Esomepral 20 mg Tablet (Esomeprazole Magnesium)

Esomepral 20 mg is a proton pump inhibitor (PPI) medication that contains esomeprazole magnesium, a refined form of omeprazole. It is widely used to manage and treat conditions associated with excessive stomach acid production. The tablet helps reduce acid secretion in the stomach, offering relief from acid-related disorders and protecting the gastrointestinal lining.

Mechanism of Action

Esomeprazole is the S-isomer of omeprazole. It works by irreversibly inhibiting the H⁺/K⁺-ATPase enzyme system (proton pump) in the gastric parietal cells. This inhibition reduces the final step in the production of gastric acid, leading to a significant and prolonged reduction in stomach acidity.

Indications

• Gastroesophageal reflux disease (GERD) – for relief from heartburn and prevention of esophageal damage

• Peptic ulcers – associated with NSAID use or Helicobacter pylori infection

• Zollinger-Ellison syndrome – treatment of chronic acid hypersecretion

• Erosive esophagitis – healing and maintenance therapy

• Prevention of gastric ulcers in at-risk patients taking NSAIDs

• Helicobacter pylori eradication therapy – as part of combination treatment

Dosage and Administration

• Adults: 20 mg once daily, preferably taken at least one hour before meals

• Duration:

  • GERD: 4 to 8 weeks

  • Peptic ulcers (NSAID-induced): Up to 8 weeks

  • H. pylori eradication: 7–14 days in combination with antibiotics

• Do not crush or chew the tablet; swallow whole with water

• Adjust dose for elderly or patients with severe liver impairment

Side Effects

Common:

• Headache

• Nausea

• Diarrhea or constipation

• Abdominal pain

• Flatulence

Serious (Rare):

• Vitamin B12 deficiency (with prolonged use)

• Hypomagnesemia

• Bone fractures (with long-term use)

• Kidney problems (interstitial nephritis)

• Clostridium difficile-associated diarrhea

Precautions

• Not intended for immediate relief of heartburn symptoms

• Use with caution in patients with severe liver disease

• Long-term therapy may require monitoring of magnesium, calcium, and vitamin B12 levels

• Consider risks of rebound acid hypersecretion when discontinuing long-term therapy

• Avoid use during pregnancy unless clearly needed (category B – consult physician)

Drug Interactions

• May reduce absorption of drugs dependent on gastric pH (e.g., ketoconazole, atazanavir)

• Can interact with warfarin, clopidogrel, diazepam, and digoxin

• Avoid concurrent use with other PPIs or H2 blockers

Storage

• Store below 30°C in a dry place

• Protect from moisture and direct light

• Keep out of reach of children

Packaging

• Usually available in blister strips of 10 or 14 tablets

• Shelf life: Typically 24–36 months from manufacturing date

Esomepral 20 mg offers reliable and sustained acid suppression, making it a cornerstone therapy for acid-related gastrointestinal disorders. It is safe and effective when used under medical guidance, particularly for short to medium-term therapy.