Esolok 20 Capsule

Indication:

Esolok 20 mg capsule is indicated for the treatment of-

• Gastro-oesophageal Reflux Disease (GORD): Treatment of erosive reflux oesophagitis and long-term management to prevent relapse.
• Peptic Ulcers: Treatment of duodenal ulcers associated with Helicobacter pylori.
• NSAID-associated Ulcers: Prevention and treatment of gastric ulcers associated with continuous NSAID therapy in patients at risk.
• Zollinger-Ellison Syndrome: Management of pathological hypersecretory conditions.
• Hyperacidity: Symptomatic treatment of heartburn and acid regurgitation.

Dogase & Adminstration:

Adults (Oral):

• Erosive Oesophagitis: 40 mg once daily for 4–8 weeks.
• GORD Maintenance: 20 mg once daily.
• H. pylori Eradication: 20 mg twice daily (as part of triple therapy with antibiotics).
• NSAID-associated Ulcers: 20 mg once daily for 4–8 weeks

Children (Oral – Based on BNFC):

• 1–11 years (Weight ≥10kg): 10 mg once daily.
• 12–18 years: 20 mg once daily (for GORD). For erosive oesophagitis, 40 mg once daily.

Administration: Should be taken at least one hour before food. Tablets/capsules should be swallowed whole. For patients with swallowing difficulties, tablets can be dispersed in non-carbonated water.

Injection Dosage For Adults:

• General Antisecretory (GORD/Ulcers): 40 mg once daily via slow IV injection or infusion.
• Prevention of Re-bleeding (High Dose): 80 mg as an intravenous bolus infusion over 30 minutes, followed by a continuous intravenous infusion of 8 mg/hour given over 3 days (72 hours).
• Renal/Liver Impairment: No dose adjustment for renal failure. In severe liver impairment, the dose should not exceed 20 mg/day (unless used for bleeding ulcers).

Injection Dosage For Children (Based on BNFC 2022-2023):

• 1 month to 1 year: 0.5 mg/kg once daily.
• 1 year to 11 years (<20kg): 10 mg once daily.
• 1 year to 11 years (≥20kg): 10 mg or 20 mg once daily.
• 12 to 18 years: 40 mg once daily.

Administration Methods:

• IV Injection: Reconstitute the 40 mg vial with 5 mL of Normal Saline. Inject slowly over at least 3 minutes.
• IV Infusion: Dilute in 100 mL of Normal Saline or 5% Dextrose. Infuse over 10 to 30 minutes.

”রেজিস্ট্রার চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন”

Pharmacology:

Mechanism of Action: Esomeprazole is a weak base that is concentrated and converted to the active form in the highly acidic environment of the secretory canaliculi of the parietal cell. It inhibits the enzyme H+/K+-ATPase (the acid pump), blocking the final step in gastric acid production.

Pharmacodynamics: As the S-isomer of omeprazole, it is metabolized more slowly, resulting in higher plasma levels and more sustained acid inhibition compared to racemic omeprazole. It inhibits both basal and stimulated acid secretion.

Pharmacokinetics: Absorption is rapid, with peak plasma levels occurring in 1–2 hours. It is 97% protein-bound and metabolized primarily by the CYP2C19 and CYP3A4 hepatic enzymes.

Side Effects:

• Common: Headache, abdominal pain, diarrhea, and nausea.
• Potential Long-term: Increased risk of GI infections (e.g., Salmonella), hypomagnesemia, and bone fractures.

Drug Interaction:

• May affect the absorption of drugs where gastric pH is a key factor (e.g., Atazanavir, Ketoconazole).
• Concomitant use with Clopidogrel is generally discouraged due to potential reduction in the antiplatelet effect.
• May increase levels of Diazepam and Digoxin.

Pregnancy & Lactation:

• Pregnancy: Clinical data is limited. Use only if clearly needed and prescribed by a doctor.
• Lactation: It is unknown if it is excreted in human milk; breastfeeding is generally not recommended during use.

Over Dosage:

Symptoms are mainly gastrointestinal. Management is symptomatic and supportive. There is no specific antidote.

Therapeutic Class:

Proton Pump Inhibitor (PPI); Gastric Acid Suppressant.

Storage Conditions:

Store below at 30°C  temperature in a dry place. Away from light and out of reach of children. Do not use the medication after its expiration date.