Esnow

Description

Esnow Tablet: Understanding Your Medication

Esnow Tablet is a medication used to manage conditions related to excessive stomach acid. Its active ingredient is Esomeprazole Magnesium Trihydrate BP, a type of proton pump inhibitor (PPI). Esnow Tablet is manufactured by Magnus Pharma Pvt. Ltd. and is available in Nepal.

What Esnow Is Used For (Indications)

Esnow Tablet is prescribed for various conditions stemming from stomach acid issues, including:

• Heartburn
• Acid-Related Dyspepsia (indigestion)
• Peptic Ulcer Disease, covering both duodenal and gastric ulcers
• Zollinger-Ellison Syndrome, a rare disorder leading to very high acid production
• Gastroesophageal Reflux Disease (GERD)
• Helicobacter pylori infection (typically as part of a multi-drug regimen to eradicate the bacteria)
• Erosive Esophagitis, which is damage to the esophageal lining caused by acid reflux
• Gouty Arthritis (listed as an indication, though Esomeprazole’s primary function is acid suppression)

How to Take Esnow (Dosage & Administration)

Always follow your healthcare provider’s specific instructions. Dosages can vary based on your condition, age, and liver function.

Adult Dose:

• GERD Without Erosive Esophagitis: 20 mg orally (PO) once daily (qDay) for 4 weeks. If symptoms don’t fully resolve, an additional 4 weeks of treatment might be considered.
• GERD With Erosive Esophagitis: 20-40 mg PO qDay for 4-8 weeks.
• When oral therapy is not appropriate or possible (e.g., in hospital settings): 20-40 mg intravenously (IV) qDay for up to 10 days; switch to oral administration once the patient can swallow.
• Maintenance (for GERD): 20 mg PO qDay for up to 6 months.
• Risk Reduction of NSAID-Associated Gastric Ulcer: 20-40 mg PO qDay for up to 6 months.
• NSAID-Induced Gastric Ulcer: 20 mg PO qDay for 4-8 weeks.
• Zollinger-Ellison Syndrome: Initial dose of 80 mg PO divided into two doses (q12hr); adjust the regimen based on efficacy, potentially up to 240 mg PO qDay, or 120 mg PO q12hr.
• Elderly Patients: No dosage adjustment is generally needed.

Dosage for Children (Oral):

• GERD Without Erosive Esophagitis:
  • Under 1 year: Safety and efficacy are not established.
  • 1-12 years: 10-20 mg PO qDay for up to 8 weeks.
  • Over 12 years: 20-40 mg PO qDay for up to 8 weeks.
• GERD With Erosive Esophagitis (Healing):
  • Under 1 month: Safety and efficacy are not established.
  • 1 month to 1 year: Dosing is weight-based:
    • 3.5 kg: 2.5 mg PO qDay for up to 6 weeks.

    • 3.5-7.5 kg: 5 mg PO qDay for up to 6 weeks.

    • 7.5 kg: 10 mg PO qDay for up to 6 weeks.

  • 1-12 years:
    • <20 kg: 10 mg PO qDay for 8 weeks.

    • 20 kg: 10-20 mg PO qDay for 8 weeks.

  • Over 12 years: 20-40 mg PO qDay for 4-8 weeks.
  • Maintenance (>12 years): 20 mg PO qDay up to 6 months.

Special Populations:

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

How to Take:

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

Important Considerations Before Taking Esnow

When You Shouldn’t Take It (Contraindications): Esomeprazole is contraindicated if you have a known hypersensitivity or allergy to any component of the formulation or to other similar medications (substituted Benzimidazoles).

Things to Be Aware Of (Precautions):

• Use with caution in pediatric patients, and during pregnancy and lactation.
• Your doctor will monitor you if you have a malignancy or hepatic (liver) impairment.
• There’s an increased risk of certain infections, such as community-acquired pneumonia.
• If you have severe liver impairment, your daily dose should not exceed 20 mg.
• Lactation: It’s unknown if esomeprazole passes into breast milk. Your doctor will advise you on whether to discontinue the drug or avoid nursing.

How Esnow Interacts with Other Medications

Esnow can interact with several other drugs. It’s crucial to inform your doctor or pharmacist about all medications, supplements, and herbal products you are currently taking to prevent potential interactions.

• Increased Risk:
  • Digoxin: Increased risk of digoxin-induced cardiotoxic effects.
  • Diuretics: Increased risk of hypomagnesaemia (low magnesium levels).
  • Warfarin: May increase INR and prothrombin time, affecting blood clotting.
  • Tacrolimus, Saquinavir, Methotrexate: May increase their serum concentrations.
  • Drugs metabolized by CYP2C19 (e.g., Diazepam): May interfere with their elimination.
• Decreased Effectiveness:
  • Ketoconazole, Erlotinib, Iron (Fe) salts: May decrease their bioavailability (how much is absorbed by the body).
• Potentially Fatal Interactions:
  • Rilpivirine, Atazanavir, Nelfinavir: May decrease their serum concentrations and pharmacological effects.
  • Clopidogrel: May decrease its antiplatelet (blood-thinning) effects.

Potential Side Effects of Esnow

Like all medications, Esnow can cause side effects, though not everyone will experience 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 cell types).
  • 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, hallucination.
  • 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 sun sensitivity), Stevens-Johnson syndrome, toxic epidermal necrolysis (severe skin reactions, sometimes fatal).

How Esnow Works (Mechanism of Action)

Esomeprazole, the active component of Esnow, is a Proton Pump Inhibitor (PPI). It works by specifically inhibiting the H+/K+ ATPase enzyme, often called the “proton pump,” found in the gastric parietal cells (the cells in your stomach lining that produce acid). By blocking this pump, Esnow significantly suppresses gastric acid secretion, which reduces stomach acidity and helps heal acid-related conditions. Esomeprazole is the S-isomer of omeprazole.

Important Note: This information, based on the Farmaco Nepal drug index, is for general informational purposes only and is not intended for diagnosis, medical advice, or treatment. It should not be considered a substitute for the professional judgment of a qualified healthcare provider.