Cap. Nexum 40 mg

Ingredients:
Esomeprazole Magnesium Trihydrate (40mg)

Direction of Use:
Take 1 capsule orally with a glass of water.
Preferably take before meals for best absorption.
Do not chew or crush the capsule; swallow it whole.
If unable to swallow, open the capsule and mix the granules with water or juice.

Indication:
Used to treat gastric and duodenal ulcers.
Effective for gastroesophageal reflux disease (GERD) and erosive esophagitis.
Helps in Zollinger-Ellison syndrome (a condition with excessive acid production).
Used in combination with antibiotics for Helicobacter pylori eradication.

Pharmacology:
Esomeprazole is a proton pump inhibitor (PPI) that reduces stomach acid secretion by blocking the H+/K+ ATPase enzyme in the stomach lining.
Helps in healing ulcers and prevents acid-related damage to the esophagus.

Dosage & Administration:
GERD & Erosive Esophagitis: 40mg once daily for 4-8 weeks.
H. pylori eradication: 40mg once daily with antibiotics for 7-14 days.
Zollinger-Ellison syndrome: Dose varies; usually 40mg twice daily.
For maintenance therapy: 20mg once daily.

Interaction:
May reduce the effectiveness of clopidogrel (antiplatelet drug).
Increases blood levels of diazepam, warfarin, and phenytoin, requiring dose adjustments.
Decreased absorption of drugs needing acidic pH (e.g., ketoconazole, atazanavir).

Contraindications:
Hypersensitivity to esomeprazole or other PPIs.
Severe liver disease (dose adjustment may be required).
Concomitant use with nelfinavir (HIV medication) is not recommended.

Side Effects:
Common: Headache, nausea, diarrhea, constipation, flatulence.
Rare: Allergic reactions, liver enzyme elevation, vitamin B12 deficiency (long-term use).

Pregnancy & Lactation:
Category B in pregnancy – generally considered safe but consult a doctor.
Excreted in breast milk – use with caution during lactation.

Precautions & Warnings:
Long-term use may increase the risk of osteoporosis & bone fractures.
May mask symptoms of gastric cancer, so proper diagnosis is needed before use.
Regular monitoring is recommended in patients with liver disease.

Overdose Effects:
Symptoms: Confusion, drowsiness, blurred vision, rapid heartbeat.
Seek immediate medical attention in case of overdose.

Therapeutic Class:
Proton Pump Inhibitor (PPI)

Storage Conditions:
Store at 25°C or below, away from direct sunlight and moisture.
Keep out of reach of children.