Zoom Cap 20 Mg 2×10’s(Esomeprazole)-Potential Overview

• Brand Name: Zoom Cap
• Generic Name: Esomeprazole
• Strength: 20 mg per capsule
• Pack Size: 2×10 capsules (20 capsules total per pack)​

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Zoom Cap 20 mg is a formulation of Esomeprazole, a proton pump inhibitor (PPI), used to reduce gastric acid secretion. It’s primarily prescribed for managing acid-related gastrointestinal conditions like gastroesophageal reflux disease (GERD), peptic ulcers, and Zollinger-Ellison syndrome. Esomeprazole works by irreversibly inhibiting the proton pump (H+/K+-ATPase enzyme) in the stomach lining, leading to decreased acid production.

Key Uses:

1. Gastroesophageal Reflux Disease (GERD):
   • Heals erosive esophagitis and prevents recurrence of symptoms like heartburn.
2. Peptic Ulcers:
   • Treats ulcers caused by H. pylori infection (when used in combination with antibiotics) or NSAID use.
3. Zollinger-Ellison Syndrome:
   • Manages conditions causing excessive stomach acid secretion.
4. H. pylori Eradication (in combination with other antibiotics):
   • Used as part of triple therapy to eradicate H. pylori and prevent duodenal ulcer recurrence.

Mechanism of Action:

• Esomeprazole inhibits the proton pump in parietal cells, reducing the production of gastric acid. This leads to symptomatic relief, promotion of ulcer healing, and long-term control of acid-related conditions.

Administration:

• Dosage: Typically taken once daily, ideally 1 hour before meals.
• The capsule should be swallowed whole, but it can be opened and mixed with applesauce for patients who cannot swallow it.

Drug Interactions:

• Increased Effects: Can interact with warfarin, diazepam, and phenytoin, potentially increasing their effects.
• Decreased Absorption: Esomeprazole may reduce the absorption of drugs requiring acidic pH for absorption, such as ketoconazole, itraconazole, and iron salts.

Side Effects:

Common side effects include headache, nausea, diarrhea, flatulence, and abdominal pain. Long-term use can increase risks such as bone fractures, vitamin B12 deficiency, and kidney problems. Caution is recommended in patients with a history of liver disease or elderly individuals.

Pharmacist Related Data

Chemical Information

• Chemical Name:
  5-Methoxy-2-[[(4-methoxy-3,5-dimethyl-2-pyridinyl)methyl]sulfinyl]-1H-benzimidazole magnesium trihydrate.
• Molecular Formula:
  C34H36MgN6O6S2C_{34}H_{36}MgN_{6}O_{6}S_{2}C34​H36​MgN6​O6​S2​
• Molecular Weight:
  713.12 g/mol.

Pharmacodynamics

• Mechanism of Action:
  Esomeprazole is a proton pump inhibitor (PPI). It works by irreversibly binding to the H+/K+ ATPase enzyme (proton pump) in the parietal cells of the stomach lining. This prevents the final step in gastric acid production, leading to a reduction in gastric acid secretion.
• Clinical Effect:
  The reduction in gastric acid helps in the healing of gastric ulcers, promotes symptom relief in GERD, and prevents acid reflux. Esomeprazole has a lasting effect on acid production, with significant acid suppression lasting up to 24 hours after a single dose.

Pharmacokinetics

1. Absorption:
   • Esomeprazole is absorbed quickly after oral administration. It has a bioavailability of 64% after a single dose and increases to about 90% with repeated dosing.
   • The drug is acid-labile, which is why it is formulated as delayed-release capsules to protect it from stomach acid. Peak plasma concentrations occur 1-2 hours after oral administration.
2. Distribution:
   • Esomeprazole is highly protein-bound (~97%) in the plasma, with a volume of distribution (Vd) of approximately 16 L.
   • It is well-distributed throughout the body, including the gastrointestinal tract, where it exerts its therapeutic effects.
3. Metabolism:
   • Esomeprazole is metabolized in the liver by the cytochrome P450 system, primarily through CYP2C19 and CYP3A4 enzymes. These metabolic pathways generate inactive metabolites, which are excreted in the urine and feces.
4. Half-Life:
   • The elimination half-life of esomeprazole is approximately 1 to 1.5 hours, though its therapeutic effects on gastric acid secretion last much longer due to its irreversible binding to the proton pump.
5. Excretion:
   • The drug is primarily eliminated through the urine, with approximately 80% of the dose excreted as inactive metabolites and the remaining 20% in the feces.

Drug Interactions

1. Drug Interactions with Other Medications:
   • Clopidogrel: Esomeprazole may reduce the effectiveness of clopidogrel (an antiplatelet), as both drugs are metabolized by CYP2C19. This interaction is especially important for patients requiring dual antiplatelet therapy.
   • Warfarin: Esomeprazole may increase the plasma concentration of warfarin, leading to a higher risk of bleeding.
   • Diazepam and Phenytoin: Esomeprazole can increase the plasma concentration of these drugs, which may increase their sedative effects and toxicity.
   • Methotrexate: High doses of methotrexate combined with esomeprazole can lead to increased methotrexate levels and potential toxicity.
2. Drug Interactions with Food:
   • Food can delay absorption but does not significantly affect the overall bioavailability of esomeprazole. It is recommended to take esomeprazole 1 hour before meals to optimize absorption.
   • Esomeprazole can alter the pH of the stomach, which may affect the absorption of other drugs that require an acidic environment, such as ketoconazole and iron salts.