ncr-fast
Generic Name
Esomeprazole
Manufacturer
General Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ncr fast 40 mg tablet | ৳ 3.80 | ৳ 38.00 |
Description
Overview of the medicine
NCR-Fast 40 mg Tablet contains Esomeprazole, a proton pump inhibitor (PPI) used to reduce the amount of acid produced in the stomach. It treats conditions like heartburn, acid reflux, stomach ulcers, and certain esophageal problems.
Uses & Indications
Dosage
Adults
GERD: 20-40 mg once daily for 4-8 weeks. Erosive Esophagitis: 20-40 mg once daily for 4-8 weeks. H. pylori eradication: 20 mg twice daily for 7-14 days with antibiotics. Zollinger-Ellison Syndrome: Initial 40 mg twice daily, adjusted as needed.
Elderly
No specific dose adjustment is generally required, but caution is advised in patients with severe hepatic impairment.
Renal_impairment
No dose adjustment needed for patients with renal impairment. Esomeprazole is highly protein-bound and not removed by hemodialysis.
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 works by irreversibly blocking the H+/K+-ATPase proton pump in the gastric parietal cells. This reduces the secretion of gastric acid.
Pharmacokinetics
Onset
Acid secretion inhibition begins within 1 hour.
Excretion
Primarily excreted in the urine (approximately 80%) and feces (approximately 20%) as metabolites.
Half life
Approximately 1.5 hours.
Absorption
Rapidly absorbed after oral administration. Bioavailability is approximately 64% for a 40 mg dose and increases with repeated dosing.
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
Drug Interactions
Digoxin
Increased digoxin absorption; monitor digoxin levels.
Warfarin
Increased INR and prothrombin time; monitor closely.
Tacrolimus
Increased tacrolimus levels; monitor blood concentrations.
Clopidogrel
Reduced antiplatelet effect of clopidogrel; consider alternative PPIs or antiplatelet therapy.
Methotrexate
Increased methotrexate levels, especially with high-dose therapy; monitor for toxicity.
Nelfinavir, Atazanavir
Reduced plasma levels of these antiretrovirals, leading to loss of therapeutic effect.
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 self-limiting (e.g., drowsiness, tachycardia, nausea, diarrhea). Treatment is symptomatic and supportive; no specific antidote.
Pregnancy & Lactation
Use during pregnancy only if clearly needed and the potential benefits outweigh the risks. Limited data available on use during breastfeeding, generally advised with caution or to avoid if possible.
Side Effects
Contraindications
- Hypersensitivity to Esomeprazole, substituted benzimidazoles, or any component of the formulation
- Concomitant use with nelfinavir
Drug Interactions
Digoxin
Increased digoxin absorption; monitor digoxin levels.
Warfarin
Increased INR and prothrombin time; monitor closely.
Tacrolimus
Increased tacrolimus levels; monitor blood concentrations.
Clopidogrel
Reduced antiplatelet effect of clopidogrel; consider alternative PPIs or antiplatelet therapy.
Methotrexate
Increased methotrexate levels, especially with high-dose therapy; monitor for toxicity.
Nelfinavir, Atazanavir
Reduced plasma levels of these antiretrovirals, leading to loss of therapeutic effect.
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 self-limiting (e.g., drowsiness, tachycardia, nausea, diarrhea). Treatment is symptomatic and supportive; no specific antidote.
Pregnancy & Lactation
Use during pregnancy only if clearly needed and the potential benefits outweigh the risks. Limited data available on use during breastfeeding, generally advised with caution or to avoid if possible.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, hospitals, clinics
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have demonstrated the efficacy and safety of Esomeprazole in treating acid-related disorders, supporting its use in GERD, ulcers, and H. pylori eradication.
Lab Monitoring
- Monitoring of Vitamin B12 levels during long-term therapy
- Magnesium levels (especially with concomitant diuretics)
- Liver function tests (in patients with hepatic impairment)
Doctor Notes
- Consider lowest effective dose for shortest duration for PPI therapy.
- Screen for H. pylori before initiating long-term therapy if clinically indicated.
- Advise patients on lifestyle modifications along with medication.
Patient Guidelines
- Take as directed by your doctor, usually once daily before a meal.
- Do not stop taking the medicine suddenly without consulting your doctor.
- Inform your doctor if you experience severe diarrhea or abdominal pain.
- Long-term use may increase the risk of bone fractures and C. difficile-associated diarrhea.
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 take a double dose to make up for a missed one.
Driving Precautions
Esomeprazole is generally not expected to affect the ability to drive or operate machinery. However, if side effects like dizziness or visual disturbances occur, caution should be exercised.
Lifestyle Advice
- Avoid trigger foods that worsen acid reflux (e.g., spicy foods, fatty foods, caffeine, alcohol).
- Eat smaller, more frequent meals.
- Elevate the head of your bed to reduce nighttime reflux.
- Quit smoking.
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