Esomeprazole Tablets

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Therapeutic Indication

Gastroesophageal reflux disease (GERD)
Peptic ulcer disease
Zollinger-Ellison syndrome
NSAID-induced gastric ulcers
Helicobacter pylori eradication (with antibiotics)
Acid-related dyspepsia
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Esomeprazole

Tablet

Esomeprazole is a proton pump inhibitor (PPI) that reduces gastric acid secretion by inhibiting the H+/K+ ATPase enzyme in gastric parietal cells. It is widely used in the management of GERD, peptic ulcers, Zollinger-Ellison syndrome, and for prevention of NSAID-induced ulcers.

Speciality Gastroenterology | Proton Pump Inhibitor
Tags GERD | Peptic Ulcer | Acid Reflux | PPI
Strength
  • 20 mg
  • 40 mg
Packing Size
  • 10 Tablets

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Mechanism

Esomeprazole irreversibly inhibits the gastric proton pump (H+/K+ ATPase) in parietal cells, blocking the final step of acid secretion. This leads to profound and sustained reduction in gastric acid production.

Pharmacokinetics

  • Absorption: Rapid oral absorption; bioavailability ~64% (20 mg dose).
  • Distribution: Plasma protein binding ~97%. Widely distributed in gastric mucosa.
  • Metabolism: Extensively metabolized in liver via CYP2C19 and CYP3A4.
  • Elimination: Excreted mainly in urine as metabolites.
  • Half-life: Approximately 1–1.5 hours.

Side Effects

  • Headache
  • Nausea, vomiting
  • Diarrhea, abdominal pain
  • Flatulence
  • Rare: hypomagnesemia, vitamin B12 deficiency (long-term use)
  • Rare: osteoporosis-related fractures (long-term use)

Contraindication

  • Hypersensitivity to Esomeprazole or other PPIs
  • Concomitant use with Nelfinavir
  • Severe hepatic impairment (dose adjustment required)

Interaction

  • Clopidogrel: Reduced efficacy due to CYP2C19 inhibition.
  • Warfarin: Monitor INR due to possible interaction.
  • Ketoconazole, Itraconazole: Reduced absorption due to decreased gastric acidity.
  • Diazepam, Phenytoin: Increased plasma levels due to CYP2C19 inhibition.

Warning and Precautions

  • Monitor magnesium levels during prolonged therapy.
  • Use cautiously in patients with osteoporosis.
  • Consider vitamin B12 supplementation in long-term use.
  • Discontinue if severe hypersensitivity or interstitial nephritis occurs.