Pronex
Generic Name
Esomeprazole 40 mg
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| pronex 40 mg tablet | ৳ 8.00 | ৳ 112.00 |
Description
Overview of the medicine
Pronex-40 mg Tablet contains Esomeprazole, a proton pump inhibitor, used to reduce the amount of acid produced in the stomach. It treats conditions like GERD, ulcers, and Zollinger-Ellison syndrome.
Uses & Indications
Dosage
Adults
Most indications: 20-40 mg once daily. For erosive esophagitis, 40 mg once daily for 4-8 weeks. For H. pylori eradication, 40 mg once daily for 10 days in combination with antibiotics. Zollinger-Ellison Syndrome: 40 mg twice daily initially, adjusted based on patient response.
Elderly
No dosage adjustment is required for elderly patients.
Renal_impairment
No dosage adjustment is required for patients with renal impairment.
How to Take
Oral administration. Tablets should be swallowed whole with water, at least one hour before a meal. Do not chew or crush.
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. This irreversible inhibition reduces gastric acid secretion.
Pharmacokinetics
Onset
Within 1 hour
Excretion
Mainly excreted in urine (approximately 80%) and feces (approximately 20%) as inactive metabolites.
Half life
Approximately 1.5 hours
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.
Metabolism
Extensively metabolized in the liver by the cytochrome P450 (CYP) enzyme system, mainly by CYP2C19 and CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation.
- Concomitant use with nelfinavir.
Drug Interactions
Warfarin
Increased INR and prothrombin time, monitor carefully.
Tacrolimus
Increased tacrolimus levels, monitor closely.
Clopidogrel
Reduced antiplatelet effect, consider alternative antiplatelet therapy or PPI.
Methotrexate
Increased methotrexate levels, monitor for toxicity.
Nelfinavir, Atazanavir
Reduced plasma levels, avoid co-administration.
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, confusion, blurred vision, tachycardia, nausea, sweating, headache, dry mouth). Treatment is symptomatic and supportive. Esomeprazole is highly protein-bound and not readily dialyzable.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have not shown harm to the fetus, but human studies are lacking. Use only if clearly needed. Excreted in breast milk in very small amounts; caution advised during lactation.
Side Effects
Contraindications
- Hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation.
- Concomitant use with nelfinavir.
Drug Interactions
Warfarin
Increased INR and prothrombin time, monitor carefully.
Tacrolimus
Increased tacrolimus levels, monitor closely.
Clopidogrel
Reduced antiplatelet effect, consider alternative antiplatelet therapy or PPI.
Methotrexate
Increased methotrexate levels, monitor for toxicity.
Nelfinavir, Atazanavir
Reduced plasma levels, avoid co-administration.
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, confusion, blurred vision, tachycardia, nausea, sweating, headache, dry mouth). Treatment is symptomatic and supportive. Esomeprazole is highly protein-bound and not readily dialyzable.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have not shown harm to the fetus, but human studies are lacking. Use only if clearly needed. Excreted in breast milk in very small amounts; caution advised during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory authorities worldwide (e.g., FDA, EMA, DGDA)
Patent Status
Generic available (original patent expired)
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated Esomeprazole's efficacy and safety in various acid-related disorders, including faster healing rates for erosive esophagitis and superior acid control compared to omeprazole in some studies.
Lab Monitoring
- Magnesium levels (for long-term use or with diuretics)
- Chromogranin A (CgA) levels (can be elevated and interfere with neuroendocrine tumor diagnosis)
Doctor Notes
- Advise patients on lifestyle modifications along with medication for optimal GERD management.
- Consider tapering off PPIs for long-term users to prevent rebound acid hypersecretion.
- Regularly assess the need for continued PPI therapy, especially for non-erosive GERD.
Patient Guidelines
- Take the tablet whole; do not chew, crush, or break it.
- Take it at least one hour before a meal.
- Complete the full course of treatment as prescribed, even if symptoms improve.
- Inform your doctor about all other medications you are taking.
- Seek immediate medical attention if you experience severe allergic reactions or unusual side effects.
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 double the dose.
Driving Precautions
Esomeprazole is generally not expected to affect the ability to drive or operate machinery. However, if side effects like dizziness or blurred vision occur, avoid driving.
Lifestyle Advice
- Avoid trigger foods such as spicy foods, fatty foods, caffeine, and acidic beverages.
- Eat smaller, more frequent meals.
- Avoid lying down immediately after eating.
- Elevate the head of your bed while sleeping.
- Quit smoking and limit alcohol intake.
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