ESOMEPRAZOLE 40mg Information for the Patient Composition Each enteric coated tablet contains: Esomeprazole 40mg Description Esomeprazole magnesium is bis(5-methoxy-2-[(S)-[(4-methoxy-3,5-dimethyl-2-pyridinyl)methyl] sulfinyl]-1H-benzimidazole-1-yl) magnesium trihydrate, a compound that inhibits gastric acid secretion. Esomeprazole is the S-isomer of omeprazole, which is a mixture of the S- and R- isomers. The stability of esomeprazole magnesium is a function of pH; it rapidly degrades in acidic media, but it has acceptable stability under alkaline conditions.
Each 40mg film coated tablet contains 44.4 mg of esomeprazole magnesium, which is equivalent to 40mg of esomeprazole, and the followinginactive ingredients: microcrystalline cellulose, maize starch, croscarmellose sodium, calcium stearate, talc, colloidal anhydrous silica, poly vinylpyrrolidone K-30, sodium propyl hydroxyl benzoate, sodium methyl hydroxyl benzoate, iso propyl alcohol. The enteric coating consists ofcellulose acetate phthalate, macrogol 6000, titanium dioxide, talc, ethyl cellulose, colour sunset yellow lake, iso propyl alcohol, and acetone. Pharmacological Action Esomeprazole is a proton pump inhibitor that suppresses gastric acid secretion by specific inhibition of H+/K+-ATPase in the gastric parietal cell. By acting specifically on the proton pump, esomeprazole blocks the final step in acid production, thus reducing gastric acidity. This effect is dose- related up to a daily dose of 20 to 40 mg and leads to inhibition of gastric acid secretion. Indications Esomeprazole is used for the treatment of symptomatic gastroesophageal reflux disease (GERD), short-term treatment of erosive esophagitis, and maintenance of erosive esophagitis healing. It is also approved for use with antibiotics for the treatment of Helicobacter pylori-associated duodenal ulcers. Contraindications Hypersensitivity to any component of the formulation of esomeprazole, omeprazole, or to substituted benzimidazoles , and hepatic function impairment. Drug Interaction Some medicines or medical conditions may interact with esomeprazole. When any drug is prescribed, the possibility of drug interactions should always be considered. Tell your doctor or pharmacist of all the prescription and nonprescription drugs that you are taking, especially:
Digoxin, Diazepam, Ketoconazole, Itraconazole, Sucralfate, Iron supplements, Vitamins with iron, Cilostazol
Warning Pregnancy: The safety of esomeprazole in pregnancy has not been established. Esomeprazole should not be administered to pregnant women unless the expected benefits outweigh the potential risks. Lactation: It has not been investigated whether or not esomeprazole is excreted in human breast milk. No studies in lactating women have been performed. Therefore, esomeprazole should not be given to nursing mothers unless its use is considered essential. Children: The safety and effectiveness of esomeprazole in children have not yet been established. Precautions Symptomatic response to therapy with esomeprazole does not preclude the presence of gastric malignancy.
Atrophic gastritis has been noted occasionally in gastric corpus biopsies from patients treated long-term with omeprazole, of which esomeprazoleis an enantiomer.
Adverse Effects The adverse events associated with esomeprazole therapy are generally similar to those seen with the placebo and omeprazole therapy. The most common adverse events reported in the clinical trials were diarrhoea, abdominal pain, flatulence, gastritis, nausea, and headache. Overdose Symptoms of an esomeprazole overdose include confusion, headache, drowsiness, blurred vision, fast heartbeat, nausea, dry mouth, sweating, flushing, shortness of breath, tremor, loss of coordination, or seizure (convulsions). Dosage For GERD, 20 or 40 mg of esomeprazole is given once daily for 4-8 weeks.
For the treatment of H. pylori, 40 mg is administered once daily in combination with amoxicillin and clarithromycin for 10 days. Esomeprazoleshould be administered one hour before meals, swallowed whole and should not be crushed or chewed. Storage Store in a dry place, protected from light. Keep out of reach of children. Store in original packaging. Presentation Esomeprazole 40mg is supplied as a reddish brown, round biconvex, enteric coated tablet of Esomeprazole magnesium. Alu-Alu packages are supplied as 3 x 10 tablets.
C u m a n n G e i n e a l a i s n a h É i r e a n n (incorporating “The Genie Gazette”) www.familyhistory.ie On-Line Access to 1911 Census Returns An Immediate Success with the Public line facility offering “free-for- view” access to the 1911 Census genealogical resources in a “pay for view” facility was advocated this service as a “free for view”
Treatment in Psychiatry Treatment in Psychiatry begins with a hypothetical case illustrating a problem in current clinical practice. The authorsreview current data on prevalence, diagnosis, pathophysiology, and treatment. The article concludes with the authors'treatment recommendations for cases like the one presented. Treating the Childhood Bipolar Controversy: A Tale of Two Children
ESOMEPRAZOLE 40mg