Medicine Information

Sergel

Name: Sergel
Brand: Sergel

Capsule40 mgProton Pump Inhibitor (PPI)ATC: A02BC05

Generic Name

Esomeprazole 40 mg

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
sergel 40 mg capsule	৳ 11.00	৳ 110.00

Description

Overview of the medicine

Sergel 40 mg Capsule contains Esomeprazole, a proton pump inhibitor used to treat acid-related conditions such as gastroesophageal reflux disease (GERD), 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 GERD

Risk reduction of NSAID-associated gastric ulcers

Treatment of Helicobacter pylori infection (in combination with antibiotics)

Treatment of Zollinger-Ellison Syndrome

Dosage

Adults

GERD: 20-40 mg once daily for 4-8 weeks. Erosive Esophagitis: 40 mg once daily for 4-8 weeks. H. pylori: 40 mg once daily with antibiotics for 10 days. Zollinger-Ellison Syndrome: Initial 40 mg twice daily, adjusted based on response.

Elderly

No dose adjustment generally required, but caution in patients with hepatic impairment.

Renal_impairment

No dose adjustment required for patients with mild to moderate renal impairment. Caution with severe renal impairment due to limited experience.

How to Take

Take orally, at least one hour before a meal. Swallow whole with water; do not chew or crush. For patients who have difficulty swallowing, capsules can be opened and the contents mixed with a small amount of water or fruit juice, then consumed immediately.

Mechanism of Action

Esomeprazole is a proton pump inhibitor that specifically inhibits the H+/K+-ATPase enzyme system (proton pump) in the gastric parietal cells. This inhibition reduces gastric acid secretion, thereby raising intragastric pH.

Pharmacokinetics

Onset

Within 1 hour

Excretion

Excreted mainly in urine (approx. 80%) as metabolites, and to a lesser extent in feces.

Half life

Approximately 1-1.5 hours

Absorption

Rapidly absorbed after oral administration. Bioavailability is approximately 64% with a single 40 mg dose, increasing to 89% with repeated once-daily administration.

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

Warfarin

Increased INR and prothrombin time; monitor closely.

Clopidogrel

May reduce the antiplatelet effect of clopidogrel. Concomitant use should be avoided or monitored.

Methotrexate

Increased methotrexate levels, especially with high doses; consider temporary esomeprazole withdrawal.

Nelfinavir, Atazanavir

Reduced plasma concentrations of nelfinavir/atazanavir; concomitant use is contraindicated/not recommended.

Diazepam, Citalopram, Imipramine, Phenytoin

Esomeprazole may inhibit CYP2C19, increasing plasma levels of drugs metabolized by this enzyme.

Storage

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

Overdose

Symptoms are generally mild and non-specific. Management involves symptomatic and supportive treatment. There is no specific antidote.

Pregnancy & Lactation

Pregnancy category B. Use only if clearly needed. Esomeprazole is excreted in human milk; use with caution during lactation and weigh benefits against risks.

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 closely.

Clopidogrel

May reduce the antiplatelet effect of clopidogrel. Concomitant use should be avoided or monitored.

Methotrexate

Increased methotrexate levels, especially with high doses; consider temporary esomeprazole withdrawal.

Nelfinavir, Atazanavir

Reduced plasma concentrations of nelfinavir/atazanavir; concomitant use is contraindicated/not recommended.

Diazepam, Citalopram, Imipramine, Phenytoin

Esomeprazole may inhibit CYP2C19, increasing plasma levels of drugs metabolized by this enzyme.

Storage

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

Overdose

Symptoms are generally mild and non-specific. Management involves symptomatic and supportive treatment. There is no specific antidote.

Pregnancy & Lactation

Pregnancy category B. Use only if clearly needed. Esomeprazole is excreted in human milk; use with caution during lactation and weigh benefits against risks.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 capsules (1x10)30 capsules (3x10)

Shelf Life

Typically 24-36 months from manufacturing date.

Availability

Pharmacies, hospitals

Approval Status

Approved by health authorities worldwide (e.g., FDA, DGDA)

Patent Status

Generic versions available, original patent expired

WHO Essential Medicine

Yes

Clinical Trials

Extensively studied in clinical trials for GERD, erosive esophagitis, H. pylori eradication, and ulcer healing, demonstrating superior or comparable efficacy to other PPIs.

Lab Monitoring

Monitor liver function tests periodically in patients with hepatic impairment
Monitor serum magnesium levels in patients on long-term therapy or concurrent digoxin/diuretics.

Doctor Notes

Consider bone mineral density assessment for long-term PPI users, especially with fracture risk factors.
Advise patients on lifestyle modifications for GERD management.
Be aware of potential drug interactions, especially with clopidogrel and HIV medications.

Patient Guidelines

Take medicine exactly as prescribed by your doctor.
Do not stop taking the medicine suddenly without consulting your doctor.
Inform your doctor about all other medications you are taking.
Report any severe or persistent side effects to your doctor.

Missed Dose Advice

If a dose is missed, take it as soon as remembered. If it's almost time for the next dose, skip the missed dose and resume the regular schedule. Do not double the dose.