doctor: Emanera

Description overdue on 10/28/2014

Latin name: Emanera
ATC code: A02BC05
Active substance: Esomeprazole (Esomeprazol)
Manufacturer: Krka, Slovenia

Photos of the drug

Composition
Product form
Pharmacological action
Pharmacodynamics and pharmacokinetics
Indications
Contraindications
Side effects
Instructions for use Emanery (method and dosage)
Overdose
Cooperation
Terms of sale
Storage conditions
Shelf life
Cautions
Analogs
Reviews
Price, where to buy

Emanera

Composition

Produced in two dosages: with 20, 645 mg esomeprazole magnesium 41 or 29 mg esomeprazole magnesium (which is equivalent to that of esomeprazole 20 mg or 40 mg).

Also it means comprises auxiliary elements: starch syrup, sucrose, povidone, sodium lauryl sulfate, polysorbate 80, titanium dioxide, polyvinyl alcohol, talc, macrogol 3000, macrogol 6000, hydroxycarbonate, sodium methacrylic to-you-ethyl acrylate copolymer, talc, E172, gelatine.

Product form

The drug in a dosage of 40 mg produced a pale pink capsules, white pellets inside.

Preparation of 20 mg - pink capsule, with the contents of the same kind.

Packages of 7, 14 or 28 pieces each.

Pharmacological action

Antiulcer .

Pharmacodynamics and pharmacokinetics

The active substance - specific an inhibitor of the parietal cell proton alluvium GI . There are two isomers of omeprazole - S-isomer esomeprazole And R-isomer . Their pharmacodynamic activity similar, but for the treatment and prevention of gastric ulcers typically use esomeprazole .

H + K + -ATRazu This basal and stimulated acid secretion is also inhibited.

Within an hour of getting the drug into the growing effect of suppressing the production of acid GI . If taken by means of one 20 mg once a day for 5 days, there will be a substantial (almost 91%) reduction in the concentration of hydrochloric acid in the stomach.

The efficacy depends on its concentration in the blood plasma.

Patients reflux esophagitis In drug treatment within a month at a dose of 40 mg, healing is 78% if the rate is 2 months, the probability to recover - 93%.

Stomach Ulcer in 60-80% of cases is caused by bacteria Helicobacter pylori, if you take esomeprazole 40 mg per day for one week, combining with antibiotics , 90% of patients recovery occurs.

During treatment is a significant reduction of the hydrochloric acid in the stomach in connection with this level gastrin increases in serum, and may increase the number of enterochromaffin cells .

Also increases the risk of glandular cysts in the stomach. These cysts are almost always benign and do not require surgical intervention.

The slightly increased risk of infectious diseases, for example, salmonellosis .

Esomeprazole It can be used for healing ulcers that result from nonsteroidal anti-inflammatory drugs, selective COX-2 inhibitors .

The drug is commonly prescribed for the prevention of stomach ulcers while taking specific medicines.

esomeprazole decomposes concerning the active substance is in Pellet and enteric capsule. A small amount of the substance passes into R-isomer .

After entering the GI the drug is well absorbed, the maximum concentration in plasma is reached after an hour or two.

Bioavailability - 64%, at regular admission - 89%. For dosage at lower bioavailability (when taking 20 ml, it is 50 and 68% respectively).

The tool is well bound to plasma proteins for 97%.

The effectiveness of the drug does not significantly affect the food eaten along with the tablet.

Metabolism in the liver using enzyme .

The metabolism involved isozymes CYP2C19 and CYP3A4 . After a single dose plasma clearance

The half-life - about 1, 5 hours. If the tool used for a long time, the period of excretion prolonged.

Esomeprazole

Conclusion metabolites is performed by the kidneys or via the gut. Do not changed the substance found in the urine in small quantities (1%).

Individuals with reduced activity of isoenzyme CYP2C19 drug metabolism is due CYP3A4 . The amount of plasma concentrations significantly (almost 60%) increased.

Women value AUC 30% more than men when a single dose. If treatment is prolonged, significant differences in performance depending on the sex of the patient is observed.

In patients with liver and kidney metabolism may be disturbed. When serious violations of the liver, the maximum daily dose is 20 mg.

Pharmacokinetic figures for people aged 12 years and over was not significantly changed.

Indications

at GERD ;
gastric and duodenal ulcers;
for the prevention of diseases ZHTK Induced by administration NSAIDs ;
at erosive esophagitis reflyus ;
in diseases caused by bacteria Helicobacter pylori ;
for the prevention of peptic yavz , In patients receiving NSAIDs
treatment idiopathic hypersecretion ;
at Zollinger-Ellison syndrome .

Contraindications

The tool does not prescribe:

at allergies on the components of the drug;
when receiving nelfinavir or atazanavir ;
fructose intolerance;
Children up to 12 years;
at galactose malabsorption glucose- or deficit sucrase-isomaltase .

Side effects

There may be:

headache and dizziness . insomnia . drowsiness . depression . hallucinations
constipation or diarrhea . flatulence , Vomiting, dryness of the mouth, abdominal pain, vomiting, hepatitis . , Aggravation or occurrence of liver disease;
jade . gynecomastia . bronchospasm ;
thrombocytopenia . agranulocytosis . leukopenia . pancytopenia ;
myalgia arthralgia ;
change in taste perception, temporary decrease in vision;
hives , Skin rash, alopecia . dermatitis Sensitivity to light, Stevens-Johnson syndrome ;
reaction hypersensitivity ( angioedema . anaphylactic shock );
weakness, edema, sweating.

Instructions for use Emanery (method and dosage)

The tablets are taken orally without sharing and without chewing, drinking plenty of fluids.

If patients have difficulty swallowing, the contents of the capsules can be dissolved in non-carbonated water. Drink resulting solution should be not later than 30 minutes after cooking. Pellets should not fully rasvoryatsya in water or remain on the walls of glass.

Perhaps the introduction of the drug through the Levin tube .

Dosage and duration of treatment should be determined by the attending physician.

According to the instructions on Emaneru, the dosage is as follows:

treatment GERD 40 mg administered funds, 1 per day for a month (the course can be extended to 2 months);
for prophylaxis GERD appoint 20 mg 1 time a day;
at stomach ulcer esomeprazole (+1 Grams Amoxicillin and 500 mg clarithromycin ), 2 times a day for one to two weeks;
for the treatment of gastric ulcers caused by taking NSAIDs Appoint 20-40 mg a day, a month or two;
for prophylaxis stomach ulcers - 20-40 mg 1 time a day;
if you want to produce prevention of bleeding peptic ulcers after intravenous administration of drugs that lower the level of hydrochloric acid, taking 40 mg means 1 times a day, for a month;
at Zollinger-Ellison syndrome . idiopathic hypersecretion At the beginning administered 40 mg 2 times per day.

In violation of the liver dose adjustment is required.

Rules of administration through Levin tube :

Pour the contents of the capsule to the probe primerno25-50 ml of water and 5-10 ml of air.
Shake the syringe until the suspension is formed.
Make sure the tip is not blocked pellets .
Attach the syringe to the probe tip, wherein the tip holding it up.
Quickly shake the syringe, turn down, enter part of the suspension.
Again, turn the syringe tip up, and repeat the previous step.
Enter the contents of the syringe into the tube until the suspension ends.

Overdose

No cases of overdose have been reported.

If you take 280 mg, there will be weakness, malfunctions gastrointestinal tract .

No specific antidote.

Hemodialysis ineffective.

If overdose does happen, it should produce symptomatic therapy.

Cooperation

Emanera can affect the processes of absorption of certain drugs, e.g., the absorption of which depends on the pH of the stomach.

Antacids . ketoconazole . itraconazole , Agents that reduce the secretion of gastric glands, are worse assimilated.

facilities ( atazanavir . rinotavir ) Reduce their effectiveness when combined with the drug.

If involved in drug metabolism isoenzyme CYP2C19 It should not be combined with Emaneroy. Therefore, while taking omeprazole and diazepam . imiprimina . phenytoin . citalopram . clomipramine . vorikonozola Be particularly careful.

amoxicillin and quinidine .

When combined with funds coumarin or warfarin Caution should be exercised and monitoring indicators INR.

If you combine the drug with clarithromycin Value AUC esomeprazole doubled.

Inhibitors isoenzyme CYP2C19 and CYP3A4 can significantly affect the pharmacokinetic parameters of the drug.

Terms of sale

It requires a prescription.

Storage conditions

Store in a cool place, in original packaging, away from children.

Shelf life

2 years.

Cautions

If you have symptoms of malignant tumors, such as severe weight loss, dysphagia, vomiting of blood, it is necessary to eliminate the risk of cancer, to produce additional studies.

Chronic administration of the drug required to control the treating physician.

It should be remembered that the medicine contains sucrose.

This tool does not affect on the reaction rate and concentration.

Match code ATC 4th level: