Savi Esomeprazole 40 Treatment Treatment of stomach ulcers, duodenum (2 blisters x 7 tablets)
Dosage form Box of 2 blisters x 7 tablets
Specifications Esomeprazole
Ingredient
| Composition information | Content |
| Esomeprazole | 40mg |
Uses
Indications
Esomeprazole 40 Savi is indicated in the following cases:
Treatment:
Pharmacy
Esomeprazole is the isomorphic form of Omeprazole, used similar to omeprazole in the treatment of gastric ulcer and gastroesophageal reflux disease - esophagus.
Esomeprazole is associated with H+/K+ - ATPase (also known as proton pump) 6 cell walls of the stomach, inhibiting this enzyme system, preventing the final step of acidic secretion into the stomach. So Esomeprazole has the effect of inhibiting the basic acid secretion and even when stimulated by any factor.
pharmacokinetics
Esomeprazole is absorbed quickly after drinking, reaching the highest concentration in plasma after 1-2 hours. Esomeprazole'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 of Esomeprazole, the area under the curve (AUC) after taking a single dose Esomeprazole 40 mg at meals compared to the time of hunger drops from 33% to 53%. Therefore, Esomeprazole has to drink at least 1 hour before meals. About 97% Esomeprazole attaches to plasma proteins.
The volume of distribution when the drug concentration is stable in healthy volunteers is 16 liters. The metabolic drug is mainly in the liver thanks to the isoenzyme CYP2C19, the cytochrom P450 enzyme system, into substances that change - chemical hydroxy - and desmethyl no longer active. The rest is converted through ISOENZYM CYP3A4 to Esomeprazole Sulfone. When used repeated, initially metabolized through the liver and the clearance of the drug reduced, possibly due to the inhibited ISOENZYM CYP2C19. However, there is no phenomenon of accumulation of drugs 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 Esomeprazole, 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 liver failure, AUC value is 2-3 times higher than stable than people with normal liver function, so Esomeprazole is reduced in patients, the dose does not exceed 20 mg a day.
Esomeprazole pharmacokinetics in people under 18 have not been studied.
Before taking Savi Esomeprazole 40 Treatment Treatment of stomach ulcers, duodenum (2 blisters x 7 tablets)
How to use
Esomeprazole40 Savi medicine used oral. Take medicine at least one hour before meals.
Must swallow the tablet, do not be crushed or chewed.
Dosage
Esomeprazole is used in the form of Magnesi dihydrate or sodium salt, but, the dose is calculated by esomeprazole.
Esomeprazole Magnesidydrate 44.4 mg or esomeprazole sodium 42.6 mg is equivalent to 40.0 mg of esomeprazole.
Esomeprazole is not stable in the acidic environment, so it must be prepared in the form of micro -granules in the intestine so that the drug is not destroyed in the stomach and increased bioavailability.
Dosage for patients over 18 years old
Treatment of gastroesophageal reflux disease - serious esophagitis
Take every 40 mg once a day for 4-8 weeks, can take another 4-8 weeks if there are still symptoms or manifestations of laparoscopic inflammation.
Treatment of Zollinger - Ellison syndrome
The recommended starting dose of Esomeprazole is 40 mg, 1 time/day. Then adjust the dose according to the response of each patient and continue treatment when it is indicated clinically. When symptoms are controlled, surgery may be used to cut tumors. If the tumor is not completely removed, the medication must be used for a long time.
Treatment of stomach ulcer - duodenum with Helicobacter pylori
Esomeprazole is an ingredient in the treatment mode along with antibiotics, for example 3 drug regimen (along with amoxicillin and clarithromycin).
Take Esomeprazole every 40 mg once a day for 10 days. (Amoxicilin at 1.0 g x twice a day and Clarithromycin each time 500 mg x twice a day in 7 or 10 days).
Person of kidney function
There is no need to reduce the dose in people with kidney function.
Liver function damage
There is no need to reduce the dose in people with liver function damage from mild to medium. In patients with severe liver failure, maximum overdose should not be used for 20 mg Esomeprazole.
children under 18 years old
Do not use drugs for children under 18 years old, because there is no data on safety and efficiency.
Elderly
No dose adjustment in the elderly.
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? The described symptoms related to the use of 200 mg of Esomeprazole are symptoms on the digestive tract and fatigue. Single doses of 80 mg Esomeprazole are still safe to use.
There is no specific detoxification. Esomeprazole is strongly connected to plasma proteins and therefore not easily separated. In case of overdose, symptomatic treatment and use of general support measures.
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 Esomeprazole 40 Savi, you may experience unwanted effects (ADR).
Overall, Esomeprazole NAP is good when used in a short time and/or long time. Unwanted reactions are arranged according to the frequency occurring.
Common, ADR> 1/100
Uncommon, 1/1000 Rare, ADR Central nerve: agitation, depression, confusion with recovery, hallucinations in serious illnesses. Due to reducing the acidity of the stomach, proton pump inhibitors have an increase in the risk of bacterial infections in the gastrointestinal tract, Instructions on how to handle ADR Meet the side effects of the drug, need 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
Esomeprazole 40 Savi is contraindicated in the following cases:
Hypersensitivity to proton pump inhibitors.
Caution when using
Before taking proton pump inhibitors, it is necessary to eliminate the possibility of stomach cancer because the drug has symptoms, slowing down the diagnosis of cancer.
Be cautious when used in people with liver disease, pregnant or nursing.
Be cautious when using Esomeprazole prolonged because it can cause stomach atrophy.
Be cautious when used for children under 18 years of age because of safety and efficiency that has not been determined. The drug is not recommended for children.
When prescribing Esomeprazole to treat Helicobacter pylori, drug interactions should be considered in the 3 -drug treatment regimen.
The ability to drive and operate machinery
Studies to determine the effect of Esomeprazole on driving and operating machinery has not been done.
When driving or operating the machine, it should be noted that dizziness may occur during treatment.
Pregnancy
There is no adequate study when using Esomeprazole in pregnant people on animals, white rats Esomeprazole dose 280 mg/kg/day (57 times the dose on humans calculated by body surface area) and oral dose of 86 mg/kg/day (35 times the dose of the body is calculated on the body of the body) Reduce fertility or toxicity for pregnancy due to Esomeprazole. However, only use Esomeprazole when really necessary during pregnancy.
Breastfeeding period
It is unknown whether esomeprazoles have excreted into human milk or not. However, the concentration of Omeprazole lemongrass in women's milk after 20 mg of omeprazole. Esomeprazole is likely to cause unexpected effects in breastfeeding, so it must be. The decision to stop breastfeeding or stopping the drug, depending on the importance of the medication for the mother.
Medicinal interaction
The impact of Esomeprazole on the pharmacokinetics of other drugs
Due to the inhibition of acid excretion, Esomeprazole increases gastric pH, affecting the bioavailability of pH -dependent absorption drugs (ie reducing absorption): ketoconazole, otraconazole, iron salt, digoxin.
Simultaneous use of ecomeprazole with clarithromycin and amoxicillin increases the shallow Esomeprazole and 14 - Hydroxyclarithromycin in the blood.
In healthy volunteers, when using 40 mg of Esomeprazole with Cisapride, the area under the curve shows Cisapride concentration in plasma over time (AUC) increases to 32% and the selling time of Cisapride excretion extends by 31% but the cisapride peak concentration in plasma increases significantly.
Esomeprazole inhibits CYP2C19, the main enzyme metabolizes Esomeprazole. Therefore, when shared Esomeprazole with metabolic drugs with CYP2CI9 such as Diazepam, Citalopram, Imipramine, Clomipramine, Phenytoin concentration of these drugs in plasma can increase and need to decrease the dose. This should pay special attention when prescribing Esomeprazole for treatment according to demand.
In a healthy vow, simultaneous use of omeprazole (40 mg, 1 time/day) and Atazanavir (300 mg) + Ritonavir (100 mg) significantly reduces the concentration and time of Atazanavir contact (reducing AUC, CMAX and CMIN by about 75%). Increasing the dose of Atazanavir to 400 mg has not compensated for the effects of omeprazole on concentration and time of Atazanavir exposure. Do not combine proton pump inhibitors, just Esomeprazole with Atazanavir.
Esomeprazole has been shown to have a significant clinical impact on pharmacokinetics of amoxicillin, quinidine.
The impact of the other drugs on Esomeprazole
Esomeprazole is metabolized by CYP2C19 and CYP3A4. When using Esomeprazole simultaneously, a CYP3A4 inhibitor, such as Clarithromycin (500 mg x 2 times/day) doubled the area under the curve (AUC) of Esomeprazole.
Storage
In the dry place, temperatures below 30 ° C. Avoid light.
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