NEXAZOL 40

NEXAZOL 40

Esomeprazole, is a new proton pump inhibitor. It is the S-isomer of omeprazole and is the first

 such inhibitor to be developed as a single isomer.

- Esomeprazole reduces gastric acid secretion through aspecific targeted mechanism of action.

 It’s a specific inhibitor of the acid proton pump in the parietal cell where it inhibits the enzyme

 H+,K+-ATpase and inhibit both basal and stimulated acid secretion. Both the R-and S-isomer

 of omeprazole have similar pharmcodynamic activity.  

- Absorption of Esomeprazole is rapid with peak plasma levels occurring approximately 1-2

 hours after oral dose. The absolute bioavailability is 64% after a single dose of 40mg and

 increases to 89% after repeated once daily administration. For 20mg of Esomeprazole the

 corresponding values are 50% and 68% respectively .The apparent volume of distribution at

 steady state in healthy subjects is approximately 0.22L/kg of body weight.

- Esomeprazole is 97% plasma protein bound.

- Food intake both delays and decreases the absorption of Esomeprazole        although this has

 no significant influence on the effect of Esomeprazole on intragastric acidity.

- Esomeprazole is completely metabolised in the liver by the cytochrome      P450 system .The

 major part of the metabolism of Esomeprazole is dependent on the polymorphic CYP2C19

 responsible for the formation of hydroxy and desmethyl metabolites of Esomeprazole. The

 remaining part is dependent on another specific (isoform), CYP3A4, responsible for the

 formation of Esomeprazole sulphone main metabolite in plasma. The major metabolites of 

 Esomeprazole have no effect on the gastric acid secretion.

-The plasma clearance is about 17L/h after a single dose and about 9L/h after repeated

 administration. The plasma elimination half-life is about 1.3 hours after repeated once daily

 dosing.

-Esomeprazole is completely eliminated from plasma between doses with no tendency for  

 accumulation during once- daily administration

- Almost 80% of an oral dose of Esomeprazole is excreted as metabolites in urine, the

 remainder in the faces. Less than 1% of the parent drug is found in urine.

- Each enteric coated tablet of NEXAZOL® 40 contains:

       ESOMEPRAZOLE 40mg (as magnesium trihydrate).

- Each enteric coated tablet of NEXAZOL® 20 contains:

       ESOMEPRAZOLE 20mg (as magnesium trihydrate)

- Each capsule of NEXAZOL® 40 contains:

      ESOMEPRAZOLE 40mg enteric coated pellets (as magnesium

 trihydrate).

- Each capsule of NEXAZOL® 20 contains:

      ESOMEPRAZOLE 20mg enteric coated pellets (as magnesium

 trihydrate).

NEXAZOL® is contraindicated in patient with known hypersensitivity to any component of

 the formulation or to substituted benzimidazoles.

- In patient with known hypersensitivity to penicillins, or Macrolide antibiotics, should not be

 given with NEXAZOL® for treatment H.pylori

NEXAZOL® inhibits gastric acid secretion. Therefore, it may interfere with the absorption of

 drugs where gastric pH is an important determinant of bioavailability (e.g, Ketoconazole,

 Itraconazole,  Iron salts and Digoxin)

-NEXAZOL®  inhibits CYP2C19, thus, when it  is combined with drugs metabolised by

 CYP2C19 such as( Diazepam, Citalopram, Imipramine, Clomipramine& Phenytoin ) the plasma

 concentrations of these drugs may increase and dose reduction could be needed .This should be

 especially when prescribing Esomeprazole  for on-demand therapy .

-Concomitant administration of NEXAZOL® to warfarin treated patients, a few isolated cases of

 elevated INR of clinical significance have been reported. Monitoring is recommended when

 initiating and ending concomitant treament .

 

Use during pregnancy and lactation :

-Caution should be exercised when NEXAZOL® prescribing to pregnant women and   should not

 be used during breast –feeding.

Caution should be exercised when NEXAZOL® prescribing to pregnant women and   should not

 be used during breast –feeding

NEXAZOL® was well tolerated in both short and long –term clinical trials .The following side

 effects have been identified. None was found to be dose- related.

 Common: headache, abdominal pain, diarrhea, flatulence, nausea, vomiting    and constipation. 

 Uncommon:  Dermatitis, pruritus, urticaria, dizziness and dry mouth.  

 Rar             :  Hypersensitivity reactions.

 Other adverse drug reaction for the racemate (Omeprazole) has not been identified in the clinical 

 trails programme for NEXAZOL®.

NEXAZOL® inhibits gastric acid secretion. Therefore, it may interfere with the absorption of

 drugs where gastric pH is an important determinant of bioavailability (e.g, Ketoconazole,

 Itraconazole,  Iron salts and Digoxin)

-NEXAZOL®  inhibits CYP2C19, thus, when it  is combined with drugs metabolised by

 CYP2C19 such as( Diazepam, Citalopram, Imipramine, Clomipramine& Phenytoin ) the plasma

 concentrations of these drugs may increase and dose reduction could be needed .This should be

 especially when prescribing Esomeprazole  for on-demand therapy .

-Concomitant administration of NEXAZOL® to warfarin treated patients, a few isolated cases of

 elevated INR of clinical significance have been reported. Monitoring is recommended when

 initiating and ending concomitant treament .

-Blister of 7 Tablets or capsules, pack of two blisters.

- Store in a cool dry place below 30° C, protect form light.