"Esomeprazole" - an effective antiulcer drug, a proton pump inhibitor, is available without a prescription. The drug is used during complex therapy in the treatment of pathologies of the digestive tract. It has a wide range of actions, therefore, when determining the dosage, it is necessary to take into account the diagnosis and the stage of development of the pathological process.
Material Content:
- 1 Dosage forms, composition
- 2 Pharmacological properties and indications for use
- 3 Age restrictions on admission
- 4 Esomeprazole: instructions for use of the drug
- 5 Pregnancy and lactation
- 6 Use for impaired renal function, liver
- 7 Drug interaction
- 8 Contraindications, side effects and overdose
- 9 Analogs of the drug Esomeprazole
Dosage forms, composition
The medicine is available in powder form for the preparation of a solution for infusion and injection. The more common dosage form is tablet.
The composition of the drug includes such components:
- esomeprazole magnesium dihydrate;
- hydroxypropyl cellulose;
- starch;
- silica;
- cellulose microcrystals, etc.
Each tablet is protected by a shell that dissolves under the influence of gastric juice. The content of the active substance may be different (20 mg, 40 mg). In the 1st blister for 14 pieces. In cardboard packaging 1 - 2 blisters.
Pharmacological properties and indications for use
Thanks to special mechanisms, esomeprazole inhibits the secretion of gastric juice. The active substance is able to inhibit different types of secretions. The expressive effect is manifested within 1 hour after taking the medicine. If you take the drug for 5 days according to the instructions, the production of hydrochloric acid will decrease by 90%.
The active substance is well absorbed by the cells of the stomach, combines with plasma, and then completely decomposes with the formation of hydroxylated and desmethylated metabolites, most of which are excreted through the kidneys and intestines. To determine the concentration of the active component of the drug in the blood, the AUC parameter was used.
The drug "Esomeprazole" is prescribed in such cases:
- prevention of recurrence of reflux esophagitis, accompanied by erosion;
- symptomatic relief of GERD;
- ulcers and erosion on the gastric mucosa;
- duodenal ulcer, including that associated with Helicobacter pylori;
- damage to the mucosa caused by NSAIDs;
- increased activity of the glands of the stomach (pathological and idiopathic secretion).
In each case, the dosage of the drug will be different, so you can not independently determine the dose and start taking the medicine without consulting a specialist.
Age restrictions on admission
The drug is not prescribed for children under the age of 12 years due to lack of information on the effectiveness of “Esomeprazole” in patients from this age category. Therapy using this medication can be carried out only in individual cases with the aim of stopping the symptoms of GERD, treating esophagitis and peptic ulcer.
Esomeprazole: instructions for use of the drug
The most common form of drug release is tablets. They must be swallowed whole, without chewing, so that the active substances are unhindered and fully delivered to the focus of the disease. If swallowing the whole tablet is difficult, you can dilute it in still mineral water. Only the shell disintegrates, the microgranules remain intact. You need to immediately drink this solution.
Other dilution liquids cannot be used, because they can damage the integrity of the microgranules and the active components disintegrate on the way to the stomach.
Dosage and administration
The dosage of the drug depends on the diagnosis and the state of health of the patient. The daily dose is determined by the attending physician after conducting a comprehensive diagnosis and evaluation of test results.
| Diagnosis | Daily dosage (mg) | Reception (number of times a day) | Duration of treatment (weeks) |
|---|---|---|---|
| GERD without esophagitis | 20 | 1 | 4 |
| erosive reflux esophagitis (treatment) | 40 | 1 | 4 |
| erosive reflux esophagitis (prevention) | 20 | 1 | - |
| duodenal ulcer | 40 | 2 | 1-2 |
| peptic ulcers resulting from prolonged use of NSAIDs | 20 | 1 | 4-8 |
Special instructions for use
Esomeprazole is prescribed for patients who have difficulty swallowing medication. In such cases, the tablets are diluted in mineral water without gases and administered using a nasogastric tube. To carry out this procedure, it is necessary to prepare a syringe, the probe itself, a tablet and water.
- Place the tablet in a syringe, fill it with 5 ml of air and 25 ml of water.
- Shake quickly until the tablet disintegrates into microgranules.
- Check if the tip of the syringe is clogged.
- Place the syringe with its tip up and carefully place it in the probe.
- Quickly introduce 10 - 15 ml of liquid into the probe, shake. Repeat this action several times until you have administered the entire volume of the medicine.
- If granules remain on the walls of the syringe, draw water, chat and introduce fluid into the probe.
The drug is prescribed with caution to patients with a diagnosis of severe hepatic insufficiency. Patients of advanced age, as well as those who are diagnosed with renal failure, do not need to adjust the dose.
Pregnancy and lactation
There is no reliable data on the effect of the main component of the drug on the health status of the expectant mother and fetus. The medicine is prescribed if the benefit to the patient exceeds the risk to the child.
Epidemiological and experimental studies conducted with the participation of pregnant animals showed that esomeprazole has no pathological effect on the condition and development of the embryo, as well as on the course of pregnancy and the passage of labor.
There is no information on whether the components of the drug with mother's milk are excreted, therefore, the drug is not prescribed for lactating women.
Use for impaired renal function, liver
Esomeprazole can be taken for diseases of the kidneys and liver. Dosage is not adjusted. Prescribe medication to patients whose liver failure is difficult, but the therapy is carried out under the close supervision of a doctor. In such cases, the dose should not be higher than 20 mg per day.
Drug interaction
Esomeprazole tablets reduce the acidity of gastric juice, and this may affect the absorption of drugs if their absorption depends on the environment.
- When taking this medication, along with other CYP2C19 inhibitors (Diazepam), the concentration of active components in the blood plasma may increase, which necessitates a reduction in the daily dose.
- If a patient carries out “Esomepraz” therapy together with “Phenytoin”, it is necessary to monitor blood counts, because the concentration of the latter can increase by 13%.
- When taking Esomeprazole and Warfarin, the INR index may increase.
- Esomeprazole does not cause significant changes in the pharmacokinetic parameters of drugs based on cisapride, quinidine, amoxicillin, rofecoxib, naproxen.
Contraindications, side effects and overdose
Esomeprazole tablets are not prescribed for patients with hypersensitivity to fructose and the components of the drug. For children, pregnant and breast-feeding women, the drug is also contraindicated.
As for the side effects, they can be divided into four categories depending on the frequency of manifestation.
- Often. In one of 10/100 cases, patients complain of a headache. As a rule, after taking the drug, reactions occur from the digestive tract, namely diarrhea, vomiting, pain in the stomach, increased gas formation.
- Often. In 100/1000 cases, patients develop skin rashes (urticaria, dermatitis), itching, visual impairment, and dry mouth.
- Seldom. Depression, leukopenia, anaphylactoid reaction, angioneurotic edema.
- Rarely. Pancytopenia, agranulocytosis.
If therapy with the use of the drug "Esomeprazole" is carried out over an extended period, the patient may encounter adverse reactions from the nervous, digestive, endocrine systems, musculoskeletal system. Sometimes dermatological and allergic reactions occur (alopecia, redness of the skin, bronchospasm, anaphylactic shock, etc.).
Isolated cases of intentionally exceeding the recommended dose are rarely recorded.
- When taking the drug “Esomeprazole” in an amount of 80 mg, no negative reactions were manifested, the condition of the patients remained practically unchanged.
- With an increase in the daily dose to 280 mg of the patient, severe muscle weakness can disturb, negative manifestations from the organs of the gastrointestinal tract occur.
The active component of the drug combines with plasma proteins, dialysis is not performed when the dose is exceeded, it is ineffective. There is no antidote either. In order to improve the patient’s condition, symptoms are stopped, gastric lavage and other measures are taken to reduce the concentration of the active substance in the patient’s blood.
Analogs of the drug Esomeprazole
Esomeprazole is considered one of the most common, affordable and effective drugs prescribed for peptic ulcer disease and GERD. The brand name of the original medicine is Nexium, and the manufacturer is Health (AstraZeneca) (Sweden). The cost of one package in which 14 tablets with an active substance content of 20 mg is 1,500 rubles, 40 mg is 2,000 rubles.The powder for the preparation of an infusion solution of 40 mg costs 600 rubles.
However, there is a fairly significant list of medicines that act in the same direction, but their cost is more affordable. The table below shows the most popular analogues of Esomeprazole.
| A drug | Manufacturing firm | The country of manufacture | Release form | Price, rub.) |
|---|---|---|---|---|
| Neo-Zext | Sandoz | Switzerland | tablets (20 mg, 28 pcs.) | 2145 |
| Esomeprazole Canon | Canonpharma | Russia | tablets (20 mg, 14 pcs.) | 168 |
| Esomeprazole Canon | Canonpharma | Russia | tablets (40 mg, 14 pcs.) | 259 |
| Emanera | Krka, dd New place | Slovenia | capsules (20 mg, 14 pcs.) | 237 |
| Emanera | Krka, dd New place | Slovenia | capsules (40 mg, 14 pcs.) | 420 |
These synonyms completely repeat the effect of Nexium, they have the same indications, features of use, the same pharmacodynamics and pharmacokinetics.
There is a large list of analogues, proton pump inhibitors, which include another active substance, for example, pantorazole, omeprazole, rabeprazole, lansoprazole.
The most popular drugs include the following:
- Omez
- "Control";
- "Rabeprazole."
Patients and specialists leave positive feedback about these drugs, noting their high effectiveness, safety, speed, and the optimal ratio of price-quality parameters.
In any case, you cannot buy any medications on your own and start a course of treatment without a full examination and obtaining test results. The treatment of serious pathologies such as GERD and peptic ulcer should be carried out under the supervision of a physician.
