Remmo 20 mg Tablet contains Esomeprazole, a proton pump inhibitor (PPI) used for the management of acid-related gastrointestinal disorders. It is highly effective in reducing gastric acid secretion, promoting healing of erosive esophagitis, alleviating gastroesophageal reflux disease (GERD) symptoms, and aiding in the eradication of Helicobacter pylori when used in combination therapy. Remmo 20 mg also plays a role in managing duodenal and gastric ulcers, acid-related dyspepsia, and Zollinger-Ellison syndrome, offering comprehensive acid control for adult patients.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Indications

Remmo 20 mg is indicated for:

• Gastroesophageal Reflux Disease (GERD): Relief of persistent heartburn and related symptoms.

• Erosive Esophagitis: Healing and maintenance of healed esophageal tissue.

• Helicobacter pylori Eradication: Used in combination with amoxicillin and clarithromycin in duodenal ulcer patients to reduce recurrence risk.

• Zollinger-Ellison Syndrome: Long-term acid suppression for hypersecretory conditions.

• Duodenal & Gastric Ulcers: Treatment of acid-induced ulcers and acid-related dyspepsia.

Therapeutic Class

Proton Pump Inhibitor (PPI)

Pharmacology & Mode of Action

Esomeprazole, the S-isomer of omeprazole, selectively inhibits the H+/K+-ATPase enzyme in gastric parietal cells, blocking the final step of acid secretion. By reducing gastric acidity, it promotes mucosal healing in esophagitis and ulcers and improves GERD symptoms. Esomeprazole has high bioavailability (~90% at steady state) and is extensively metabolized in the liver by CYP2C19 and CYP3A4, with metabolites lacking acid-suppressing activity.

Dosage and Administration

Oral Administration:

• Take one tablet 1 hour before a meal, swallow whole.

• Delayed-release suspension: Mix contents with 15 ml water, allow to thicken 2–3 minutes, then stir and consume within 30 minutes. Can be administered via nasogastric tube if necessary.

Standard Adult Doses:

• Healing of erosive esophagitis: 20–40 mg once daily for 4–8 weeks.

• Maintenance therapy: 20 mg once daily.

• Symptomatic GERD: 20 mg once daily for 4 weeks.

• 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 dosing.

• Duodenal/Gastric ulcers: 20–40 mg daily for 2–8 weeks depending on ulcer type.

Intravenous Administration:

• 40 mg once daily by slow IV injection (≥3 minutes) or infusion (10–30 minutes). Do not mix with other drugs in the same IV line.

Pediatric Use: Safety and efficacy not established.
Geriatric Use: No significant differences in safety or efficacy noted.
Hepatic Impairment: Dose adjustment to 20 mg daily for severe hepatic impairment.
Renal Impairment: No adjustment required; less than 1% excreted unchanged in urine.

Drug Interactions

• Metabolized by CYP2C19 and CYP3A4; generally low risk of significant interactions.

• May reduce absorption of pH-dependent drugs (e.g., ketoconazole, iron salts, digoxin).

• Interactions reported with diazepam (CYP2C19 substrate) and certain antibiotics (clarithromycin, amoxicillin).

• No significant interactions with phenytoin, warfarin, quinidine, or oral contraceptives.

  রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Contraindications

• Known hypersensitivity to esomeprazole or other PPI formulations.

Side Effects

Common adverse effects include:

• Headache

• Diarrhea

• Nausea

• Flatulence

• Abdominal pain

• Constipation

• Dry mouth

Long-term maintenance therapy up to 12 months has shown no new or different adverse effects.

Precautions and Warnings

• Symptom relief does not exclude serious conditions such as stomach cancer.

• Take at least 1 hour before meals.

• Capsules can be opened and mixed with cold applesauce if swallowing is difficult; do not chew pellets.

• Antacids may be taken concurrently.

• Monitor hepatic and renal function in severe impairment cases.

Overdose

Symptoms may include decreased motor activity, tremors, ataxia, changes in respiration, and convulsions. No specific antidote exists; provide symptomatic and supportive care. Dialysis is ineffective due to high protein binding.

Storage Conditions

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