Tab. Esoral 20 mg

Indication:
Treatment of gastroesophageal reflux disease (GERD)
Healing of erosive esophagitis
Prevention of gastric ulcers associated with NSAID use
Eradication of Helicobacter pylori infection (in combination with antibiotics)
Management of Zollinger-Ellison syndrome

Pharmacology, Dosage & Administration:
Pharmacology: Esomeprazole inhibits the H+/K+ ATPase enzyme in gastric parietal cells, leading to reduced gastric acid secretion.
Dosage & Administration:
GERD: 20 mg once daily for 4 to 8 weeks.
Erosive Esophagitis: 20 to 40 mg once daily for 4 to 8 weeks.
NSAID-associated Ulcers: 20 mg once daily for up to 6 months.
H. pylori Eradication: 20 mg twice daily in combination with antibiotics for 10 days.
Zollinger-Ellison Syndrome: 40 mg twice daily, adjusted as needed.
Take at least one hour before meals.

Interaction:
Drugs Affecting Esomeprazole:
CYP2C19 and CYP3A4 inhibitors (e.g., clarithromycin) may increase esomeprazole levels.
CYP2C19 inducers (e.g., rifampin) may decrease its efficacy.
Esomeprazole’s Effects on Other Drugs:
May reduce absorption of drugs like ketoconazole and iron salts.
May increase levels of drugs such as diazepam and phenytoin.
May diminish the effect of clopidogrel.

Contraindications:
Known hypersensitivity to esomeprazole or substituted benzimidazoles.
Concomitant use with rilpivirine-containing products.

Side Effects:
Common:
Headache
Diarrhea
Nausea
Stomach pain
Constipation
Dry mouth
Serious:
Severe allergic reactions
Kidney problems
Vitamin B-12 deficiency with long-term use

Pregnancy & Lactation:
Pregnancy: Use only if clearly needed; consult a healthcare provider.
Lactation: Caution advised; unknown if excreted in human milk.

Precautions & Warnings:
Rule out gastric malignancy before treatment.
Long-term use may increase the risk of fractures and vitamin B-12 deficiency.
Monitor for Clostridium difficile-associated diarrhea.
Use with caution in patients with severe liver impairment.

Overdose Effects:
Symptoms may include confusion, drowsiness, blurred vision, tachycardia, nausea, sweating, flushing, headache, and dry mouth.
Treatment is supportive and symptomatic.

Therapeutic Class:
Proton Pump Inhibitor (PPI).

Storage Conditions:
Store at room temperature, away from moisture and heat.
Keep out of reach of children.