Asgizole 20mg Valpharma Treatment Treatment of Gastro -ulcer, benign duodenal, Zollinger syndrome - Ellison (4 blisters x 7 tablets)

Dosage form Box of 4 blisters x 7 tablets
Specifications Esomeprazol
Ingredient Gastroesophageal reflux, heartburn

Ingredient

Composition information	Content
Esomeprazol	20mg

Uses

indications

Asgizole is indicated in the following cases:

Gastroenter ulcer - benign duodenum.

Zollinger - Ellison syndrome. Learning

Esomeprazol is the isomorphic form of omeprazol, used similar to omeprazol in the treatment of gastric ulcer - duodenum and gastroesophageal reflux disease.

Esomeprazol is attached to H+/K+ - Atpase (proton pump) in the stomach wall, inhibiting this enzyme system, preventing the final step of acid secretion into the stomach. So Esomeprazol has the effect of inhibiting the basic acid secretion and even when stimulated by any agent.

Dynamic pharmacokinetics

absorption

Esomeprazol absorbs quickly after drinking, reaching the highest concentration in plasma after 1 to 2 hours. Esomeprazol's bioavailability increases according to the dose and when used to repeat, reaching about 68% when using 20 mg and 89% when using 40 mg dose. Food slows down and reduces the absorption of Esomeprazol, the area under the curve (AUC) after taking a single dose of Esomeprazol 40 mg at meals compared to when hunger decreases from 33 - 53%. Therefore, Esomeprazol has to drink at least 1 hour before meals.

distribution

About 97% Esomeprazol attaches to plasma proteins. The distribution of the drug concentration in healthy people is 16 liters.

transformation

Maximum metabolic drugs are mainly in the liver thanks to the isoenzyme CYP2C19, the cytochrome P450 enzyme system into hydroxy and desmethyl metabolites is no longer active. The rest is converted through isenzyme CYP3A4 to Esomeprazol Sulfon. When used repeated, initially metabolized through the liver and the clearance of the drug decreased, possibly due to the inhibited isoenzyme CYP2C19. However, there is no phenomenon of accumulation of drugs when used once a day. In some people because of the deficiency of CYP2C19 due to genetics (15-20% of Asians) should slow down the metabolism of Esomeprazol, resulting in an increase in AUC about 2 times higher than people with enough enzymes.

Elimination

Sell waste time in plasma 1 to 1.5 hours. About 80% of oral doses are eliminated in the form of non -active metabolites in the urine, the rest is eliminated in the feces. Under 1% of the mother is eliminated in the urine.

In people with severe liver failure, AUC value is 2 to 3 times higher than that of people with normal liver function, so Esomeprazol has to be reduced in these patients, the dose must not exceed 20 mg/day.

Esomeprazol pharmacokinetics in people under 18 have not been studied.

Before taking Asgizole 20mg Valpharma Treatment Treatment of Gastro -ulcer, benign duodenal, Zollinger syndrome - Ellison (4 blisters x 7 tablets)

How to use

oral oral medication, take at least 1 hour before meals. Should swallow the whole tablet with liquid, do not chew or crush the pill.

Dosage

Treatment of stomach ulcer - duodenum with Helicobacter pylori:

Esomeprazol 20 mg/time x 2 times/day for 7 days, or 40 mg/time/day for 10 days (along with amoxicillin 1 g/time x 2 times/day and Clarithromycin 500 mg/time x 2 times/day for 7 or 10 days).

Treatment of gastroesophageal reflux - serious esophagitis:

Take 40 mg/day/day for 4-8 weeks, can take 4-8 weeks more if there are still symptoms or manifestations of endoscopic inflammatory inflammation.

Maintenance treatment after gustary inflammation:

Take 20 mg/time/day, can last up to 6 months.

Treatment of gastroesophageal reflux - symptoms but no esophagitis:

Take 20 mg/day/day for 4 weeks, can take 4 more weeks if the symptoms are not completely cured.

Treatment of stomach ulcers due to nonsteroidal anti -inflammatory drugs:

Take 20 mg/time/day for 4 - 8 weeks.

Prevention of stomach - duodenal ulcer due to nonsteroidal anti -inflammatory drugs (NSAID) in patients at risk: taking 20 mg/time/day.

Treatment of Zollinger syndrome - Ellison:

Depending on the individual and the level of acid secretion of the gastric juice, the dosage daily is higher in other cases, divided into 1-2 times/day. When symptoms are controlled, surgery can be cut. If the tumor is not completely removed, the medication must be used for a long time.

Severe liver failure does not use more than 20 mg/day.

There is no need to reduce the dose in mild and medium liver failure people, kidney or elderly people.

Do not take medicine for children.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when using overdose?

There is no specific antidote for Esomeprazol. Mainly treat symptoms and support. Hemorrhage does not have the effect of increasing the elimination of drugs because the drug is highly attached to the protein.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

Overall, Esomeprazol tolerates well when used in a short time or a long time. When using Asgizole, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Systemic: headache, dizziness, skin extra skin.

digestive: Nausea, vomiting, abdominal pain, diarrhea, constipation, flatulence, dry mouth.

Uncommon, 1/1000

Body: fatigue, insomnia, drowsiness, rash, itching.

Eye: visual disorders.

Rare, ADR

Body: Fever, sweat, peripheral edema, sensitivity to light, hypersensitivity reaction (urticaria, angioedema, bronchospasm, anaphylactic shock).

Central nervous system: agitation, depression, confusion with recovery, hallucinations in serious patients.

Hematology: granulocytes, leukopenia, platelets.

liver: Increased liver enzyme, hepatitis, jaundice, liver failure. digestion: taste disorders.

Muscle muscle: joint pain, muscle pain.

urinary: interstitial nephritis. skin: bullous rash, Stevens - Johnson syndrome, poisoned epidermal necrosis, dermatitis.

Due to reducing the acidity of the stomach, proton pump inhibitors may increase the risk of bacterial infections in the gastrointestinal tract.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

ASGIZOLE drug is contraindicated in the following cases:

Hypersensitivity to proton pump inhibitors or hypersensitivity to any ingredients of the drug.

Do not use esomeprazol simultaneously with nelfinavir.

Be cautious when used

Before taking proton pump inhibitors, it is necessary to eliminate stomach cancer because the drug can cover symptoms, slow down the diagnosis of cancer.

Be cautious when used in people with liver disease, pregnant or nursing.

Precautions when using Esomeprazol prolonged because it can cause gastritis.

The drug is not recommended for children.

When prescribing Esomeprazol to eliminate Helicobacter pylori, drug interactions should be considered in the 3 -drug treatment regimen. Clarithromycin is a strong CYP3A4 inhibitor and therefore should consider contraindicated and interact with Clarithromycin when using a 3 -drug regimen for patients who are taking other drugs metabolized through CYP3A4 as Cisaprid.

The ability to drive and operate machinery

Caution should be cautious because Esomeprazol can cause adverse effects such as headaches, dizziness

Pregnancy

There is no adequate study when using Esomeprazol in pregnant women. In vivo, no evidence of fertility or toxic impairment with pregnancy caused by esomeprazol. However, only use drugs when really necessary during pregnancy.

Nursing period

It is unknown whether esomeprazole will excrete in human milk or not. However, the concentration of omeprazol in women's milk after taking 20 mg of omeprazol.

Esomeprazol is likely to cause serious unwanted effects in breastfeeding, so it is necessary to decide to stop breastfeeding or stop the medication, depending on the importance of the medication for the mother.

Drug interaction

Due to the inhibition of acid excretion, Esomeprazol increases the stomach pH, affecting the bioavailability of pH -dependent absorption drugs (ketoconazol, iron salt, digoxin ...)

Simultaneously use Esomeprazol, Clarithromycin and Amoxicillin, increasing the concentration of ecomeprazol and 14 - Hydroxyclarithromycin in the blood.

Esomeprazol interact with dynamic pharmacokinetics with metabolic drugs by the cytochrome p450 enzyme system, isoenzyme CYP2C19 in the liver.

Storage

In closed containers at temperatures below 30 ° C.

Other drugs

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