Medicine Information

Neopra

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

Capsule20 mgProton Pump Inhibitors (PPIs)ATC: A02BC05

Generic Name

Esomeprazole 20 mg capsule

Manufacturer

Beximco Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
neopra 20 mg capsule	৳ 5.00	N/A

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 such as gastroesophageal reflux disease (GERD), stomach ulcers, and Zollinger-Ellison syndrome.

Uses & Indications

Treatment of gastroesophageal reflux disease (GERD)

Healing of erosive esophagitis

Maintenance of healing of erosive esophagitis

Symptomatic treatment of non-erosive reflux disease

Treatment of Zollinger-Ellison syndrome

Helicobacter pylori eradication (in combination with appropriate antibiotics)

Prevention of NSAID-associated gastric ulcers in at-risk patients

Dosage

Adults

For GERD: 20 mg or 40 mg once daily for 4-8 weeks. For maintenance of healing of erosive esophagitis: 20 mg once daily. For symptomatic non-erosive GERD: 20 mg once daily for 4 weeks. For H. pylori eradication: 20 mg twice daily with antibiotics for 7-14 days. For Zollinger-Ellison syndrome: Initial dose 40 mg twice daily, adjusted as needed.

Elderly

No specific dose adjustment is generally required for elderly patients based on age alone, but caution is advised in patients with severe hepatic impairment.

Renal_impairment

No dose adjustment is necessary for patients with impaired renal function.

How to Take

Take orally, at least one hour before a meal. Swallow the capsule whole with water; do not chew, crush, or break it. If unable to swallow, the capsule may be opened and the contents mixed with a small amount of applesauce or water, and consumed immediately.

Mechanism of Action

Esomeprazole works by irreversibly binding to the H+/K+-ATPase enzyme (the proton pump) in the gastric parietal cells. This action effectively blocks the final step in acid production, leading to a sustained reduction in gastric acid secretion.

Pharmacokinetics

Onset

Acid suppression occurs within 1 hour of administration.

Excretion

Metabolites are primarily excreted in the urine (about 80%) and feces (about 20%).

Half life

Approximately 1-1.5 hours.

Absorption

Rapidly absorbed after oral administration, with peak plasma concentrations reached in 1-2 hours. Bioavailability is approximately 64% after a single 20 mg dose, increasing to 89% with repeated daily dosing.

Metabolism

Extensively metabolized in the liver by the cytochrome P450 (CYP) enzyme system, primarily by CYP2C19 and CYP3A4.

Side Effects

Contraindications

Known hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation.
Concomitant use with nelfinavir (an antiretroviral drug).

Drug Interactions

Diazepam

Increased plasma levels of diazepam due to inhibition of CYP2C19.

Warfarin

Increased INR/prothrombin time; monitor coagulation parameters closely.

Tacrolimus

Increased serum concentrations of tacrolimus; monitor tacrolimus levels and kidney function.

Clopidogrel

Reduced antiplatelet effect of clopidogrel; consider alternative antiplatelet therapy or monitor.

Methotrexate

Increased and prolonged serum levels of methotrexate, potentially leading to toxicity. Consider temporary withdrawal of PPI therapy.

St. John's Wort

May decrease plasma concentrations of esomeprazole.

Storage

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

Overdose

Symptoms of overdose are generally limited and may include drowsiness, tachycardia, nausea, and headache. Treatment is supportive and symptomatic; there is no specific antidote.

Pregnancy & Lactation

Pregnancy Category B. Studies in animals have shown no evidence of harm to the fetus, but there are no adequate and well-controlled studies in pregnant women. Use only if clearly needed. Esomeprazole is excreted in human breast milk; use with caution in nursing mothers.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 capsules per pack30 capsules per pack

Shelf Life

Typically 24-36 months from the manufacturing date.

Availability

Available in pharmacies and hospitals

Approval Status

Approved by regulatory authorities worldwide

Patent Status

Off-patent

WHO Essential Medicine

Yes

Clinical Trials

Esomeprazole has been extensively studied in numerous clinical trials demonstrating its efficacy in healing and preventing acid-related damage to the esophagus and stomach, as well as its role in H. pylori eradication. These trials have established its favorable safety profile.

Lab Monitoring

Serum magnesium levels (especially with long-term use or concomitant diuretics)
Liver function tests (if signs of hepatic impairment or jaundice develop)
Consider bone density monitoring with very long-term use

Doctor Notes

Educate patients about the proper administration (one hour before meals, swallowed whole) to maximize efficacy.
Be vigilant for potential drug interactions, especially with warfarin, clopidogrel, and methotrexate.
For long-term users, consider periodic monitoring of serum magnesium and advising on bone health (e.g., calcium and vitamin D supplementation).
Always rule out underlying malignancy in patients with alarm symptoms (e.g., dysphagia, unexplained weight loss, GI bleeding) before initiating PPI therapy.

Patient Guidelines

Take Esomeprazole exactly as prescribed by your doctor, usually once daily before a meal.
Swallow the capsule whole; do not chew, crush, or open it.
Inform your doctor about all other medications, supplements, and herbal products you are taking.
Seek medical attention if symptoms do not improve after a few weeks or if they worsen.
Long-term use may require periodic monitoring for certain side effects like low magnesium or bone health.

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

May cause dizziness, somnolence, or visual disturbances. If affected, avoid driving or operating machinery.

Lifestyle Advice

Avoid trigger foods and beverages such as spicy or fatty foods, caffeine, alcohol, and carbonated drinks.
Eat smaller, more frequent meals.
Avoid eating late at night or before bedtime.
Maintain a healthy weight and elevate the head of your bed to reduce nighttime reflux.
Quit smoking as it can worsen acid reflux.