Gastroesophageal reflux disease, heartburn, ulcer… Esomeprazole is one of the very commonly prescribed antacid drugs, from the family of “proton pump inhibitors (PPI)”.
What is esomeprazole?
Esomeprazole is a synthetic chemical drug belonging to the family proton pump inhibitors (PPIs). It has the role of decrease acid secretion in the stomach by reducing the activity of the pump responsible for the exchange of H+/Na+/K+ ions located on the cells of the stomach wall. H+ ions (called protons), once released in the stomach, are responsible for gastric acidity. By preventing the passage of H+ ions into the stomach, esomeprazole contributes to reduce heartburn and acid reflux. This drug is used in particular in the treatment and prevention of digestive ulcers (stomach, duodenum), esophagitis and gastroesophageal reflux.
What is the trade name of esomeprazole?
Esomeprazole is marketed as of Inexium®, drug only available on prescription. Various generics of Inexium® are also marketed under the name of esomeprazole (Almus, Alter, Arrow, Biogaran, Cristers, EG, Evolugen Pharma, KRKA, Mylan, Ranbaxy, Sandoz, Sun, Teva, Zentiva and Zydus laboratories). Nexium control® (and its generics Esomeprazole Biogaran conseil® and Esomeprazole Mylan conseil®) is an advice form of esomeprazole and contains fewer tablets than Inexium® (7 or 14 depending on the presentation); he is available on sale.
What are the indications for esomeprazole?
Esomeprazole is indicated for the management of gastroesophageal reflux disease (symptomatic treatment of GERD, treatment and prevention of reflux oesophagitis), for the eradication of Helicobacter pylorithe bacterium responsible for gastroduodenal ulcers (in combination with antibiotic therapy) and in recurrence preventionin the treatment or prevention of peptic ulcers associated with taking NSAIDs (non-steroidal anti-inflammatory drugs) as well as in the Zollinger-Ellison syndrome treatment (pathology responsible for multiple, severe and recalcitrant gastric and duodenal ulcers).
What is the difference with omeprazole?
Esomeprazole is a very similar molecule to omeprazole: this is its S-isomer, i.e. its gross molecular formula is identical to that of omeprazole but it is the organization of the atoms which is different. Its effects are therefore very comparable to those of omeprazole. These two drugs also present the same indications, even if their dosages are not identical (for example, 20 mg of esomeprazole is not equivalent to 20 mg of omeprazole).
When is the best time to take esomeprazole?
Esomeprazole is taken interchangeably during or without a meal. Food intake may delay or decrease the gastric absorption of esomeprazole but this does not affect its efficacy. Morning or evening intake depends on when symptoms occur : in the morning if the symptoms are predominant during the day, in the evening if they occur mainly at night. Tablets or capsules should be taken whole with a drink, without being bitten or chewed. In some cases, the tablets may be dispersed in a half glass of still waterthe solution to be drunk immediately or within 30 minutes and without chewing the granules.
Esomeprazole should not be taken without medical advice or outside of its indications
What are the side effects of esomeprazole?
The most common side effects of esomeprazole are headaches, dizziness, drowsiness and digestive upset (abdominal pain, constipation, diarrhea, flatulence, nausea, vomiting, polyps). Various other effects can occur but are much rarer. Also, esomeprazole has various drawbacks, as do all PPIs. If taken over the long term (more than 3 months or even more than a year), it increases the risk of gastrointestinal infections linked in particular to Campylobacter or Salmonella germs. Esomeprazole can also decrease the absorption of magnesium and vitamin B12 and thus cause deficiencies such as hypomagnesemia (may manifest as fatigue, tetany, delirious flushes, convulsions, dizziness and arrhythmia). Likewise, he increases the risk of fractures of the hip, wrist and vertebrae, especially in the elderly or at risk. In rare cases, esomeprazole can trigger subacute cutaneous lupus erythematosus or other serious skin reactions. This drug can also interact with many drugs (certain antiretrovirals, methotrexate, tacrolimus, certain antifungals, digoxin, certain antidepressants, certain antiepileptics, anticoagulants and antiplatelet agents or even St. John’s wort). Thus, esomeprazole should not be taken without medical advice or outside its indications. The duration of treatment should be as short as possible and adapted to the symptoms. Complementary examinations are recommended so as not to delay the management of a potentially serious pathology.
What are the contraindications of esomeprazole?
Esomeprazole is contraindicated in case of hypersensitivity to the active substance, benzimidazole derivatives or an excipient contained in the medicinal product. This medicine should not be used concomitantly with nelfinavir (medicine for HIV). Due to the presence of sucrose, it should not be taken by people with fructose intolerance, having a syndrome glucose or galactose malabsorption or sucrase-isomaltase deficiency.