Neptor MUPS 40 Tablet

✔️ Uses of Neptor MUPS 40

• Gastroesophageal reflux disease (GERD)
• Acid reflux and heartburn
• Peptic ulcer disease
• Erosive esophagitis
• Gastric and duodenal ulcers
• Zollinger-Ellison syndrome
• Helicobacter pylori infection, as part of combination therapy
• Prevention and treatment of NSAID-associated gastric ulcers

✔️ Side Effects of Neptor MUPS 40

• Headache
• Dizziness
• Dry mouth
• Nausea and vomiting
• Abdominal pain
• Constipation
• Flatulence
• Diarrhoea

✔️ How does Neptor MUPS 40 work?

Neptor MUPS 40 belongs to the proton pump inhibitor (PPI) class. It blocks the H+/K+ ATPase enzyme system, commonly known as the gastric proton pump, which is responsible for the final step of stomach acid production. By reducing acid secretion, it helps relieve heartburn, acid reflux, and other acid-related conditions.

✔️ Drug Interaction

✔️ Use Neptor MUPS 40 cautiously in patients with:

• Severe liver impairment
• A history of osteoporosis or increased fracture risk
• Low magnesium levels
• A history of allergic reactions to proton pump inhibitors
• Suspected gastric malignancy, as treatment may mask certain symptoms
• A history of kidney problems
• Long-term use of proton pump inhibitors may be associated with an increased risk of certain infections, including community-acquired pneumonia and gastrointestinal infections. Prolonged treatment may also contribute to low magnesium levels, vitamin B12 deficiency, and bone fractures.
• For patients with severe liver impairment, the daily dose should generally not exceed 20 mg.

Pregnancy and lactation: Limited information is available regarding esomeprazole use during pregnancy and breastfeeding. Discuss the potential benefits and risks with your doctor before taking this medicine.

✔️ Renal Dose

Patients with renal impairment generally do not require a dose adjustment. However, treatment should be supervised by a healthcare professional.

✔️ Dosage & Administration

Adult Dose

The following doses are general reference information. The appropriate dose depends on the condition being treated and the patient's response.

GERD without erosive esophagitis:

20 mg orally once daily for 4 weeks.

An additional 4 weeks may be considered if symptoms have not completely resolved.

GERD with erosive esophagitis:

20–40 mg orally once daily for 4–8 weeks.

If oral treatment is not possible, intravenous treatment may be considered under medical supervision.

Maintenance treatment: 20 mg orally once daily for up to 6 months.

Prevention of NSAID-associated gastric ulcers:

20–40 mg orally once daily for up to 6 months.

NSAID-induced gastric ulcers:

20 mg orally once daily for 4–8 weeks.

Zollinger-Ellison syndrome:

Initial dose: 80 mg orally per day, divided into two doses.

The dose may be adjusted according to the patient's response. Higher doses may be required under specialist supervision.

Elderly patients: Dose adjustment is generally not necessary based on age alone.

Hepatic impairment:

• Mild to moderate liver impairment: Usually no dose adjustment is required.
• Severe liver impairment: The dose should generally not exceed 20 mg daily.

Child Dose

Paediatric doses must be determined by a specialist according to the child's age, weight, diagnosis, and formulation.

GERD without erosive esophagitis:

• Below 1 year: Safety and effectiveness have not been established.
• 1–12 years: 10–20 mg orally once daily for up to 8 weeks.
• Above 12 years: 20–40 mg orally once daily for up to 8 weeks.

Healing of erosive esophagitis:

Below 1 month: Safety and effectiveness have not been established.

1 month to 1 year:

• Weight 3.5 kg: 2.5 mg once daily for up to 6 weeks.
• Weight above 3.5–7.5 kg: 5 mg once daily for up to 6 weeks.
• Weight above 7.5 kg: 10 mg once daily for up to 6 weeks.

1–12 years:

• Weight below 20 kg: 10 mg once daily for 8 weeks.
• Weight above 20 kg: 10–20 mg once daily for 8 weeks.
• Above 12 years: 20–40 mg once daily for 4–8 weeks.

Maintenance treatment: 20 mg orally once daily for up to 6 months in appropriate patients.

✔️ Contraindications:

Esomeprazole is contraindicated in patients with a known hypersensitivity to esomeprazole, any ingredient in the formulation, or substituted benzimidazoles.

✔️ Interaction

Neptor MUPS 40 may interact with certain medicines and affect their absorption, metabolism, or effectiveness.

• Digoxin: May increase the risk of digoxin-related toxicity.
• Diuretics: May increase the risk of low magnesium levels.
• Warfarin: May increase INR and prothrombin time, potentially affecting bleeding risk.
• Tacrolimus: May increase blood concentrations of tacrolimus.
• Saquinavir: May increase its serum concentration.
• Methotrexate: May increase methotrexate exposure, particularly at high doses.
• Diazepam: May reduce its metabolism and increase its blood concentration.
• Ketoconazole, erlotinib, and iron salts: Reduced stomach acidity may decrease their absorption.
• Rilpivirine, atazanavir, and nelfinavir: Reduced stomach acidity may lower their absorption and effectiveness.
• Clopidogrel: Esomeprazole may reduce its antiplatelet activity.

Inform your doctor about all prescription medicines, over-the-counter products, and supplements you use before starting Neptor MUPS 40.

✔️ Pregnancy & Lactation (গর্ভাবস্থা ও দুগ্ধদান):

Pregnancy: Adequate, well-controlled studies of esomeprazole in pregnant women are not available. Esomeprazole is the S-isomer of omeprazole. Available epidemiological data on first-trimester omeprazole exposure have not demonstrated a clear increase in major congenital malformations or other adverse pregnancy outcomes. However, animal studies have reported embryo-related adverse effects at certain doses. Use during pregnancy should be considered only when medically necessary and recommended by a healthcare professional.

Lactation: Limited information suggests that omeprazole may pass into human breast milk. However, clinical data on the effects of esomeprazole on breastfed infants and milk production are limited. A doctor should assess the mother's treatment needs alongside the potential benefits of breastfeeding and possible risks to the infant.

✔️ Storage:

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