Stosec
Generic Name
Esomeprazole Sodium
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| stosec 40 mg injection | ৳ 90.00 | N/A |
Description
Overview of the medicine
Esomeprazole is a proton pump inhibitor (PPI) that reduces stomach acid production. The 40 mg injection is used for short-term treatment of gastroesophageal reflux disease (GERD) with erosive esophagitis, and other acid-related conditions when oral therapy is not appropriate.
Uses & Indications
Dosage
Adults
For erosive esophagitis: 40 mg once daily by IV infusion over 30 minutes, usually for 7-10 days. For Zollinger-Ellison Syndrome: Initial 80 mg IV twice daily, adjusted based on patient response.
Elderly
No specific dose adjustment generally needed, but monitor for adverse effects.
Renal_impairment
No dose adjustment needed for patients with impaired renal function.
How to Take
Administer as an intravenous infusion over 30 minutes. The reconstituted solution should not be administered as a bolus injection.
Mechanism of Action
Esomeprazole irreversibly blocks the H+/K+-ATPase enzyme system (the proton pump) in the gastric parietal cells, thereby inhibiting the final step in acid production and significantly reducing gastric acid secretion.
Pharmacokinetics
Onset
Within 30-60 minutes.
Excretion
Primarily via urine (80%) and feces (20%).
Half life
Approximately 1.5 hours.
Absorption
Rapidly absorbed after IV administration, bioavailability is 100%.
Metabolism
Extensively metabolized in the liver by CYP2C19 and CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation.
- Concomitant use with nelfinavir due to significant reduction in nelfinavir plasma concentrations.
Drug Interactions
Warfarin
Increased INR and prothrombin time, monitor closely.
Clopidogrel
Reduced antiplatelet effect, consider alternative antiplatelet therapy.
Methotrexate
Increased methotrexate levels, especially with high-dose methotrexate; monitor for toxicity.
Nelfinavir, Atazanavir
Decreased plasma levels of antiretrovirals, avoid co-administration.
Storage
Store below 30°C, protected from light and moisture. Keep out of reach of children. Reconstituted solution should be used within a specific time (e.g., 6 hours at room temperature, 24 hours refrigerated).
Overdose
Overdose experience is limited. Symptomatic and supportive treatment should be given. No specific antidote is known.
Pregnancy & Lactation
Use during pregnancy only if clearly needed and the potential benefits outweigh the risks. Exercise caution when administered to a nursing woman as esomeprazole is excreted in human milk.
Side Effects
Contraindications
- Hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation.
- Concomitant use with nelfinavir due to significant reduction in nelfinavir plasma concentrations.
Drug Interactions
Warfarin
Increased INR and prothrombin time, monitor closely.
Clopidogrel
Reduced antiplatelet effect, consider alternative antiplatelet therapy.
Methotrexate
Increased methotrexate levels, especially with high-dose methotrexate; monitor for toxicity.
Nelfinavir, Atazanavir
Decreased plasma levels of antiretrovirals, avoid co-administration.
Storage
Store below 30°C, protected from light and moisture. Keep out of reach of children. Reconstituted solution should be used within a specific time (e.g., 6 hours at room temperature, 24 hours refrigerated).
Overdose
Overdose experience is limited. Symptomatic and supportive treatment should be given. No specific antidote is known.
Pregnancy & Lactation
Use during pregnancy only if clearly needed and the potential benefits outweigh the risks. Exercise caution when administered to a nursing woman as esomeprazole is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years, varies by manufacturer. Refer to product packaging for specific dates.
Availability
Pharmacies, hospitals, clinics
Approval Status
Approved by major regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generally off-patent, but depends on specific formulations/countries
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of Esomeprazole for its approved indications, including the intravenous formulation for conditions where oral administration is not feasible.
Lab Monitoring
- Monitor serum magnesium levels periodically, especially with prolonged use (more than 3 months) or with concomitant diuretics.
- Monitor INR and prothrombin time in patients on concomitant warfarin.
- Consider monitoring Vitamin B12 levels with long-term therapy.
Doctor Notes
- Assess patients for underlying causes of gastrointestinal symptoms before initiating therapy and monitor for symptom resolution.
- Consider the lowest effective dose for the shortest duration necessary to achieve and maintain therapeutic goals.
- Be aware of potential drug interactions, especially with warfarin, clopidogrel, and nelfinavir, and monitor accordingly.
Patient Guidelines
- Report any unusual symptoms, such as persistent diarrhea, fever, or rash, to your doctor immediately.
- This injection is typically used for short-term treatment. Follow your doctor's prescribed duration.
- Do not stop treatment abruptly without consulting your doctor, even if symptoms improve.
Missed Dose Advice
If a dose is missed, administer it as soon as remembered, unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed one.
Driving Precautions
Esomeprazole may cause dizziness, visual disturbances, or somnolence in some patients. Patients should be cautious when driving or operating machinery if they experience these side effects.
Lifestyle Advice
- Avoid trigger foods and beverages that worsen reflux symptoms (e.g., spicy food, fatty food, caffeine, alcohol, acidic fruits).
- Maintain a healthy weight and avoid lying down immediately after meals.
- Eat smaller, more frequent meals and wear loose-fitting clothing.
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