Neptor MUPS 20 Tablet

✔️ Adults (18 years and older)

Neptor MUPS (esomeprazole) is indicated for the treatment of the following conditions:

1. Gastroesophageal reflux disease (GERD), including:
2. Non-erosive reflux disease (NERD), characterized by heartburn and regurgitation
3. Maintenance treatment of NERD
4. Reflux or erosive esophagitis
5. Maintenance treatment after healing of reflux esophagitis
6. Healing of gastric ulcers associated with NSAID use
7. Reducing the risk of NSAID-related gastric ulcers
8. Zollinger-Ellison syndrome
9. Eradication of Helicobacter pylori (H. pylori) as part of combination therapy

✔️ Pharmacology

Esomeprazole belongs to the proton pump inhibitor (PPI) class. It reduces stomach acid production by blocking the hydrogen-potassium ATPase enzyme system, also known as the gastric proton pump, in the stomach's parietal cells.

It is used for the short-term treatment of gastric and duodenal ulcers and for the treatment and prevention of gastric ulcers associated with NSAID use.

✔️ Pediatrics (12–17 years)

Neptor MUPS is indicated for:

• Gastroesophageal reflux disease (GERD)
• Non-erosive reflux disease (NERD), including heartburn and regurgitation
• Reflux or erosive esophagitis

✔️ Drug Interaction

The dose and duration of treatment depend on the condition being treated and the patient's response. Use only as prescribed by a healthcare professional.

Adults (18 years and older)

Gastroesophageal reflux disease (GERD):

1. Non-erosive reflux disease (NERD), including heartburn and regurgitation: 20 mg once daily for 24 weeks
2. Maintenance treatment of NERD: 20 mg once daily
3. Reflux or erosive esophagitis: 20 mg or 40 mg once daily for 4–8 weeks
4. Maintenance treatment after healing of reflux esophagitis: 20 mg once daily

Other conditions:

1. Healing of NSAID-associated gastric ulcers: 20 mg once daily for 4–8 weeks
2. Reducing the risk of NSAID-associated gastric ulcers: 20 mg once daily
3. Zollinger-Ellison syndrome: 40 mg twice daily

H. pylori eradication with amoxicillin 1000 mg and clarithromycin 500 mg: 20 mg tablet twice daily for 7 days or 40 mg capsule once daily for 10 days, as prescribed

Pediatrics (12–17 years):

1. Non-erosive reflux disease (NERD): 20 mg once daily for 2–4 weeks
2. Reflux or erosive esophagitis: 20 mg or 40 mg once daily for 4–8 weeks

✔️ Interaction

• Esomeprazole is primarily metabolized in the liver by the CYP2C19 and CYP3A4 enzymes. It may affect the metabolism or absorption of certain medicines.
• Diazepam: Esomeprazole may reduce diazepam clearance and increase its concentration in the blood.
• Medicines affected by stomach acidity: Reduced stomach acid may affect the absorption of medicines such as ketoconazole, iron salts, and digoxin.
• Phenytoin, warfarin, quinidine, clarithromycin, and amoxicillin: Studies have not shown clinically significant interactions in certain settings; however, medical supervision is still advised.
• Combination therapy with clarithromycin and amoxicillin: Co-administration may increase the blood levels of esomeprazole and 14-hydroxyclarithromycin.
• Tell your doctor or pharmacist about all medicines and supplements you take before starting esomeprazole.

✔️ Directions For Use:

• Esomeprazole MUPS tablets may be taken with or without food. Swallow the tablet whole with liquid. Do not crush or chew it.
• If swallowing is difficult, the tablet may be dispersed in half a glass of non-carbonated water. Stir until it breaks apart and drink the mixture immediately or within 30 minutes. Rinse the glass with another half glass of water and drink it.
• Do not chew or crush the pellets. Do not use other liquids to disperse the tablet. Follow the product-specific instructions provided by your pharmacist or doctor.

✔️ Pregnancy & Lactation

Pregnancy: Clinical information regarding esomeprazole use during pregnancy is limited. It should be used during pregnancy only when considered essential by a healthcare professional.

Lactation: It is not known whether esomeprazole passes into breast milk. Consult a doctor before using this medicine while breastfeeding.

✔️ Precautions & Warnings

Use esomeprazole cautiously in patients with severe liver dysfunction or severe renal impairment.

Long-term use of proton pump inhibitors, particularly for more than one year, may be associated with a slightly increased risk of fractures involving the hip, wrist, or spine. Discuss prolonged treatment and any relevant risk factors with your doctor.

✔️ Side Effects

• Common side effects may include nausea, vomiting, abdominal pain, flatulence, diarrhea, constipation, and headache.
• Less common effects may include dry mouth, peripheral oedema, dizziness, sleep disturbances, fatigue, tingling sensations, joint or muscle pain, rash, and itching.
• Rare or very rare reactions have also been reported, including taste disturbances, stomatitis, hepatitis, jaundice, severe allergic reactions, fever, depression, hallucinations, confusion, breast enlargement in men, interstitial nephritis, low sodium levels, blood-cell abnormalities, visual disturbances, increased sweating, photosensitivity, hair loss, Stevens-Johnson syndrome, and toxic epidermal necrolysis.

✔️ Contraindications:

Esomeprazole should not be used by patients who have a known allergy or hypersensitivity to esomeprazole or any ingredient in the formulation.

✔️ Storage:

Store in a cool, dry place below 25°C. Protect from light and keep out of the reach of children.