Maxima 40 mg contains Esomeprazole, a proton pump inhibitor (PPI) that effectively reduces gastric acid secretion. It is widely used in the management of acid-related gastrointestinal disorders. By suppressing acid production at its source, Maxima 40 mg provides sustained symptom relief and promotes healing of acid-induced mucosal damage.

Esomeprazole is the S-isomer of omeprazole and offers improved acid control compared to racemic proton pump inhibitors. It acts by specifically inhibiting the H+/K+-ATPase enzyme system (proton pump) in the gastric parietal cells, thereby blocking the final step of acid production.

Maxima 40 mg is available in oral and intravenous formulations, ensuring flexibility in both outpatient and hospital settings.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Therapeutic Class

• Proton Pump Inhibitor (PPI)

• Anti-ulcerant

Indications

Maxima 40 mg is indicated for:

• Gastroesophageal Reflux Disease (GERD), including persistent heartburn

• Healing of erosive esophagitis

• Maintenance of healed erosive esophagitis

• Eradication of Helicobacter pylori infection in combination with amoxicillin and clarithromycin for duodenal ulcer disease

• Zollinger-Ellison Syndrome

• Acid-related dyspepsia

• Duodenal ulcer

• Gastric ulcer

Dosage & Administration

Dosage depends on the indication and patient condition:

Healing of Erosive Esophagitis: 20–40 mg once daily for 4–8 weeks.
Maintenance Therapy: 20 mg once daily (clinical data up to 6 months).
Symptomatic GERD: 20 mg once daily for 4 weeks; may extend for another 4 weeks if required.
H. pylori Eradication (Triple Therapy):

• Esomeprazole 40 mg once daily

• Amoxicillin 1000 mg twice daily

• Clarithromycin 500 mg twice daily
  For 10 days.

Zollinger-Ellison Syndrome: 20–80 mg once daily, individualized.
Duodenal Ulcer: 20 mg once daily for 2–4 weeks.
Gastric Ulcer: 20–40 mg once daily for 4–8 weeks.

Injection: 40 mg once daily by slow IV injection (minimum 3 minutes) or IV infusion (10–30 minutes).

Tablets should be taken at least one hour before meals and swallowed whole without crushing or chewing.

Pharmacology

Esomeprazole is rapidly absorbed after oral administration, reaching peak plasma levels in approximately 1.5 hours. It is 97% protein-bound and extensively metabolized in the liver via CYP2C19 and CYP3A4 enzymes. The plasma half-life is approximately 1–1.5 hours.

About 80% of an oral dose is excreted in urine as inactive metabolites, and the remainder in feces.

Drug Interactions

Esomeprazole may:

• Reduce absorption of drugs affected by gastric pH (e.g., ketoconazole, iron salts, digoxin)

• Reduce diazepam clearance

• Increase plasma levels when co-administered with clarithromycin

• Show no clinically significant interaction with phenytoin, warfarin, quinidine, amoxicillin, or oral contraceptives

  রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Contraindications

• Known hypersensitivity to esomeprazole or any component of the formulation

Side Effects

Common adverse effects include:

• Headache

• Diarrhea

• Nausea

• Abdominal pain

• Flatulence

• Constipation

• Dry mouth

Long-term safety profile is similar to short-term therapy.

Precautions & Warnings

• Symptomatic improvement does not exclude gastric malignancy.

• Use caution in severe hepatic impairment (do not exceed 20 mg daily).

• Antacids may be used concomitantly.

• Not recommended in pediatric patients due to insufficient data.

Pregnancy & Lactation

Adequate human studies are lacking. Use during pregnancy only if clearly needed. As excretion in breast milk is unknown, breastfeeding should be discontinued if treatment is essential.

Storage Conditions

Store below 30°C in a dry place. Protect from moisture and light. Keep out of reach of children.