"Esomeprazole" is a drug that belongs to organotropic gastrointestinal medicines. The drug has an antiulcer effect and is a proton pump inhibitor.
Composition, release form of the drug "Esomeprazole"
The medicine is available in the form of tablets with a dosage of 20 and 40 mg of the active component of esomeprazole, as well as in the form of a powder intended for the preparation of an injection solution (40 mg vial). The tablets are coated, the dissolution of which occurs in the intestine.
Pharmacological action of the drug "Esomeprazole"
What is the drug "Esomeprazole"? Instructions for use show that it is an antiulcer drug, which, being a weak base, takes an active form after it enters the stomach. Esomeprazole inhibits the action of the enzyme H + -K + -ATPase, as well as the secretion of hydrochloric acid (stimulated, basal). The necessary action occurs one hour after taking the drug. When “Esomeprazole” is taken daily for five days, with an allowable daily dose of 20 mg, after stimulation with pentagastrin, the maximum level of hydrochloric acid is significantly reduced (approximately 90%).
Pharmacokinetics
“Esomeprazole” instructions for use are presented as a drug that, penetrating the body, is rapidly and well absorbed, binds to proteins by almost 100% (97%). Bioavailability increases with repeated use of the drug from 64 to 89%. The medication takes the form of metabolites and is excreted mainly in the urine, a small part of it is present in the feces.
Indications for use of the drug "Esomeprazole"
Esomeprazole analogues are prescribed for patients with gastroesophageal reflux disease for the treatment and prevention of exacerbations. This tool is used in the complex treatment of duodenal ulcer or stomach ulcer, for the prevention of the disease that arose as a result of taking NSAIDs.
The drug is used for peptic ulcer, when the duodenum or stomach is affected. It can be used in patients in whom esophagitis has been cured, with prolonged prevention of relapse. It is acceptable to use Esomeprazole with antibacterial drugs. Tablets and injection for complex therapy in this case can destroy Helicobacter pylori.
Contraindications to taking the drug "Esomeprazole"
Contraindications include age less than twelve years, hypersensitivity to esomeprazole, period of breastfeeding. The consequences of treatment with the drug during pregnancy have not been established.
Medication
The drug is used in a daily dose of 20-40 mg. The duration of therapy is determined by the indications, treatment regimen and the effectiveness of the Esomeprazole medication. Tablets and solution for severely occurring renal failure are used in a maximum dose of 20 mg.
Erosive reflux esophagitis is treated for four weeks using a daily dose of 40 mg. With long-term relapse prevention based on taking the drug in patients with esophagitis, the daily dose is set within 20 mg.
In the treatment of reflux esophagitis, aimed at eliminating the main symptoms of the disease, take 20 mg of Esomeprazole. Preparations in the form of tablets and powder are used to kill H. pylori when there is a connection with a duodenal ulcer, as part of the combination therapy - Esomeprazole (20 mg), Clarithromycin (500 mg), Amoxicillin (1 g). All medicines are taken twice a day.
Gastric ulcers caused by the use of NSAIDs are recommended to be treated with 20 mg of Esomeprazole per day. The necessary dose is always prescribed by the doctor, taking into account the patient’s health, illness, severity of its course and other important factors.
Side effects of the drug "Esomeprazole"
Patients who take these drugs for a long time are more prone to the formation of glandular cysts in the stomach than other patients. Of the frequent negative manifestations of the body during the treatment with the Esomeprazole preparation, the instructions for use isolate a headache and some negative reactions from the gastrointestinal tract, namely: constipation, flatulence, diarrhea, nausea with vomiting, pain in the abdomen. Rare side effects include drying out of the oral mucosa, dizziness, urticaria, pruritus, dermatitis. Other reactions are possible, so treatment should be carried out strictly under the supervision of a specialist.
Overdose is accompanied by general weakness, enhanced by the manifestation of side effects, including from the gastrointestinal tract. In such cases, treatment is performed by eliminating the symptoms of an overdose and maintenance therapy. Dialysis practically does not have the desired effect, antidotes do not exist.
special instructions
Esomeprazole pregnant women, analogues are prescribed with extreme caution. Treatment during pregnancy should be carried out under the supervision of a doctor. Pregnant women are prescribed the drug only in those cases when the positive effect for their body significantly exceeds the possible harm to the unborn child. There are no reliable data on the effect of the drug on the embryo, treatment with this medication should be avoided if possible. The use of the drug "Esomeprazole" when breastfeeding is prohibited.
In case of impaired liver function, exceeding the prescribed dose is hazardous to health (in the event that these disorders are severe).
When the patient has signaling symptoms, such as hemathemesis, dysphagia, nausea, a significant decrease in body weight, during the treatment with Esomeprazole in order to eliminate the ulcer or due to taking the drug if it is suspected that this disease is present, malignancy should be excluded. To identify malignant neoplasms, it is necessary to conduct an appropriate study.
Patients who have sucrose-isomaltase deficiency, hereditary fructose intolerance, it is forbidden to prescribe “Esomeprazole”, synonyms.
Interaction of "Esomeprazole" with other drugs
With the simultaneous use of the drug with "Citalopram", "Clomipramine", "Imipramine", an enhanced effect of these agents, an increase in the level of the active substance in the blood, are possible. When used in conjunction with Esomeprazole, the effectiveness of Ketoconazole, Itraconazole decreases, their absorption worsens.
When combining "Esomeprazole" with "Atazanavir" there is a significant decrease in the exposure of this medication. Esomeprazole is not recommended for use at the same time as Phenytoin, Clomipramine, Imipramine, and drugs such as Citalopram, Diazepam, Nelfinavir, and Atazanavir. The level of these drugs in the blood can increase, so there may be a need to reduce their dose. Concomitant use of “Esomeprazole” and “Clarithromycin” leads to a significant change in the exposure of “Esomeprazole”, there is an increase associated with inhibition of the metabolism of this drug. Before use, you should carefully study the tool for the drug and consult with a specialist.
The cost of the drug, reviews on the drug "Esomeprazole"
The medicine is mainly acquired in the form of tablets. In pharmacies, Esomeprazole can be found under the trade names Nexium and Emanera. When buying the drug "Esomeprazole" the price depends on the dose of the active substance in its composition. The cost of a medicine with a dosage of 20 mg ("Emanera") is approximately 500 rubles. for 28 tablets and determined by the manufacturer. A medicine with a dose of the active ingredient 40 mg (Nexium, 28 tablets) can be purchased for 3000 rubles.
Esomeprazole reviews are mostly positive. They noted the property of the drug to inhibit the secretion of hydrochloric acid, both basal and stimulated. The drug has shown high efficiency in the treatment of conditions that correspond to the indications indicated in the instructions. During therapy with this agent there is a slight chance of side effects. Not everyone can easily find the drug in pharmacies; for some patients who have been prescribed Esomeprazole, the price seems high.
Those who took the medicine as prescribed by the doctor after an accurate diagnosis and at the recommended dose, noted a significant improvement in well-being. According to reviews, Nexium is more popular among patients than Emanera. In case of a stomach ulcer, Nexium provides the appearance of the desired result after about one month from the start of therapy. Improvement can be observed after 1.5 weeks of treatment. Side effects are very rare. The drug "Nexium" is effective, it helps in eliminating the conditions specified in the instructions. In order for the result to be positive, you need to complete the entire course and fully adhere to the doctor's recommendations.
Analogues of Esomeprazole
From the analogues of the drug, the following options can be distinguished:
- "Omeprazole" - it is also called "Losek", "Omez", "Ultop";
- “Rabeprazole” - the drug is known under the names “Ontaym”, “Zulbeks”, “Noflux”, “Pariet”, “Khairabesol”;
- Pantoprazole (Sanpraz, Kontrolok, Nolpaza);
- "Lansoprazole" ("Lantsit", "Lansoptol").
All of these drugs have a similar effect, but differ from each other in cost.
Compare Esomeprazole and Omeprazole. The differences between these drugs are obvious. Esomeprazole is an isomer of omeprazole. This drug, based on data from the medical literature, has a significant advantage, but the effect of medicines is similar. Omeprazole is a basic drug with a large number of side effects. If we consider the properties of Esomeprazole, the drug is presented as an improved version of Omeprazole, the price of which attracts many patients. However, Esomeprazole is less likely to cause unwanted reactions of the body, so its acquisition is considered more profitable than the acquisition of Omeprazole.
"Rabeprazole" and "Esomeprazole" have a similar chemical composition, they treat the same disease. But experts believe that some diseases, such as gastroesophageal reflux disease, “Rabeprazole” eliminates more effectively, it better removes symptoms, and helps to quickly restore the work of the esophagus. The lack of a positive effect in the treatment of "Esomeprazole" may be due to the individual characteristics of the body.
If necessary, choose an analog should consult a doctor. Be more attentive to your health and be examined in time, then recovery will be faster, and many complications will be avoided.