Medicine Information

Sergel

Name: Sergel
Brand: Sergel

Tablet40 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 tablet	৳ 9.00	৳ 90.00

Description

Overview of the medicine

Sergel 40 mg Tablet contains Esomeprazole, a proton pump inhibitor (PPI) that reduces the amount of acid produced in the stomach. It is used to treat conditions caused by excess stomach acid, such as heartburn, acid reflux, gastroesophageal reflux disease (GERD), and stomach ulcers.

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

Helicobacter pylori eradication (in combination with antibiotics)

Zollinger-Ellison syndrome and other pathological hypersecretory conditions

Dosage

Adults

For GERD: 20-40 mg once daily for 4-8 weeks. For H. pylori eradication: 40 mg once daily for 10 days with appropriate antibiotics. For Zollinger-Ellison syndrome: Initial dose 40 mg twice daily, adjusted as needed.

Elderly

No specific dosage adjustment is generally required for elderly patients with normal renal and hepatic function.

Renal_impairment

No dosage adjustment is needed for patients with renal impairment.

How to Take

Take one tablet orally, preferably at least one hour before a meal. Swallow the tablet whole with water; do not crush, chew, or break it.

Mechanism of Action

Esomeprazole selectively and irreversibly inhibits the gastric H+/K+-ATPase (proton pump) in the parietal cells of the stomach, thereby blocking the final step of acid secretion. This leads to a dose-dependent inhibition of both basal and stimulated gastric acid secretion.

Pharmacokinetics

Onset

Within 1 hour.

Excretion

Approximately 80% of the dose is excreted as metabolites in the urine, and the remainder in the feces.

Half life

Approximately 1-1.5 hours.

Absorption

Rapidly absorbed after oral administration, peak plasma concentrations occur within 1-2 hours. Bioavailability is about 64% after a single 40 mg dose, increasing to 89% after repeated once-daily dosing.

Metabolism

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

Side Effects

Contraindications

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

Drug Interactions

Warfarin

Increased INR and prothrombin time, monitor closely.

Clopidogrel

Potential reduction in antiplatelet effect, use with caution.

Methotrexate

Increased methotrexate levels, especially with high doses.

Nelfinavir, Atazanavir

Reduced plasma concentrations of antiretrovirals, avoid concomitant use.

Diazepam, Citalopram, Imipramine, Phenytoin

Esomeprazole can inhibit the metabolism of drugs metabolized by CYP2C19, potentially increasing their levels.

Storage

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

Overdose

There is limited experience with Esomeprazole overdose. Symptoms are generally mild and may include drowsiness, tachycardia, nausea, headache, diarrhea, and abdominal pain. Treatment should be symptomatic and supportive.

Pregnancy & Lactation

Pregnancy Category B. Studies in animals have not shown harm to the fetus, but there are no adequate and well-controlled studies in pregnant women. Use only if clearly needed. It is unknown whether Esomeprazole is excreted in human milk; use with caution during breastfeeding.

Side Effects

Contraindications

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

Drug Interactions

Warfarin

Increased INR and prothrombin time, monitor closely.

Clopidogrel

Potential reduction in antiplatelet effect, use with caution.

Methotrexate

Increased methotrexate levels, especially with high doses.

Nelfinavir, Atazanavir

Reduced plasma concentrations of antiretrovirals, avoid concomitant use.

Diazepam, Citalopram, Imipramine, Phenytoin

Esomeprazole can inhibit the metabolism of drugs metabolized by CYP2C19, potentially increasing their levels.

Storage

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

Overdose

Pregnancy & Lactation

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 tablets per blister30 tablets per box

Shelf Life

36 months from the date of manufacture

Availability

Available in pharmacies and hospitals nationwide.

Approval Status

Approved

Patent Status

Off-patent

WHO Essential Medicine

Yes

Clinical Trials

Numerous clinical trials have established the efficacy and safety of Esomeprazole for various acid-related disorders, including GERD, erosive esophagitis, and H. pylori eradication. Studies have demonstrated its superiority or non-inferiority compared to other PPIs in certain indications.

Lab Monitoring

Monitor magnesium levels in patients on long-term therapy (≥3 months) or concomitant digoxin/diuretics.
Consider liver function tests in patients with severe hepatic impairment.

Doctor Notes

Consider lowest effective dose for shortest duration necessary.
Assess for drug interactions, especially with CYP2C19 inhibitors/substrates.
Monitor for long-term adverse effects like hypomagnesemia and bone mineral density changes.

Patient Guidelines

Take this medicine exactly as prescribed by your doctor.
Swallow the tablet whole with a glass of water; do not crush, chew, or break it.
Take it at least one hour before your morning meal.
Do not stop taking this medicine suddenly without consulting your doctor.

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 to catch up.