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Nexium 40 Information:

 Trade name:

International name:
Esomeprazole (Esomeprazole)

Group Affiliation:
Proton pump inhibitor

Description of the active substance (INN):

Dosage form:
coated tablets

Pharmacological Effects:
Antiulcer agent - proton pump inhibitor, dextro isomer of omeprazole, decreases the secretion of HCl in the stomach by specific inhibition of proton pumps in parietal cells. Being a weak base and going into an active form in the acidic environment of the secretory tubules of parietal cells of gastric mucosa, activates and inhibits the proton pump - H + / K + ATPase. Inhibits basal and stimulated secretion of HCl. The action begins at 1 h after oral administration of 20 mg or 40 mg. When taking the drug daily for five days at a dose of 20 mg 1 time per day average maximum concentration of HCl after pentagastrin stimulation is decreased by 90%. When you receive esomeprazole 40 mg treatment of reflux esophagitis occurs in approximately 78% of patients after 4 weeks of therapy and in 93% - 8 weeks. Treatment with esomeprazole 20 mg 2 times a day in combination with standard anti-bacterial drugs for 1 week leads to the successful eradication of Helicobacter pylori in approximately 90% of patients. Patients with uncomplicated ulcer 12 duodenal ulcer after 1 week of eradication rate does not require further antisecretory therapy monotherapy for the healing of sores or eliminate symptoms.

Gastroesophageal reflux disease (GERD): erosive reflux esophagitis (treatment), prevention of relapse in patients with healed esophagitis, symptomatic GERD. As part of combination therapy: peptic ulcer and 12 duodenal ulcer associated with Helicobacter pylori (treatment and prevention).

Hypersensitivity (including to substituted benzimidazole), a period laktatsii.C caution. Pregnancy.

Side effects:
Frequent (0.1-1%): headache, abdominal pain, diarrhea, flatulence, nausea, vomiting, and constipation. Rare (0.01-0.1%): dermatitis, itching, hives, dizziness, dry rtu.Peredozirovka. Treatment: the specific antidote is not known, dialysis is ineffective, as appropriate symptomatic therapy.

Dosage and administration:
Inside. Tablet should be swallowed whole, washed down with fluid. Pills can not chew or crush. Treatment of erosive reflux esophagitis: 40 1 mg once daily for 4 weeks. Recommended an additional 4-week course of treatment in cases where after the first course treatment of esophagitis does not occur or symptoms persist. Prevention of relapse in patients with healed oesophagitis: 20 mg 1 time per day. Symptomatic treatment of GERD: 20 mg 1 every day - patients without esophagitis. If after 4 weeks of treatment, symptoms do not disappear, it should hold an additional examination of the patient. In combination with appropriate antibiotic therapy for eradication of Helicobacter pylori, ulcers treated 12 duodenal ulcer associated with Helicobacter pylori, prevention of recurrence of peptic ulcers in patients with peptic ulcer associated with Helicobacter pylori: esomeprazole - 20 mg, amoxicillin - 1 g and clarithromycin - 500 mg 2 times a day for 7 days. Patients with renal insufficiency and for elderly patients dose adjustment is required. In severe hepatic insufficiency the dose should not exceed 20 mg / day.

Special instructions:
If there is any anxiety symptoms (eg, as a large spontaneous weight loss, frequent vomiting, dysphagia, vomiting of blood or melena), as well as the presence of gastric ulcers (or suspected peptic ulcer) should eliminate the possibility of malignancy, as treatment with esomeprazole can lead to a smoothing of the symptoms and thus delay correct diagnosis. Patients taking the drug over a long period (especially more than 1 year) should be under regular medical supervision. During treatment with proton pump inhibitors, the concentration of gastrin in plasma increased as a result of reduced secretion of intragastric HCl. Patients taking proton pump inhibitors for a long time, often marked the formation of glandular cysts in the stomach. These phenomena are due to physiological changes as a result of inhibition of secretion of HCl. Cysts are benign and tend to disappear. There is currently no data on the use of esomeprazole during pregnancy. With the introduction of esomeprazole animals did not reveal any direct or indirect negative impact on the developing embryo or fetus. The introduction of the racemic drug also does not have any negative impact to animals during pregnancy, childbirth, and during postnatal development. Nevertheless, pregnant women should appoint a drug only if the expected benefit to the mother justifies the potential risk to the fetus. It is unknown whether to select a esomeprazole in breast milk.