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Indications of Remmo 40 mg Tablet
Gastro-esophageal Reflux Disease (GERD) is treated with esomeprazole MUPS tablets (GERD).
NSAID-related stomach ulcer risk is reduced.
Eradication of Helicobacter pylori (Triple therapy).
Idiopathic hypersecretion and Zollinger-Ellison syndrome
Pharmacology
Esomeprazole is a proton pump inhibitor that inhibits the H+/K+ ATPase in the gastric parietal cell, suppressing gastric acid output. The first single optical isomer of a proton pump inhibitor, esomeprazole (S-isomer of omeprazole), provides superior acid control than racemic proton pump inhibitors.
Dosage
Erosive esophagitis-
Adult (≥18 years): 40 mg once daily for 4 weeks.
Children & adolescents (12-18 years): 40 mg once daily for 4 weeks.
Maintenance of healing of erosive esophagitis-
Adult (≥18 years): 20 mg once daily.
Children & adolescents (12-18 years): 20 mg once daily.
Risk reduction in NSAID associated gastric ulcer-
Adult (≥18 years): 20 mg once daily for 4-8 weeks.
H. pylori eradication (Esomeprazole MUPS tablet with 1000 mg Amoxicillin and 500 mg Clarithromycin)-
Adult (≥18 years): 20 mg twice daily for 7 days.
Children & adolescents (12-18 years): 20 mg twice daily for 7 days.
Zollinger-Ellison syndrome and idiopathic hypersecretion-
Adult (≥18 years): 40-80 mg twice daily.
Children 1-11 years:
Erosive esophagitis: Weight <20 kg: 10 mg once daily for 8 weeks. Weight ≥20 kg: 10 mg or 20 mg once daily for 8 weeks
Maintenance of healing of erosive esophagitis: 10 mg once daily
Children below the age of 1 year: Esomeprazole MUPS tablet is not approved for use in children younger than 1 year.
Administration
Esomeprazole MUPS tablets should be swallowed whole with liquid. The tablets should not be chewed or crushed. If required, the tablets can also be dispersed in half a glass of non-carbonated water (mineral water is not suitable). No other liquids should be used. Stir until the tablets disintegrate and drink the liquid with the pellets immediately or within 30 minutes. Rinse the glass with half a glass of water and drink. The pellets must not be chewed or crushed.
Interaction of Remmo 20
Esomeprazole is broadly metabolized within the liver by CYP2C19 and CYP3A4. In vitro and in vivo thinks about have shown that Esomeprazole isn't likely to restrain CYPs 1A2, 2A6, 2C9, 2D6, 2E1 and 3A4. No clinically significant intuitive with drugs metabolized by these CYP proteins would be anticipated. Medicate interaction thinks about have appeared that Esomeprazole does not have any clinically noteworthy intuitive with phenytoin, warfarin, quinidine, clarithromycin or amoxicillin. Esomeprazole may possibly meddled with CYP2C19, the major Esomeprazole metabolizing chemical. Co-administration of Esomeprazole 30 mg anddiazepam, a CYP2C19 substrate has brought about in a 45% diminish in clearance of diazepam. Expanded plasma levels of diazepam have been watched 12 hours after dosing and onwards. Esomeprazole hinders gastric corrosive discharge. Hence, Esomeprazole may meddled with the retention of drugs where gastric pH is an imperative determinant of bioavailability (e.g., ketoconazole, press salts a
Co-administration of verbal contraceptives, diazepam, phenytoin, or quinidine don't appear to alter the pharmacokinetic profile of Esomeprazole. Combination Treatment with Clarithromycin: Co-administration of esomeprazole, clarithromycin, and amoxicillin has resulted in increments within the plasma levels of esomeprazole and 14-hydroxyclarithromycin.
Contraindications
In patients who have a history of hypersensitivity to any of the formulations, esomeprazole is not recommended.
Side Effects of Remmo 20
Headache, diarrhoea, nausea, flatulence, abdominal pain, constipation, and dry mouth are the most common side effects reported with Esomeprazole. When compared to short-term treatment, there is no difference in the categories of linked adverse events noticed with maintenance treatment up to 12 months.
Pregnancy & Lactation
Caution is advised by the manufacturer. Esomeprazole or its metabolites are not known to occur in human breast milk.
Precautions & Warnings
If the patient has severe liver failure and renal impairment, esomeprazole should be administered with caution. Proton pump inhibitors, such as Esomeprazole, may marginally increase the risk of hip, wrist, and spine fractures, especially when used for more than a year.
Storage Conditions
Protect from light and store in a cool, dry area below 25°C. Keep out of children's reach.
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