NexCap Capsule Delayed 20mg
10 capsulesProduct Information
NEXCAP
NexCap®(Esomeprazole)
Presentation
NexCap-20 capsule: Opaque purple cap with two golden ring and opaque purple body imprinted with ‘NexCap 20 mg’ capsule; each
delayed-release capsule contains Esomeprazole 20 mg present as Esomeprazole Magnesium Trihydrate INN in the form of enteric-coated
pellets.
NexCap-40 capsule: Opaque purple cap with three golden ring and opaque purple body imprinted with ‘NexCap 40 mg’ capsule; each
delayed-release capsule contains Esomeprazole 40 mg present as Esomeprazole Magnesium Trihydrate INN in the form of enteric-coated
pellets.
Indications
Gastroesophageal reflux disease (GERD)
-Healing of erosive esophagitis
-Maintenance of healing of erosive esophagitis
-Symptomatic gastroesophageal reflux disease
Risk reduction of NSAID-associated gastric ulcer
H. pylori eradication to reduce the risk of duodenal ulcer recurrence
Peptic ulcer
Dosage and administration
Gastroesophageal reflux disease (GERD)
Healing of erosive esophagitis: Esomeprazole 20 mg (one NexCap-20 capsule) or Esomeprazole 40 mg (one NexCap-40 capsule) once
daily for 4 to 8 weeks. (The majority of patients are healed within 4 to 8 weeks. For patients who do not heal after 4-8 weeks, an
additional 4-8 weeks of treatment may be considered).
Maintenance of healing of erosive esophagitis: Esomeprazole 20 mg (one NexCap- 20 capsule) once daily is recommended. (Controlled
studies did not extend beyond six months).
Symptomatic gastroesophageal reflux disease: Esomeprazole 20 mg (one NexCap- 20 capsule) once daily for 4 weeks. (If symptoms do
not resolve completely after 4 weeks, an additional 4 weeks of treatment may be considered).
Risk reduction of NSAID-associated gastric ulcer: Esomeprazole 20 mg (one NexCap-20 capsule) or Esomeprazole 40 mg (one NexCap-40
capsule) once daily for up to 6 months. (Controlled studies did not extend beyond six months).
H. pylori. eradication to reduce the risk of duodenal ulcer recurrence: Triple therapy: Esomeprazole 20 mg (one NexCap-20 capsule)
twice daily, Clarithromycin 500 mg twice daily and Amoxicillin 1 g or Metronidazole 400 mg twice daily for 7 days.
Peptic ulcer: Esomeprazole 20 mg (one NexCap-20 capsule) twice daily or Esomeprazole 40 mg (one NexCap-40 capsule) once daily for
8 weeks.
Contra-indications, warnings, etc.
Contra-indication: Esomeprazole is contra-indicated in patients with known hypersensitivity to esomeprazole.
Precautions: Symptomatic response to therapy with esomeprazole does not preclude the presence of gastric malignancy. Atrophic
gastritis has been noted occasionally in gastric corpus biopsies from patients treated long-term with omeprazole, of which
esomeprazole is an enantiomer. Esomeprazole should be taken at least one hour before meals. The capsules should not be chewed or
crushed
.
Use in pregnancy and lactation: Esomeprazole should be used during pregnancy only if clearly needed. The excretion of esomeprazole
in milk has not been studied. However, omeprazole concentrations have been measured in breast milk of a woman following oral
administration of 20 mg. Because esomeprazole is likely to be excreted in human milk, because of the potential for serious adverse
reactions in nursing infants from esomeprazole, and because of the potential for tumorigenicity shown for omeprazole in rat
carcinogenicity studies, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account
the importance of
the drug to the mother.
Use in pediatric patients: Safety and effectiveness in pediatric patients have not been established. Use in geriatric patients: No
overall differences in safety and efficacy were observed between the elderly and younger individuals, and other reported clinical
experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some
older individuals cannot be ruled out. Use in patients with renal insufficiency- No dose adjustment is necessary.
Use in patients with hepatic insufficiency: No dose adjustment is necessary in patients with mild to moderate liver impairment.
For patients with severe Iiver impairment a dose of 20 mg of esomeprazole should not be exceeded.
Drug interactions: Esomeprazole inhibits gastric acid secretion. Therefore, esomeprazole may interfere with the absorption of
drugs where gastric pH is an important determinant of bioavailability (e.g., ketoconazole, iron salts and digoxin).
Co-administration of oral contraceptives, diazepam, phenytoin, or quinidine did not seem to change the pharmacokinetic profile of
esomeprazole. Co-administration of esomeprazole, clarithromycin, and amoxicillin has resulted in increase in the plasma level of
esomeprazole and 14-hydroxyclarithromycin.
Adverse reactions: The most frequently occurring adverse events are headache and diarrhea. Nausea, flatulence, abdominal pain,
constipation, and dry mouth occurred at similar rates among patients taking esomeprazole or omeprazole.
Overdosage: There have been no reports of overdose with esomeprazole. No specific antidote for esomeprazole is known. Since
esomeprazole is extensively protein bound, it is not expected to be removed by dialysis. In the event of overdosage, treatment
should be symptomatic and supportive. As with the management of any overdose, the possibility of multiple drug ingestion should be
considered.
Pharmaceutical precautions
Store in a cool and dry place, protected from light.
Packaging quantities
NexCap-20 capsule: Cartons of 56 capsules in alu-alu blister.
NexCap-40 capsule: Cartons of 28 capsules in alu-alu blister.