Maxima 20mg Tablet

✔️ Dosage and Administration of Maxima Tablet

Erosive Esophagitis

• 20 mg or 40 mg once daily for 4–8 weeks.
• If healing is incomplete, treatment may continue for another 4–8 weeks.

Maintenance Therapy

• 20 mg once daily.

Symptomatic GERD

• 20 mg once daily for 4 weeks.
• If symptoms persist, treatment may be extended for another 4 weeks.

H. pylori Eradication (Triple Therapy)

• Esomeprazole 40 mg once daily
• Amoxicillin 1000 mg twice daily
• Clarithromycin 500 mg twice daily
• Duration: 10 days

Zollinger-Ellison Syndrome

• 20–80 mg daily, adjusted according to clinical response.

Acid-Related Dyspepsia

• 20–40 mg daily for 2–4 weeks.

Duodenal Ulcer

• 20 mg daily for 2–4 weeks.

Gastric Ulcer

• 20–40 mg daily for 4–8 weeks.
• Swallow whole without crushing or chewing.
• Take at least one hour before meals.

Children

• Safety and effectiveness have not been fully established.

Elderly Patients

• No major dosage adjustment is generally required, although some individuals may be more sensitive to treatment.

Liver Impairment

• No adjustment is needed in mild to moderate liver disease.
• In severe liver impairment, the dose should not exceed 20 mg daily.

Kidney Impairment

• Dose adjustment is generally unnecessary because very little unchanged drug is excreted in urine.

✔️ Side Effects

• Headache
• Diarrhea
• Nausea
• Abdominal discomfort
• Flatulence
• Constipation
• Dry mouth

✔️ Interaction

Esomeprazole is metabolized mainly by CYP2C19 and CYP3A4 enzymes.

Potential interactions include:

• Increased diazepam levels due to reduced clearance
• Reduced absorption of drugs that require stomach acid for absorption, such as:
  • Ketoconazole
  • Iron supplements
  • Digoxin
• Increased esomeprazole levels when used with clarithromycin

No clinically significant interactions have been observed with:

• Phenytoin
• Warfarin
• Quinidine
• Amoxicillin

✔️ Contraindications

Maxima should not be used in individuals who are allergic to esomeprazole or any component of the formulation.

✔️ Pregnancy & Lactation

Adequate studies in pregnant women are lacking. Animal studies have not shown birth defects, but Maxima should only be used during pregnancy when clearly needed.

Because it is unknown whether esomeprazole passes into human breast milk, breastfeeding should be discontinued if treatment is considered essential.

✔️ Safety Information

• Improvement of symptoms does not rule out serious stomach diseases, including gastric cancer.
• Take the medication before meals for optimal effect.
• Antacids may be used alongside Maxima if required.
• Do not crush or chew the enteric-coated pellets.

✔️ Storage:

Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.