Neusangel 20 mg is a prescription medication containing Esomeprazole Magnesium Trihydrate, a proton pump inhibitor (PPI) that reduces stomach acid production. Manufactured by Pristine Pharmaceuticals Ltd., it is primarily used to treat acid-related conditions such as:

• Gastroesophageal reflux disease (GERD)

• Erosive esophagitis

• Peptic ulcers

• Zollinger-Ellison syndrome

• Prevention of NSAID-associated gastric ulcers Medex

Pharmacology

Esomeprazole is a proton pump inhibitor that suppresses gastric acid secretion by specific inhibition of the H⁺/K⁺-ATPase in the gastric parietal cell. Esomeprazole (S-isomer of omeprazole) is the first single optical isomer of proton pump inhibitor, providing better acid control than racemic proton pump inhibitors.Medex

• Absorption: Peak plasma levels occur approximately 1.5 hours after oral administration. The systemic bioavailability is approximately 90% after repeated once-daily dosing.Medex

• Distribution: Esomeprazole is 97% bound to plasma proteins, with an apparent volume of distribution of approximately 16 L.Medex

• Metabolism: Extensively metabolized in the liver by the cytochrome P450 (CYP) enzyme system, primarily by CYP2C19 and CYP3A4.Medex+1Pharmacist BD+1

• Excretion: The plasma elimination half-life is approximately 1–1.5 hours. Less than 1% of the parent drug is excreted in the urine. Approximately 80% of an oral dose is excreted as inactive metabolites in the urine, and the remainder in the feces. Medex+1Planewebfront+1

Dosage and Administration

Neusangel 20 mg should be taken at least one hour before meals. The dosage and duration depend on the specific condition being treated:Medex

• GERD without erosive esophagitis: 20 mg once daily for 4 weeks; an additional 4 weeks may be considered if symptoms do not resolve.Planewebfront

• GERD with erosive esophagitis: 20–40 mg once daily for 4–8 weeks.Medex+2Planewebfront+2Pharmacist BD+2

• Maintenance of healing of erosive esophagitis: 20 mg once daily.

• Risk reduction of NSAID-associated gastric ulcer: 20–40 mg once daily for up to 6 months.Planewebfront

• H. pylori eradication (triple therapy): Esomeprazole 40 mg once daily, combined with amoxicillin 1000 mg twice daily and clarithromycin 500 mg twice daily for 7–10 days.Medex

• Zollinger-Ellison syndrome: Initial dose of 80 mg per day, adjusted as needed; doses up to 240 mg per day have been used.

Side Effects

Common side effects include:

• Headache

• Nausea

• Abdominal pain

• Constipation or diarrhea

• Flatulence

• Dry mouth

These side effects are usually mild and temporary. 

Precautions

• Pregnancy and Lactation: Use with caution during pregnancy. It is not known if esomeprazole passes into breast milk; consult a doctor before use.Pharmacist BD+1WebMD+1

• Liver Impairment: Use with caution in patients with severe liver impairment.

• Long-term Use: May lead to mineral deficiencies; monitoring is advised. 

Storage

Store in a cool, dry place below 25°C, away from light. Keep out of reach of children.