Medicine Information

Gerdnil

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

Capsule60 mgProton Pump Inhibitor (PPI)ATC: A02BC05

Generic Name

Esomeprazole

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
gerdnil 60 mg capsule	৳ 16.00	৳ 160.00

Description

Overview of the medicine

Gerdnil 60 mg Capsule contains Esomeprazole, a proton pump inhibitor used to reduce stomach acid production. It is prescribed for conditions like severe GERD, peptic ulcers, and Zollinger-Ellison Syndrome, especially when higher acid suppression is needed.

Uses & Indications

Treatment of Erosive Esophagitis (healing and maintenance) where higher acid suppression is required.

Symptomatic Gastroesophageal Reflux Disease (GERD) refractory to lower doses.

Zollinger-Ellison Syndrome and other pathological hypersecretory conditions.

Risk reduction of NSAID-associated gastric ulcers (in specific cases, dosage may vary).

Helicobacter pylori eradication (in combination with appropriate antibiotics, dosage regimen may vary).

Dosage

Adults

For Zollinger-Ellison Syndrome, the initial recommended dose is 40 mg twice daily. The dose should be individually adjusted, and treatment continued as long as clinically indicated. Doses up to 240 mg daily have been administered. For other conditions requiring higher acid suppression or refractory cases, 60 mg daily may be considered under strict medical supervision.

Elderly

No specific dose adjustment is generally required, but caution should be exercised due to potential age-related decrease in liver function. Close monitoring for adverse effects is recommended.

Renal_impairment

No dose adjustment is needed for patients with renal impairment. However, use with caution in severe renal impairment.

How to Take

Take Gerdnil 60 mg Capsule whole, with a glass of water, at least one hour before a meal. Do not chew or crush the capsule. For patients who have difficulty swallowing, the capsule can be opened and the pellets mixed with water or soft food and swallowed immediately.

Mechanism of Action

Esomeprazole is a proton pump inhibitor that specifically inhibits the H+/K+-ATPase enzyme system (the proton pump) in the gastric parietal cells, thereby blocking the final step in acid secretion.

Pharmacokinetics

Onset

Acid secretion inhibition occurs within 1 hour; full effect usually within 3-4 days of continuous use.

Excretion

Primarily excreted in the urine (about 80%) and feces (about 20%) as metabolites.

Half life

Approximately 1-1.5 hours (plasma half-life), but the duration of acid suppression is much longer due to irreversible binding to the proton pump.

Absorption

Rapidly absorbed after oral administration, bioavailability is approximately 64% after a single 40 mg dose, increasing to 89% with repeated once-daily administration. Peak plasma concentrations are reached within 1-2 hours.

Metabolism

Extensively metabolized in the liver via the cytochrome P450 system (primarily 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, monitor carefully.

Clopidogrel

Reduced effectiveness of clopidogrel due to inhibition of CYP2C19, potentially increasing cardiovascular event risk.

Methotrexate

Increased plasma levels of methotrexate, especially with high doses, potentially leading to toxicity.

Nelfinavir, Atazanavir

Significant decrease in plasma levels of antiretrovirals, concomitant use is contraindicated with Nelfinavir and generally not recommended with Atazanavir.

Ketoconazole, Itraconazole, Erlotinib

Decreased absorption due to increased gastric pH, reducing their efficacy.

Storage

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

Overdose

Limited experience with Esomeprazole overdose. Symptoms may include drowsiness, tachycardia, and nausea. Treatment should be symptomatic and supportive; there is no specific antidote. Gastric lavage and activated charcoal may be considered if ingestion was recent.

Pregnancy & Lactation

**Pregnancy Category B.** Studies in animals have not shown a risk to the fetus, but there are no adequate and well-controlled studies in pregnant women. Use only if clearly needed. **Lactation:** Esomeprazole is likely 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

10 Capsules per strip30 Capsules per box

Shelf Life

24 to 36 months from manufacturing date when stored under recommended conditions.

Availability

Pharmacies, hospitals

Approval Status

Approved by major regulatory bodies

Patent Status

Generic available

WHO Essential Medicine

Yes

Clinical Trials

Esomeprazole has been extensively studied in numerous clinical trials demonstrating its efficacy and safety in various acid-related disorders, including GERD, peptic ulcer disease, and Zollinger-Ellison Syndrome. Studies have confirmed its superior acid suppression compared to other PPIs in some patient populations.

Lab Monitoring

Monitor INR/prothrombin time in patients receiving concomitant warfarin.
Monitor serum magnesium levels, especially in patients on long-term therapy or taking other drugs that can cause hypomagnesemia.
Monitor vitamin B12 levels in patients on long-term therapy (over 3 years) due to potential malabsorption.

Doctor Notes

The 60 mg dose of Esomeprazole is typically reserved for severe hypersecretory conditions like Zollinger-Ellison Syndrome or refractory GERD, as determined by clinical judgment.
Educate patients on potential long-term risks associated with PPI use and the need for regular monitoring, especially for magnesium and vitamin B12 levels with extended therapy.
Thoroughly review concomitant medications for potential drug interactions, particularly with agents metabolized by CYP2C19 or those sensitive to gastric pH changes.
Consider de-prescribing or reducing PPI dose once clinically appropriate to minimize long-term risks.

Patient Guidelines

Take the capsule exactly as prescribed by your doctor, usually before a meal.
Do not stop taking the medicine suddenly without consulting your doctor, as symptoms may return.
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 resume your regular dosing schedule. Do not take a double dose to make up for a missed one.

Driving Precautions

Gerdnil is unlikely to affect your ability to drive or operate machinery. However, if you experience side effects like dizziness or visual disturbances, avoid such activities until you feel safe.

Lifestyle Advice

Avoid foods and drinks that trigger your symptoms (e.g., spicy foods, caffeine, alcohol, fatty meals).
Eat smaller, more frequent meals instead of large ones.
Avoid lying down immediately after eating and elevate the head of your bed.
Maintain a healthy weight and quit smoking to alleviate GERD symptoms.