Zunex
Generic Name
Esomeprazole
Manufacturer
Beximco Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| zunex 5 w cream | ৳ 30.00 | N/A |
Description
Overview of the medicine
Zunex contains Esomeprazole, a proton pump inhibitor, used to reduce stomach acid production. It treats conditions such as gastroesophageal reflux disease (GERD), duodenal ulcers, and Zollinger-Ellison syndrome.
Uses & Indications
Dosage
Adults
GERD: 20-40 mg once daily for 4-8 weeks. Erosive Esophagitis: 20-40 mg once daily for 4-8 weeks. Zollinger-Ellison Syndrome: 40 mg twice daily initially, adjusted based on response.
Elderly
No dosage adjustment generally required, but caution is advised due to potential for reduced hepatic function.
Renal_impairment
No dosage adjustment needed for mild to moderate renal impairment. For severe impairment, caution is advised.
How to Take
Take orally, at least one hour before a meal. Swallow capsules whole; do not chew or crush. For patients unable to swallow, capsules can be opened and granules mixed with soft food or water.
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, thereby blocking the final step of acid production.
Pharmacokinetics
Onset
Within 1 hour
Excretion
Approximately 80% excreted in urine as metabolites, and the remainder in feces.
Half life
Approximately 1-1.5 hours
Absorption
Rapidly absorbed after oral administration, bioavailability is approximately 64% for a 40 mg dose and increases with repeated dosing.
Metabolism
Extensively metabolized in the liver via cytochrome P450 (CYP) enzyme system, mainly by CYP2C19 and CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to esomeprazole or any components of the formulation
- Hypersensitivity to other substituted benzimidazoles (e.g., omeprazole, lansoprazole)
Drug Interactions
Warfarin
Increased INR and prothrombin time have been reported; monitor carefully.
Clopidogrel
May reduce the antiplatelet effect of clopidogrel by inhibiting CYP2C19. Consider alternative antiplatelet therapy or PPI.
Methotrexate
May increase serum levels of methotrexate, especially at high doses. Consider temporary withdrawal of PPI.
Atazanavir, Nelfinavir
Reduced absorption due to increased gastric pH, avoid concomitant use.
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 transient, including drowsiness, confusion, blurred vision, tachycardia, nausea, vomiting, sweating, flushing, headache, dry mouth, and other gastrointestinal disturbances. Treatment is symptomatic and supportive.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Excreted in human milk, exercise caution when administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to esomeprazole or any components of the formulation
- Hypersensitivity to other substituted benzimidazoles (e.g., omeprazole, lansoprazole)
Drug Interactions
Warfarin
Increased INR and prothrombin time have been reported; monitor carefully.
Clopidogrel
May reduce the antiplatelet effect of clopidogrel by inhibiting CYP2C19. Consider alternative antiplatelet therapy or PPI.
Methotrexate
May increase serum levels of methotrexate, especially at high doses. Consider temporary withdrawal of PPI.
Atazanavir, Nelfinavir
Reduced absorption due to increased gastric pH, avoid concomitant use.
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 transient, including drowsiness, confusion, blurred vision, tachycardia, nausea, vomiting, sweating, flushing, headache, dry mouth, and other gastrointestinal disturbances. Treatment is symptomatic and supportive.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Excreted in human milk, exercise caution when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months, refer to product packaging
Availability
Pharmacies, hospitals
Approval Status
Approved by FDA/DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated efficacy and safety in acid-related disorders.
Lab Monitoring
- Monitor magnesium levels with prolonged use (especially >1 year) or with concomitant diuretics.
- Monitor Vitamin B12 levels with prolonged use.
Doctor Notes
- Counsel patients on potential long-term risks, especially for those requiring extended therapy.
- Consider bone mineral density assessment for at-risk patients on long-term treatment.
- Monitor for C. difficile associated diarrhea.
Patient Guidelines
- Take as directed by your doctor.
- Do not stop taking without consulting your doctor.
- Inform your doctor about all other medications you are taking.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the 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 visual disturbances occur, caution is advised.
Lifestyle Advice
- Avoid spicy and fatty foods.
- Eat smaller, more frequent meals.
- Elevate the head of your bed to reduce reflux symptoms.
- Avoid smoking and excessive alcohol consumption.
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