Esofar 40 kwality pharmaceutical treatment for benign peptic ulcer (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Esomeprazole

Ingredient

Composition information	Content
Esomeprazole	40mg

Uses

Indications

Esofar 40 drugs are indicated in the following cases:

benign peptic ulcer.

Zollinger - Ellison syndrome. Learning

Esomeprazol is the isomorphic form of omeprazol, used similarly to Omeprazol in the treatment of stomach ulcers - duodenum and gastroesophageal reflux disease. Esomeprazol is attached to H+/K+ - ATPSE (also known as proton pump) in the stomach wall cell, 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.

pharmacokinetic

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% after taking the dose of 20 mg and 89% when taking the dose of 40mg. Food slows down and reduces the absorption of Esomeprazol, the area under the curve (AUC) after taking a single dose of Esomeprazol 40mg at meals compared to the time of hunger drops from 33% to 53%. Therefore, Esomeprazol must be used for at least 1 hour before meals.

About 97% Esomeprazol attaches to plasma proteins. The distribution volume, when the concentration of drugs stabilizes in healthy volunteers is 16 liters. The medication is mainly metabolic in the liver thanks to isenzyme CYP2C19, the cytochrom P450 enzyme system, into hydroxyl and desmethyl metabolites that are no longer active.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 ISOENZYM CYP2C19. However, there is no drug accumulation when used once a day. In some people, because of the lack of CYP2C19 due to genetics (15-20% of Asians), they should slow down the metabolism of Esomeprazol, resulting in an increase in AUC value about 2 times compared to people with enough enzymes.

Half lifetime elimination in plasma 1 - 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 6 stable value is 2-3 times higher than people with normal liver function, so it is necessary to reduce the dose of Esomeprazol in this patient, the dose does not exceed 20mg a day.

Before taking Esofar 40 kwality pharmaceutical treatment for benign peptic ulcer (3 blisters x 10 tablets)

How to use

Take at least 1 hour before eating. Must swallow the whole tablet, do not chew or crush when taking the drug.

Dosage

Dosage for adults:

Treatment of stomach ulcer - duodenum with Helicobacter Pylori: Esomeprazol is a component in the treatment regimen along with antibiotics, for example 3 drugs (along with amoxicillin and clarithromycin). Take Esomeprazol at 20mg, twice a day for 7 days, or 40mg once a day for 10 days. (Amoxicilin daily 1.0g twice a day and Clarithromycin at 500mg, twice a day for 7 or 10 days). Ellison: Depending on the individual and the level of acid secretion of the gastric juice, the daily dose is higher daily in other cases, used once or divided into 2 times a day. When symptoms are controlled, surgery may be used to cut tumors. If you do not remove the tumor completely, you must take the medication for a long time.

Severe liver failure:

Do not use more than 20mg/day.

Other objects:

No need to reduce the dose in mild and medium liver failure, mild kidney failure or the elderly.

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 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

When using Esofar 40, you may experience unwanted effects (ADR).

Overall, Esomeprazol is well tolerated even when used in a short time or for a long time.

Common, ADR> 1/100:

Systemic: headache, dizziness, skin extra skin.

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

Rare, ADR, 1/100:

Body: Fever, sweating, peripheral edema, sensitivity to light, hypersensitivity reactions (including urticaria, angioedema, bronchospasm, anaphylactic shock). Hepatitis, hepatitis, jaundice, liver function. Can increase the risk of bacterial infections in the digestive 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

Esofar 40 contraindicated in the following cases:

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

Caution when using

Before taking proton pump inhibitors, it is necessary to eliminate the possibility of 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 lactating women.

Be cautious when using Esomeprazol for prolonged because it can cause gastricular atrophy.

Be cautious when used for patients under 18 years of age because of safety and effectiveness.

The drug is not recommended for children.

The ability to drive and operate machinery

Be cautious when taking the drug when driving and operating machinery because the drug can cause dizziness, headache.

Pregnancy

There is no adequate study when using Esomeprazol in pregnant people. On animals, white rats use Esomeprazol dose of 280mg/kg/day (57 times the dose on humans calculated by the body surface area) and the rabbit oral the dose of 86mg/kg/day (35 times the dosage on the person calculated by the body surface area) did not see evidence of quite reproductive or toxic impairment for the fetus due to the fetus due to Esomeprazol. However, only use Esomeprazol when really necessary during pregnancy.

Breastfeeding period

It is unknown whether esomeprazol has excreted in human milk or not. However, the concentration of omeprazol in women's milk after taking 20mg of omeprazol. Esomeprazol has the ability to cause serious unwanted effects in breastfed babies, so it is necessary to decide to stop breastfeeding or stopping the drug, depending on the importance of the medication for the mother.

Medicinal interaction

Due to the inhibition of acid excretion, Esomeprazol increases the gastric pH, affecting the bioavailability of pH -dependent absorption drugs: ketoconazole, iron salt, digoxin.

Simultaneous use of Esomeprazol, Clarithromycin, erythromycin and amoxicilin increases the concentration of ecomeprazol and 14- hydroxyclarithromycin in the blood.

Simultaneous use of Esomeprazol and warfarin can increase the time of prothrombin and INR causing abnormal bleeding.

Esomeprazol interact with dynamic pharmacokinetics with metabolic drugs by the cythochrom paso isoenzyme enzyme system CYP2C19 in the liver. Simultaneous use of 30mg of Esomeprazol and Diazepam reduces 45% of the clearance of diazepam.

Storage

Store in a cool dry place, temperatures below 30 ° C, avoid light.

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