ESOMEPRAZOLE: Tablet/Capsule.
Esomeprazole is the newest proton pump inhibitor.
Ind: Esomeprazole is indicated for the relief of heartburn and other symptoms associated with gastroesophageal reflux disease (GERD) and for the healing of erosive esophagitis, a potentially serious
condition associated with GERD. Esomeprazole is also approved for use in combination with 'triple therapy' with amoxicillin and clarithromycin for the eradication of Helicobacter Pylori infection in patients with duodenal ulcer disease.
C/I: Known hypersensitivity to any component of the formulation.
S/E: Side-effects may include- headache, diarrhoea, abdominal pain, etc.
Precaution: Exclude the possibility of malignancy when gastric ulcer is suspected and before treatment for dyspepsia. When using 'triple therapy' refer to the prescribing information of the respective antibiotics.
Dosage & admin: Dosage schedule for adult.
Gastroesophageal reflux disease (GERD):
i.Symptomatic gastroesophageal reflux- 20mg once daily for 4 weeks; if symptoms do not resolve completely after 4 weeks, an additional 4 weeks of treatment may be considered. ii. Healing of erosive esòphagitis- 20mg or 40mg once daily for 4 to 8 weeks; patients who do not heal after 8 weeks, an additional 4-8 weeks treatment may be considered.
ii. Maintenance of healing of erosive esophagitis-20mg once daily for up to not beyond six months. Triple therapy for H. pylori eradication: Esomeprazole 40mg once daily for 10 days with Amoxycillin 1gm twice daily for 10 days & Clarithromycin 500mg twice daily for 10 days.
Warnings: No dosage adjustment is necessary for geriatric patients; no dosage adjustment is necessary
for renal insufficiency & in patients with mild to moderate liver impairment; patients with severe liver
impairment a dose of 20mg of esomeprazole should not be exceeded. In pediatric patients, safety and effectiveness have not yet been established.
Drug inter: Esomeprazole appears to be a selective inhibitor of the cytochrome P-450 mono-oxygenase
system; there may be an effect on hepatic clearance, but there have been no reports to date of clinically
relevant interactions. There 1S some uncertainty over the effect of esomeprazole on the oral combined
contraceptive pill. Physiological changes similar to those found with omeprazole are likely to take place
because of the reduction in gastric acid, which is likely to influence the bacterial colonization of the
stomach and duodenum and also vitamin B, absorption.