Generic
Esomeprazole Magnesium Trihydrate
328 brands available in the market
At a glance
Esomeprazole Magnesium Trihydrate is a proton pump inhibitor (PPI) that reduces stomach acid production. It is used for heartburn, acid reflux, esophageal problems and peptic ulcer prevention and treatment.
Description
Esomeprazole Magnesium Trihydrate irreversibly blocks the H+/K+-ATPase enzyme (proton pump) in gastric parietal cells, inhibiting the final step of gastric acid secretion. It is the S-isomer of omeprazole, providing longer-lasting acid control. It is used for GERD, erosive esophagitis, Zollinger-Ellison syndrome and duodenal ulcers associated with H. pylori infection. It provides relief from acid-related indigestion and heartburn.
Indications
GERD (acid reflux), peptic ulcer disease, erosive esophagitis, Zollinger-Ellison syndrome, NSAID-induced gastric ulcer, duodenal ulcers associated with H. pylori infection (in combination with antibiotics).
Therapeutic class
Proton Pump Inhibitor
Pharmacological class
Proton Pump Inhibitor (PPI)
Pharmacology
Esomeprazole Magnesium Trihydrate irreversibly inhibits the proton pump (H+/K+ ATPase) in gastric parietal cells, blocking the final step of gastric acid secretion. It is the S-isomer of omeprazole, providing faster and higher bioavailability compared to the R-isomer. By reducing gastric acid production, it provides relief from acid-related indigestion and heartburn and helps heal the esophageal and gastric lining.
Mechanism of action
Esomeprazole Magnesium Trihydrate irreversibly blocks the H+/K+-ATPase enzyme (proton pump) in gastric parietal cells, stopping the final step of gastric acid secretion. This reduces stomach acid production, providing relief from acid reflux, heartburn and peptic ulcers and helping heal the esophageal and gastric lining.
Dosage
Adult Dose:
- GERD (without Erosive Esophagitis): 20 mg once daily for 4 weeks; additional 4 weeks if needed.
- GERD (with Erosive Esophagitis): 20-40 mg once daily for 4-8 weeks.
- Maintenance: 20 mg once daily for up to 6 months.
- NSAID-associated gastric ulcer risk reduction: 20-40 mg once daily for up to 6 months.
- NSAID-induced gastric ulcer: 20 mg once daily for 4-8 weeks.
- Zollinger-Ellison Syndrome: 80 mg (initial) every 12 hours (max 240 mg/day).
Pediatric Dose (1-12 years): 10-20 mg once daily (weight-based). Above 12 years: Adult dose.
Administration
Swallow the tablet whole on an empty stomach at least 1 hour before meals. Do not chew or crush. Take at a fixed time each day. Regular monitoring of magnesium and vitamin B12 levels is recommended for long-term use.
Missed dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.
Side effects
Common side effects: Headache, dizziness, dry mouth, nausea, abdominal pain, constipation, flatulence, diarrhea.
Rare side effects: Allergic reactions, kidney problems (decreased urination, back pain, fatigue), hypomagnesemia (muscle cramps, irregular heartbeat), increased fracture risk with long-term use.
Precautions & warnings
Long-term use may cause magnesium and vitamin B12 deficiency. Regular blood tests as advised by your doctor. Inform your doctor if you experience symptoms of hypomagnesemia (muscle cramps, irregular heartbeat). Ensure adequate calcium and vitamin D intake to reduce fracture risk. Inform your doctor if you experience watery diarrhea, fever or persistent stomach pain. Avoid use during pregnancy and breastfeeding. Caution while driving.
Contraindications
Hypersensitivity to esomeprazole or substituted benzimidazoles. Use with caution in severe liver disease (Child-Pugh C).
Drug interactions
Avoid use with clopidogrel (reduces antiplatelet effect). Avoid with rilpivirine, atazanavir, nelfinavir (reduced bioavailability). Increases INR and prothrombin time with warfarin. Increased risk of digoxin cardiotoxicity. Increased risk of hypomagnesemia with diuretics. Other interactions: Diazepam, tacrolimus, methotrexate, ketoconazole, erlotinib, iron salts.
Food interactions
Caution advised when consuming alcohol as it may increase stomach acid production and worsen symptoms.
Use in pregnancy
Unsafe during pregnancy. Animal studies have shown harmful effects on the fetus. Use only if clearly needed under medical supervision.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Unsafe during breastfeeding. Limited data suggests the drug may pass into breast milk and harm the baby.
Pediatric use
Safety and efficacy established in children 1-12 years (weight-based dosing). Avoid use in children under 1 year.
Geriatric use
No dosage adjustment needed for elderly patients. However, long-term use increases fracture risk.
Renal / hepatic impairment
Safe in kidney disease; no dose adjustment needed. Severe liver disease (Child-Pugh C): Do not exceed 20 mg/day.
Overdose effects
Symptoms of overdose: Drowsiness, irregular heartbeat, stomach discomfort, nausea, vomiting, headache. Seek medical attention immediately if overdose is suspected.
Storage conditions
Store below 30°C in a cool and dry place, protected from light. Keep out of reach of children.
Chemical structure
Esomeprazole Magnesium Trihydrate