Maxpro
Generic Name
Esomeprazole
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| maxpro 20 mg tablet | ৳ 7.00 | ৳ 98.00 |
Description
Overview of the medicine
Maxpro 20 mg tablet contains Esomeprazole, a proton pump inhibitor that works by reducing the amount of acid produced in the stomach. It is used to treat conditions such as gastroesophageal reflux disease (GERD), stomach ulcers, and Zollinger-Ellison syndrome.
Uses & Indications
Dosage
Adults
For GERD: 20 mg or 40 mg once daily for 4-8 weeks. For maintenance: 20 mg once daily. For H. pylori eradication: 20 mg twice daily for 7-10 days (in combination with antibiotics).
Elderly
No dosage adjustment is generally required for elderly patients.
Renal_impairment
No dosage adjustment is necessary for patients with impaired renal function.
How to Take
Take the tablet whole with a glass of water, at least one hour before a meal. Do not crush or chew the tablet.
Mechanism of Action
Esomeprazole is a proton pump inhibitor that specifically inhibits the H+/K+-ATPase enzyme system (the proton pump) at the secretory surface of the gastric parietal cell. This irreversible inhibition blocks the final step in acid production, reducing gastric acid secretion.
Pharmacokinetics
Onset
Onset of acid suppression within 1 hour.
Excretion
Approximately 80% excreted in urine as metabolites and the remainder in feces.
Half life
Plasma elimination half-life is approximately 1-1.5 hours.
Absorption
Rapidly absorbed after oral administration. Bioavailability is approximately 50-68% with a single 20 mg dose, increasing with repeated dosing.
Metabolism
Extensively metabolized in the liver by the cytochrome P450 enzyme system, primarily by CYP2C19 and to a lesser extent by CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation
- Concomitant use with nelfinavir
Drug Interactions
Digoxin
Increased plasma levels of digoxin; monitor digoxin levels.
Warfarin
Increased INR and prothrombin time; monitor closely.
Nelfinavir
Coadministration with esomeprazole is contraindicated due to decreased nelfinavir plasma concentrations.
Tacrolimus
Increased tacrolimus plasma concentrations; monitor tacrolimus levels and adjust dose as needed.
Clopidogrel
Decreased antiplatelet effect of clopidogrel; consider alternative antiplatelet therapy.
Methotrexate
Increased plasma levels of methotrexate; monitor for toxicity.
Drugs dependent on gastric pH for absorption
e.g., ketoconazole, iron salts, atazanavir, nelfinavir; esomeprazole may alter their absorption.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose are generally mild and non-specific. Management should be symptomatic and supportive. There is no specific antidote for esomeprazole.
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; use with caution during lactation.
Side Effects
Contraindications
- Hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation
- Concomitant use with nelfinavir
Drug Interactions
Digoxin
Increased plasma levels of digoxin; monitor digoxin levels.
Warfarin
Increased INR and prothrombin time; monitor closely.
Nelfinavir
Coadministration with esomeprazole is contraindicated due to decreased nelfinavir plasma concentrations.
Tacrolimus
Increased tacrolimus plasma concentrations; monitor tacrolimus levels and adjust dose as needed.
Clopidogrel
Decreased antiplatelet effect of clopidogrel; consider alternative antiplatelet therapy.
Methotrexate
Increased plasma levels of methotrexate; monitor for toxicity.
Drugs dependent on gastric pH for absorption
e.g., ketoconazole, iron salts, atazanavir, nelfinavir; esomeprazole may alter their absorption.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose are generally mild and non-specific. Management should be symptomatic and supportive. There is no specific antidote for esomeprazole.
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; use with caution during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date, check packaging for exact expiry.
Availability
Pharmacies, hospitals
Approval Status
Approved by FDA (USA) and DGDA (Bangladesh)
Patent Status
Generic versions available, original patent expired
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of esomeprazole in various acid-related disorders. Trials have investigated its use in GERD, erosive esophagitis, H. pylori eradication, and NSAID-induced ulcers.
Lab Monitoring
- Monitor serum magnesium levels periodically during long-term treatment, especially if co-administered with other magnesium-lowering drugs.
- Monitor liver function tests in patients with severe hepatic impairment.
- Consider bone mineral density assessment in patients at risk of osteoporosis with long-term high-dose therapy.
Doctor Notes
- Consider alternative antiplatelet therapy in patients taking clopidogrel.
- Assess for hypomagnesemia in patients on prolonged therapy, especially with diuretics.
- Educate patients on potential long-term risks, including bone fractures and C. difficile infection.
- Rule out malignancy in patients with recurrent symptoms, as PPIs may mask symptoms.
Patient Guidelines
- Take this medicine exactly as prescribed by your doctor.
- Swallow the tablet whole with water; do not chew or crush it.
- Take it at least one hour before a meal.
- Do not stop taking the medicine suddenly without consulting your doctor.
- 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. If you experience these side effects, avoid driving or operating machinery.
Lifestyle Advice
- Avoid foods and beverages that may worsen acid reflux, such as spicy foods, fatty foods, caffeine, and alcohol.
- Eat smaller, more frequent meals.
- Avoid lying down immediately after eating.
- Elevate the head of your bed during sleep to reduce nighttime reflux.
- Quit smoking if applicable.
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