Esmosim

Description

Esmosim Tablet: Your Guide to Acid Relief

Esmosim Tablet is a medication that helps manage conditions caused by excess stomach acid. It contains Esomeprazole Magnesium Trihydrate BP, a type of proton pump inhibitor (PPI). This medication is manufactured by Simca and is readily available in Nepal.

What Esmosim Is Used For (Indications)

Esmosim Tablet is prescribed for a variety of acid-related digestive issues, including:

• Heartburn
• Acid-Related Dyspepsia (indigestion)
• Peptic Ulcer Disease, encompassing both duodenal and gastric ulcers
• Zollinger-Ellison Syndrome, a rare condition causing severe acid overproduction
• Gastroesophageal Reflux Disease (GERD)
• Helicobacter pylori infection (often used as part of a combination therapy to eradicate the bacteria)
• Erosive Esophagitis, which is damage to the esophagus lining caused by stomach acid
• Gouty Arthritis (though its primary action is acid suppression, it’s listed here)

How to Take Esmosim (Dosage & Administration)

Always follow your doctor’s instructions carefully. Dosing can vary depending on your condition, age, and liver function.

Adult Dose:

• GERD Without Erosive Esophagitis: Typically 20 mg orally once daily for 4 weeks. If symptoms don’t fully resolve, your doctor might suggest another 4 weeks of treatment.
• GERD With Erosive Esophagitis: Usually 20-40 mg orally once daily for 4-8 weeks.
• When oral therapy isn’t possible (e.g., in a hospital setting): 20-40 mg IV once daily for up to 10 days. You’ll switch to oral medication once you can swallow.
• Maintenance for GERD: 20 mg orally once daily for up to 6 months.
• Reducing Risk of NSAID-Associated Gastric Ulcer: 20-40 mg orally once daily for up to 6 months.
• Treating NSAID-Induced Gastric Ulcer: 20 mg orally once daily for 4-8 weeks.
• Zollinger-Ellison Syndrome: An initial dose of 80 mg orally, divided into two doses (every 12 hours). Your doctor will adjust this based on effectiveness, potentially up to 240 mg orally once daily, or 120 mg orally every 12 hours.
• Elderly Patients: Generally, no dosage adjustment is needed.

Dosage for Children (Oral):

• GERD Without Erosive Esophagitis:
  • Under 1 year: Safety and effectiveness aren’t established.
  • 1-12 years: 10-20 mg orally once daily for up to 8 weeks.
  • Over 12 years: 20-40 mg orally once daily for up to 8 weeks.
• GERD With Erosive Esophagitis (Healing):
  • Under 1 month: Safety and effectiveness aren’t established.
  • 1 month to 1 year: Dosing is weight-based:
    • 3.5 kg: 2.5 mg orally once daily for up to 6 weeks.
    • Over 3.5-7.5 kg: 5 mg orally once daily for up to 6 weeks.
    • Over 7.5 kg: 10 mg orally once daily for up to 6 weeks.
  • 1-12 years:
    • Under 20 kg: 10 mg orally once daily for 8 weeks.
    • Over 20 kg: 10-20 mg orally once daily for 8 weeks.
  • Over 12 years: 20-40 mg orally once daily for 4-8 weeks.
  • Maintenance (for over 12 years): 20 mg orally once daily for up to 6 months.

Special Populations:

• Hepatic (Liver) Impairment (Oral Administration):
  • Mild to Moderate (Child-Pugh A/B): No dosage adjustment is typically required.
  • Severe (Child-Pugh C): The daily dose should not exceed 20 mg.
• Renal (Kidney) Impairment: No dosage adjustment is generally needed.

How to Take:

• Delayed-release capsules: Take these on an empty stomach, ideally 1 hour before meals.
• Tablets: Can be taken with or without food.

Important Considerations Before Taking Esmosim

When You Shouldn’t Take It (Contraindications): Do not use Esmosim if you have a known hypersensitivity or allergy to Esomeprazole or any other similar medications (known as substituted Benzimidazoles).

Things to Be Aware Of (Precautions):

• Use with caution in children, and if you are pregnant or breastfeeding.
• Your doctor will monitor you if you have a malignancy (cancer) or hepatic (liver) impairment.
• Taking Esmosim might slightly increase your risk of certain infections, like community-acquired pneumonia.
• If you have severe liver impairment, your daily dose should not go over 20 mg.
• Breastfeeding: It’s not definitively known if Esomeprazole passes into breast milk. Your doctor will weigh the benefits and risks and may advise you to stop the drug or avoid nursing.

How Esmosim Interacts with Other Medications

Esmosim can interact with several other drugs. Always inform your doctor or pharmacist about all medications, supplements, and herbal products you are taking to avoid potential issues.

• Increased Risk:
  • Digoxin: Can increase the risk of digoxin-related heart problems.
  • Diuretics: May increase the risk of low magnesium levels (hypomagnesaemia).
  • Warfarin: Can increase INR and prothrombin time, which affects blood clotting.
  • Tacrolimus, Saquinavir, Methotrexate: May increase their levels in your blood.
  • Drugs metabolized by CYP2C19 (e.g., Diazepam): Esmosim can interfere with their elimination from the body.
• Decreased Effectiveness:
  • Ketoconazole, Erlotinib, Iron (Fe) salts: Esmosim can reduce their absorption.
• Potentially Fatal Interactions:
  • Rilpivirine, Atazanavir, Nelfinavir: Esmosim may significantly decrease their levels and effects.
  • Clopidogrel: Esmosim may reduce its antiplatelet (blood-thinning) effects.

Potential Side Effects of Esmosim

Like all medications, Esmosim can cause side effects, though not everyone experiences them.

• Very Common (>10%):
  • Headache (2-11%)
• Common (1-10%):
  • Flatulence (10%)
  • Indigestion (6%)
  • Nausea (6%)
  • Abdominal pain (1-6%)
  • Diarrhea (2-4%)
  • Dry mouth (xerostomia) (3-4%)
  • Dizziness (2-3%)
  • Constipation (2-3%)
  • Drowsiness (somnolence) (1-2%)
  • Itching (pruritus) (1%)
• Rare (<1%) and Serious (Seek medical attention if these occur):
  • Blood and lymphatic system disorders: Agranulocytosis (severe drop in white blood cells), pancytopenia (deficiency of all blood cells).
  • Blurred vision.
  • GI disorders: Pancreatitis (inflammation of the pancreas), stomatitis (mouth inflammation), microscopic colitis.
  • Hepatobiliary disorders: Hepatic failure (liver failure), hepatitis with or without jaundice.
  • Severe allergic reactions: Anaphylactic reaction/shock.
  • GI candidiasis (yeast infection in the gut).
  • Hypomagnesemia (low magnesium levels).
  • Musculoskeletal disorders: Muscular weakness, muscle pain (myalgia), bone fracture.
  • Nervous system disorders: Hepatic encephalopathy (brain dysfunction due to liver disease), taste disturbance.
  • Psychiatric disorders: Aggression, agitation, depression, hallucinations.
  • Interstitial nephritis (kidney inflammation).
  • Gynecomastia (breast enlargement in males).
  • Bronchospasm (tightening of airways).
  • Skin and subcutaneous tissue disorders: Hair loss (alopecia), erythema multiforme, excessive sweating (hyperhidrosis), photosensitivity (increased sensitivity to sunlight), Stevens-Johnson syndrome, toxic epidermal necrolysis (severe skin reactions, sometimes fatal).

How Esmosim Works (Mechanism of Action)

Esomeprazole, the active ingredient in Esmosim, is a Proton Pump Inhibitor (PPI). It works by specifically targeting and inhibiting the H+/K+ ATPase enzyme, often called the “proton pump,” which is located in the gastric parietal cells (the cells in your stomach lining that produce acid). By blocking this pump, Esmosim effectively suppresses the secretion of gastric acid, leading to a reduction in stomach acidity. Esomeprazole is the S-isomer of omeprazole, another well-known PPI.

Important Disclaimer: This information, sourced from the Farmaco Nepal drug index, is provided for general knowledge only. It is not intended to provide diagnosis, medical advice, or treatment, and should not be considered a substitute for the professional judgment of a qualified healthcare provider.