Neusangel
Generic Name
Esomeprazole 20 mg Capsule
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| neusangel 20 mg capsule | ৳ 7.00 | ৳ 70.00 |
Description
Overview of the medicine
Neusangel 20 mg Capsule is a proton pump inhibitor used to reduce stomach acid production, treating conditions like GERD, ulcers, and heartburn. It helps in the healing of acid-related damage and provides symptom relief.
Uses & Indications
Dosage
Adults
For GERD: 20-40 mg once daily for 4-8 weeks. For Erosive Esophagitis: 20-40 mg once daily for 4-8 weeks. For H. pylori eradication: 20 mg twice daily for 7-10 days in combination with antibiotics. Dosage varies by indication and severity.
Elderly
No specific dose adjustment is generally required based on age, but caution is advised in severe hepatic impairment.
Renal_impairment
No dose adjustment is needed for patients with impaired renal function, but caution should be exercised in severe renal insufficiency.
How to Take
Take orally, at least one hour before a meal. Swallow the capsule whole with water; do not chew or crush the capsule, as this may affect the extended-release properties. If swallowing is difficult, the capsule may be opened and the contents mixed with a small amount of water or soft food and consumed immediately.
Mechanism of Action
Esomeprazole, an S-isomer of omeprazole, works by irreversibly binding to and inhibiting the H+/K+-ATPase (proton pump) in gastric parietal cells, thereby reducing gastric acid secretion. This leads to a decrease in both basal and stimulated acid output.
Pharmacokinetics
Onset
Within 1 hour; maximal acid suppression reached within 2-4 days of repeated dosing.
Excretion
Primarily via urine (approximately 80%) as inactive metabolites, and the remaining via feces.
Half life
Approximately 1-1.5 hours in healthy volunteers, but the duration of acid suppression is much longer due to irreversible binding.
Absorption
Rapidly absorbed after oral administration. Bioavailability is approximately 64% after a single 40 mg dose and increases to 89% after repeated once-daily administration. Food delays and decreases absorption.
Metabolism
Extensively metabolized in the liver by the cytochrome P450 (CYP) enzyme system, mainly by CYP2C19 and CYP3A4. The primary metabolites have no acid-inhibiting activity.
Side Effects
Contraindications
- Hypersensitivity to esomeprazole, other substituted benzimidazoles, or any component of the formulation.
- Concomitant use with nelfinavir.
Drug Interactions
Digoxin
Increased absorption of digoxin due to increased gastric pH, requiring dose adjustment and monitoring.
Warfarin
Increased INR/prothrombin time with concomitant use, monitor closely for bleeding.
Clopidogrel
Esomeprazole may reduce the antiplatelet effect of clopidogrel by inhibiting CYP2C19, potentially increasing the risk of cardiovascular events.
Methotrexate
Increased plasma levels of methotrexate, especially at high doses, leading to potential toxicity.
Diazepam/Citalopram/Phenytoin
Esomeprazole can inhibit the metabolism of these drugs, leading to increased plasma concentrations and potential toxicity.
Ketoconazole/Itraconazole/Atazanavir
Decreased absorption of these drugs due to increased gastric pH, reducing their efficacy.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children. Do not freeze.
Overdose
Symptoms of overdose are generally mild and may include drowsiness, tachycardia, nausea, diarrhea, headache, and abdominal pain. Treatment is symptomatic and supportive. There is no specific antidote for esomeprazole.
Pregnancy & Lactation
Pregnancy Category C. Use in pregnancy only if clearly needed and the potential benefit outweighs the potential risk. Esomeprazole is excreted in human milk; use with caution during lactation, considering the benefits of breastfeeding and the potential risks to the infant.
Side Effects
Contraindications
- Hypersensitivity to esomeprazole, other substituted benzimidazoles, or any component of the formulation.
- Concomitant use with nelfinavir.
Drug Interactions
Digoxin
Increased absorption of digoxin due to increased gastric pH, requiring dose adjustment and monitoring.
Warfarin
Increased INR/prothrombin time with concomitant use, monitor closely for bleeding.
Clopidogrel
Esomeprazole may reduce the antiplatelet effect of clopidogrel by inhibiting CYP2C19, potentially increasing the risk of cardiovascular events.
Methotrexate
Increased plasma levels of methotrexate, especially at high doses, leading to potential toxicity.
Diazepam/Citalopram/Phenytoin
Esomeprazole can inhibit the metabolism of these drugs, leading to increased plasma concentrations and potential toxicity.
Ketoconazole/Itraconazole/Atazanavir
Decreased absorption of these drugs due to increased gastric pH, reducing their efficacy.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children. Do not freeze.
Overdose
Symptoms of overdose are generally mild and may include drowsiness, tachycardia, nausea, diarrhea, headache, and abdominal pain. Treatment is symptomatic and supportive. There is no specific antidote for esomeprazole.
Pregnancy & Lactation
Pregnancy Category C. Use in pregnancy only if clearly needed and the potential benefit outweighs the potential risk. Esomeprazole is excreted in human milk; use with caution during lactation, considering the benefits of breastfeeding and the potential risks to the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from the date of manufacture when stored under recommended conditions.
Availability
Pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Esomeprazole has undergone extensive clinical trials demonstrating its efficacy and safety in various acid-related disorders. Studies have shown superior acid control and healing rates compared to other PPIs in certain conditions.
Lab Monitoring
- Magnesium levels (with prolonged use, especially >1 year or with concomitant diuretics)
- Vitamin B12 levels (with prolonged use, especially >3 years)
- Chromogranin A (CgA) levels (can be elevated, interfering with neuroendocrine tumor diagnosis)
Doctor Notes
- Always confirm the diagnosis before initiating PPI therapy for new-onset dyspepsia to rule out malignancy.
- Consider the lowest effective dose and shortest duration of therapy necessary.
- Monitor magnesium levels periodically in patients on prolonged PPI therapy, especially if concomitantly using diuretics or other drugs that can cause hypomagnesemia.
- Advise patients on appropriate lifestyle and dietary modifications alongside PPI treatment.
Patient Guidelines
- Take Neusangel exactly as directed by your doctor, usually once daily before a meal.
- Do not chew, crush, or open the capsule; swallow it whole.
- Do not stop taking the medicine suddenly without consulting your doctor, even if your symptoms improve.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
- Seek medical advice if you experience severe or persistent side effects.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it's 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. Consult your doctor if unsure.
Driving Precautions
Neusangel may cause dizziness, somnolence, or visual disturbances in some patients. If you experience these effects, avoid driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Avoid trigger foods and beverages that worsen acid reflux, such as spicy, fatty, acidic foods, caffeine, and alcohol.
- Maintain a healthy weight and avoid large meals, especially close to bedtime.
- Elevate the head of your bed to reduce nighttime reflux symptoms.
- Quit smoking, as it can worsen acid reflux.
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