Stosec
Generic Name
Esomeprazole
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| stosec 20 mg capsule | ৳ 6.00 | ৳ 60.00 |
| stosec 40 mg injection | ৳ 90.00 | N/A |
Description
Overview of the medicine
Stosec (Esomeprazole) is a proton pump inhibitor (PPI) that reduces gastric acid secretion by irreversibly blocking the H+/K+-ATPase pump in gastric parietal cells. It is used to treat conditions caused by excess stomach acid, such as GERD, peptic ulcers, and Zollinger-Ellison syndrome.
Uses & Indications
Dosage
Adults
For GERD: 20 mg or 40 mg once daily for 4 to 8 weeks. For erosive esophagitis healing: 20 mg or 40 mg once daily for 4 to 8 weeks. For H. pylori eradication: 20 mg twice daily for 7-10 days (with appropriate antibiotics).
Elderly
No specific dosage adjustment is generally required for elderly patients.
Renal_impairment
No dosage adjustment is necessary for patients with impaired renal function.
How to Take
Stosec capsules should be swallowed whole with water at least one hour before a meal. Do not chew or crush the capsule. For patients who have difficulty swallowing, the capsule can be opened and the pellets mixed with a small amount of water or fruit juice.
Mechanism of Action
Esomeprazole is a proton pump inhibitor that reduces gastric acid secretion by irreversibly blocking the H+/K+-ATPase pump (proton pump) in the gastric parietal cells. This inhibition prevents the final step in gastric acid production.
Pharmacokinetics
Onset
Onset of antisecretory effect within 1 hour.
Excretion
Approximately 80% of the dose is excreted as metabolites in the urine, and the remainder (20%) in the feces.
Half life
Plasma elimination half-life is approximately 1-1.5 hours.
Absorption
Rapidly absorbed after oral administration, with peak plasma concentrations occurring within 1-2 hours. Absolute bioavailability is approximately 64% after a single dose and increases to 89% with repeated once-daily dosing.
Metabolism
Primarily metabolized in the liver by the cytochrome P450 enzyme system, mainly via CYP2C19 and to a lesser extent 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
Digoxin
Increased absorption and plasma levels of digoxin.
Diazepam
Decreased metabolism and increased half-life of diazepam.
Warfarin
Increased INR and prothrombin time.
Clopidogrel
Reduced antiplatelet effect of clopidogrel.
Methotrexate
Increased plasma levels of methotrexate.
Nelfinavir/Atazanavir
Reduced absorption of these antiretrovirals.
Ketoconazole/Itraconazole
Reduced absorption of these antifungals.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
There is limited experience with overdose. Symptoms may include gastrointestinal disturbances, weakness, and central nervous system effects. Treatment should be symptomatic and supportive.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown whether esomeprazole is excreted in human milk; use with caution during lactation.
Side Effects
Contraindications
- Known hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation.
- Concomitant use with nelfinavir (an antiretroviral drug).
Drug Interactions
Digoxin
Increased absorption and plasma levels of digoxin.
Diazepam
Decreased metabolism and increased half-life of diazepam.
Warfarin
Increased INR and prothrombin time.
Clopidogrel
Reduced antiplatelet effect of clopidogrel.
Methotrexate
Increased plasma levels of methotrexate.
Nelfinavir/Atazanavir
Reduced absorption of these antiretrovirals.
Ketoconazole/Itraconazole
Reduced absorption of these antifungals.
Storage
Store below 30°C in a dry place, away from direct light and moisture. Keep out of reach of children.
Overdose
There is limited experience with overdose. Symptoms may include gastrointestinal disturbances, weakness, and central nervous system effects. Treatment should be symptomatic and supportive.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown whether esomeprazole is excreted in human milk; use with caution during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from the date of manufacture, specific details on packaging.
Availability
Available in pharmacies and hospitals
Approval Status
Approved
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, including GERD, erosive esophagitis, and H. pylori eradication. These trials support its use in both short-term and long-term management.
Lab Monitoring
- Magnesium levels (especially with long-term use, concomitant diuretics, or digoxin)
- Liver function tests (if underlying liver disease or signs of hepatic dysfunction)
- Chromogranin A levels (may increase with PPI use and interfere with neuroendocrine tumor diagnosis)
Doctor Notes
- Consider the lowest effective dose for the shortest duration necessary.
- Monitor magnesium levels in patients on long-term therapy, especially with diuretics.
- Assess for C. difficile infection if diarrhea occurs.
- Counsel patients on potential long-term risks.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not crush, chew, or break the capsule; swallow it whole.
- Take it at least one hour before a meal.
- Do not stop taking the medicine suddenly without consulting your doctor.
- Inform your doctor about all other medications you are taking.
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 take a double dose to make up for a missed one.
Driving Precautions
Stosec may cause dizziness or visual disturbances in some patients. If you experience these symptoms, avoid driving or operating machinery.
Lifestyle Advice
- Avoid trigger foods such as spicy foods, fatty foods, citrus fruits, chocolate, and caffeine.
- Elevate the head of your bed to reduce nighttime reflux symptoms.
- Avoid lying down immediately after eating.
- Maintain a healthy weight.
- Quit smoking and reduce alcohol consumption.
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