سعر نيكسيوم 40مجم 14 قرص 2023

Nexium 40 mg gastro-resistant tablets (AstraZeneca): oral esomeprazole proton pump inhibitor; pack of 14 tablets.

• Adults: GERD - treatment of erosive reflux oesophagitis.electronic Medicines Compendium (eMC) / MHRA
• Adults: prolonged treatment after intravenously induced prevention of rebleeding of peptic ulcers.electronic Medicines Compendium (eMC) / MHRA
• Adults: treatment of Zollinger-Ellison syndrome.electronic Medicines Compendium (eMC) / MHRA

• Most commonly reported: headache, abdominal pain, diarrhoea and nausea. Common: headache, abdominal pain, constipation, diarrhoea, flatulence, nausea/vomiting, fundic gland polyps (benign). Uncommon: peripheral oedema, insomnia, dizziness, paraesthesia, somnolence, vertigo, dry mouth, increased liver enzymes, dermatitis, pruritus, rash, urticaria, fracture of hip/wrist/spine.International label, same formulation · electronic Medicines Compendium (eMC) / MHRA
• Rare/very rare/not known: leukopenia, thrombocytopenia, agranulocytosis, pancytopenia, hypersensitivity reactions (angioedema, anaphylaxis), hyponatraemia, hypomagnesaemia, hepatitis, hepatic failure, SJS/TEN/DRESS, interstitial nephritis, microscopic colitis, subacute cutaneous lupus erythematosus, gynaecomastia.International label, same formulation · electronic Medicines Compendium (eMC) / MHRA
• US label most common adverse reactions - adults (>1%): headache, diarrhea, nausea, flatulence, abdominal pain, constipation, dry mouth; pediatrics 1-17 years (>2%): headache, diarrhea, abdominal pain, nausea, somnolence.International label, equivalent formulation · DailyMed (NLM)

• Hypersensitivity to esomeprazole, to substituted benzimidazoles or to any of the excipients.International label, same formulation · electronic Medicines Compendium (eMC) / MHRA
• Must not be used concomitantly with nelfinavir.International label, same formulation · electronic Medicines Compendium (eMC) / MHRA
• US label: known hypersensitivity to substituted benzimidazoles or any component (reactions may include anaphylaxis, angioedema, bronchospasm, acute tubulointerstitial nephritis, urticaria); patients receiving rilpivirine-containing products.International label, equivalent formulation · DailyMed (NLM)

• With alarm symptoms (significant unintentional weight loss, recurrent vomiting, dysphagia, haematemesis or melaena) or suspected/present gastric ulcer, exclude malignancy first, as treatment may alleviate symptoms and delay diagnosis. Patients on long-term treatment (especially over a year) should be kept under regular surveillance.International label, same formulation · electronic Medicines Compendium (eMC) / MHRA
• Severe hypomagnesaemia has been reported with PPIs used for at least three months (mostly for a year); consider measuring magnesium before and periodically during prolonged treatment or with digoxin or drugs that may cause hypomagnesaemia. Long-term acid suppression may reduce vitamin B12 absorption.International label, same formulation · electronic Medicines Compendium (eMC) / MHRA
• PPIs, especially at high doses and over long durations (>1 year), may modestly increase the risk of hip, wrist and spine fracture, mainly in the elderly or with other risk factors; they may also slightly increase the risk of gastrointestinal infections such as Salmonella and Campylobacter.International label, same formulation · electronic Medicines Compendium (eMC) / MHRA

• Atazanavir; nelfinavirReduced atazanavir and nelfinavir levels with omeprazole/esomeprazole: atazanavir not recommended, nelfinavir contraindicated.electronic Medicines Compendium (eMC) / MHRA
• Methotrexate (high dose)Methotrexate levels may increase with PPIs; consider temporary withdrawal of esomeprazole with high-dose methotrexate.electronic Medicines Compendium (eMC) / MHRA
• TacrolimusEsomeprazole may increase tacrolimus levels; reinforce tacrolimus level and renal function monitoring and adjust dose.electronic Medicines Compendium (eMC) / MHRA

• Caution when prescribing in pregnancy. A moderate amount of data on pregnant women (300-1000 outcomes) indicates no malformative or foeto/neonatal toxicity of esomeprazole; epidemiological data with omeprazole indicate no malformative or foetotoxic effect, and animal studies show no harmful effects.International label, same formulation · electronic Medicines Compendium (eMC) / MHRA
• US label: no adequate and well-controlled studies with esomeprazole in pregnant women; epidemiologic data fail to show an increased risk of major congenital malformations or other adverse outcomes with first-trimester omeprazole use; animal studies with esomeprazole showed no teratogenicity at high multiples of the human dose.International label, equivalent formulation · DailyMed (NLM)
• It is not known whether esomeprazole is excreted in human milk and data in infants are insufficient; esomeprazole should not be used during breast-feeding.International label, same formulation · electronic Medicines Compendium (eMC) / MHRA

• Esomeprazole: S-isomer of omeprazole; reduces gastric acid secretion as a specific inhibitor of the acid (proton) pump H+/K+-ATPase in the parietal cell.