.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Esomeprazole is likely excreted in human milk; caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date
Availability
Available in pharmacies and hospitals
Approval Status
Approved by regulatory authorities worldwide, including DGDA
Patent Status
Patent expired, generics widely available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated efficacy and safety in various acid-related disorders, including GERD, erosive esophagitis, and H. pylori eradication.
Lab Monitoring
- Serum magnesium levels (especially with long-term use, diuretics, or digoxin).
- Liver function tests (in patients with severe hepatic impairment).
- Vitamin B12 levels (with prolonged therapy).
Doctor Notes
- Assess patient's symptoms and endoscopic findings before initiating long-term PPI therapy.
- Consider the lowest effective dose for the shortest possible duration.
- Monitor for potential long-term adverse effects, especially hypomagnesemia and bone mineral density in susceptible patients.
- Advise patients on lifestyle modifications to complement PPI therapy.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Swallow the capsule whole with a glass of water, do not chew or crush it.
- Take it at least one hour before food, usually in the morning.
- Do not stop taking the medicine suddenly without consulting your doctor.
- Inform your doctor about all other medications you are taking.
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 schedule. Do not double the dose to catch up.
Driving Precautions
Esomeprazole generally does not impair the ability to drive or operate machinery. However, if you experience side effects such as dizziness or blurred vision, avoid driving or operating machinery until these symptoms resolve.
Lifestyle Advice
- Avoid trigger foods (e.g., fatty, spicy, acidic foods, caffeine, chocolate).
- Eat smaller, more frequent meals.
- Avoid eating close to bedtime (at least 2-3 hours before).
- Elevate the head of your bed.
- Maintain a healthy weight.
- Quit smoking and reduce alcohol consumption.
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