Nesteloc 40 USP medicine used to inhibit the excretion of gastric acid gastric juice (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Esomeprazol

Ingredient

Composition information	Content
Esomeprazol	40mg

Uses

Indications

Nesteloc 40 drugs are indicated in the following cases:

Gastroesophageal reflux syndrome.

Pharmacy

Nesteloc 40 contains Esomeprazol which is the isomorphic form of omeprazol that reduces gastric acid secretion according to the selective link mechanism and does not recover into the proton pump. The drug has a specific affinity with H + K +- Atpase enzyme (proton pump) in the stomach lining cells. This enzyme controls the final stage of the process of gastric acid secretion, so Nesteloc 40 inhibits the basic acid secretion process as well as due to any stimulation.

pharmacokinetic

absorption

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

Distribution

About 97% Esomeprazol binds to plasma proteins.

Metabolism

Esomeprazol is widely metabolized in the liver by the cytochrom P450 ISOENZYM CYP2C19 system into non -activated hydroxy and demethyl derivatives. The rest is converted through isenzyme CYP3A4 to Esomeprazol Sulfon. The initial metabolism through the liver and the clearance of the drug may be due to the inhibited ISOENZYM CYP2C19. However, there is no accumulated phenomenon when used once a day. Where some Asians (15 - 20%) because of the lack of genetic ISOENZYMYMYMM, it slows the metabolism of Esomeprazol, leading to an increase of 2 times compared to people with enough enzymes.

Elimination

Esomeprazol's waste sale time is about 1 - 1.5 hours, about 80% of oral doses are eliminated in the form of non -active metabolites in the urine, the rest is excreted through feces. Under 1% of the mother is eliminated in the urine. In people with severe liver failure, AUC value is 2-3 times higher than that of people with normal liver function, so they must reduce the dose for these objects and should not be used more than 20 mg per day. Pharmacokinetics in people under 18 have not been studied.

Before taking Nesteloc 40 USP medicine used to inhibit the excretion of gastric acid gastric juice (3 blisters x 10 tablets)

How to use

Take the whole pill, do not chew or grind the micro -seeds. Drink before meals (preferably before breakfast).

Dosage

Gastroesophageal reflux syndrome - Esophageal

The starting dose is recommended for the treatment of gastroesophageal reflux disease - esophagus is from 20 to 40 mg daily, which can last for more than 4-8 weeks for patients who do not heal after 4-8 weeks of treatment. In the case of maintenance or diseases without symptoms of esophageal erosion, a daily dose of 20 mg.

Stomach ulcer disease - duodenum with HP

In the trio combined with amoxicillin and clarithromycin, the common dose is 20 mg of esomeprazol x 2 times/day for 7 days or Esomeprazol 40 mg x 1 time/day for 10 days.

Stomach - duodenum ulcerative disease

The required dose is 20 mg or 40 mg x 1 time/day for 6 months.

Patients with liver failure

No dose adjustment for patients with mild and medium liver failure. Esomeprazol dose for patients with severe liver failure does not exceed 20 mg/day.

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 currently no specific antidote, in case of overdose should treat symptoms and use general support measures. Hemorrhage does not have the effect of eliminating drugs.

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 Nesteloc you can experience unwanted effects (ADR).

Common, ADR> 1/100

Neurology: headache, dizziness, ..

digestive: abdominal pain, diarrhea, flatulence, constipation.

Uncommon, 1/1000

Skin: Dermatitis, itching, urticaria, ..

nerve: dizzy, ..

digestive: dry mouth.

Rare, 1/10000

Hypersensitivity reactions include: urticaria, angioedema, bronchospasm, anaphylactic shock.

Other disorders: Sweating fever, peripheral edema, sensitive to light.

Very rare, ADR

Loss of granulocytes, leukopenia, thrombocytopenia, hyper enzyme, hepatitis, liver failure, interstitial nephritis, muscle pain, joints.

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

Nesteloc 40 contraindications in the following cases:

History of hypersensitivity to Esomeprazole or any ingredients of the drug.

Prisable when using

When there is a vigilant symptom such as: significant weight loss, unintentional, recurrent vomiting, difficulty swallowing, vomiting, or defecation of black blood and when there is a suspected stomach ulcer, should eliminate the possibility of malignant stomach ulcer, because treatment with Esomeprazol can reduce symptoms and delay the diagnosis.

Be cautious when taking the drug for a long time because it can cause stomach atrophy.

Be cautious when used for children under 18 years old.

For people with renal failure, do not need to adjust the dose, but be cautious when used for patients with severe renal impairment.

The ability to drive and operate machinery

Some cases of dizziness, headache, dizziness when using Esomeprazol, so be careful to take the drug while driving or operating machinery.

Pregnancy

The drug does not affect the development of fetuses in humans and animals, but should only be used for pregnant women when really necessary.

Breastfeeding period

Do not take medicine for women during breastfeeding.

Drug interaction

Esomeprazol inhibits acid secretion, increases gastric pH, so the drug can affect the bioavailability of some pH -dependent absorption drugs such as ketoconazole, digoxin, iron salt.

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 cytochrom P450 enzyme system P450 isoenzyme CYP2C19 in the liver.

Simultaneously use 30 mg of Esomeprazol and Diazepam, reducing Diazepam's 45% of clearance.

Esomeprazol may increase the blood concentration of Saquinavir and reduce the concentration of Nelfinavir and Atazanavir through an unclear mechanism. Therefore, it is advisable to consider reducing the dose of Saquinavir when used with Esomeprazol to avoid unwanted effects of Saquinavir.

Esomeprazol reduces the activity of clopidogrel metabolic enzymes into an active form, thus reducing the activity of clopidogrel, so it is recommended to use only the combination of these two drugs when it is really necessary.

Esomeprazol increases the concentration of cilostazol and its metabolites. The dose of cilostazol should be reduced from 100 mg twice a day to 50 mg twice daily when used with Esomeprazol.

Storage

Store drugs in a dry place, temperatures below 30 ° C, avoiding light.

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