Nexcap 40mg Capsule 1 Strip

✔️ Dosage

• Healing of Erosive Esophagitis: 20-40 mg daily for 4-8 weeks. If not healed, an additional 4-8 weeks may be required.
• Maintenance of Healing: 20 mg daily (studied for up to 6 months).
• Symptomatic GERD: 20 mg daily for 4 weeks. Treatment can be extended by another 4 weeks if symptoms persist.
• H. pylori Eradication: 40 mg daily for 10 days with amoxicillin (1000 mg twice daily) and clarithromycin (500 mg twice daily).
• Zollinger-Ellison Syndrome: 20-80 mg daily, adjusted as necessary.
• 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.

✔️ Side Effects

Common side effects include headache, diarrhea, nausea, flatulence, abdominal pain, constipation, and dry mouth. Long-term maintenance therapy shows no new adverse effects compared to short-term use.

✔️ Interactions

• Esomeprazole is metabolized by CYP2C19 and CYP3A4 but does not significantly interact with most drugs processed by these enzymes (e.g., phenytoin, warfarin, quinidine, clarithromycin, and amoxicillin).
• May affect the absorption of drugs dependent on gastric pH (e.g., ketoconazole, iron salts, and digoxin).
• Co-administration with oral contraceptives, diazepam, phenytoin, or quinidine does not alter its pharmacokinetics significantly.
• Combination therapy with clarithromycin and amoxicillin increases plasma levels of both esomeprazole and 14-hydroxyclarithromycin.

✔️ Contraindications

Hypersensitivity to esomeprazole or any formulation components.

✔️ Overdose Management

• No specific antidote. Overdose treatment is symptomatic and supportive. Dialysis is not expected to be effective due to high protein binding. Animal studies suggest toxicity signs like reduced activity, respiratory changes, tremors, and convulsions at high doses.

✔️ Pregnancy and Lactation

• Limited data on use during pregnancy; animal studies show no teratogenic effects.
• Unknown if excreted in human milk. Discontinue breastfeeding if treatment is necessary.

✔️ Precautions and Warnings

• Symptom relief does not rule out the presence of gastric malignancy.
• For patients with swallowing difficulty, capsules can be opened, and pellets mixed with a tablespoon of soft applesauce (not hot). Consume immediately without storing.
• Safe use in pediatric and geriatric populations has been established, but caution is advised in older patients due to potential sensitivity.
• For severe hepatic impairment, do not exceed 20 mg daily.

✔️ Storage

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