Nexum Capsule 40mg

About Nexum Capsule 40mg

Nexum Tablet Uses

• Gastroesophageal reflux disease (GERD) presenting with recurring heartburn and acid regurgitation.
• Erosive esophagitis caused by long-term exposure of the esophagus lining to stomach acid.
• Duodenal and gastric ulcers linked to excess stomach acid production.
• Zollinger-Ellison syndrome, a rare condition in which tumors cause the stomach to produce excessive acid.
• Helicobacter pylori related ulcers, used alongside antibiotics as part of eradication therapy.

Nexum Tablet Benefits

• Delayed release design protects the medicine from stomach acid until it reaches the small intestine for absorption.
• Provides reliable acid suppression across a full day from a once daily dose in most cases.
• Delayed release coating protects the medicine until it reaches the small intestine, so it works reliably even without extra food buffering stomach acid.
• Effective for both short courses of ulcer healing and longer term reflux management.
• Widely used and extensively studied proton pump inhibitor.

What Experts Say

Nexum contains Esomeprazole, the S isomer of Omeprazole, which irreversibly blocks the hydrogen potassium ATPase enzyme responsible for the final step of acid production in the stomach lining. This action reduces gastric acid output more consistently than medicines that work earlier in the acid producing pathway.

Unlike Pantoprazole, Esomeprazole has a more meaningful effect on the liver enzyme CYP2C19, the same pathway that activates Clopidogrel. Combining Nexum with Clopidogrel can reduce Clopidogrel's antiplatelet effect, which is why patients on Clopidogrel who need a proton pump inhibitor are often prescribed a different one instead.

Because Esomeprazole breaks down quickly in stomach acid, Nexum is formulated as a delayed release tablet with a special coating that keeps it intact until it reaches the less acidic environment of the small intestine. This is also why the tablet should not be crushed or chewed, since doing so would destroy the coating before the medicine reaches its intended site of absorption.

Drug Class

• Proton Pump Inhibitor

Packaging and Quantity

• Pack of 14 tablets (2 strips of 7 tablets each).

When Not to Use Nexum

• If you have a known allergy or hypersensitivity to Esomeprazole or any other proton pump inhibitor.
• If you are taking Rilpivirine, an HIV medicine that requires stomach acid for proper absorption.
• If you have severe liver impairment, unless the dose has been adjusted by a doctor.
• If you have low magnesium levels that have not been corrected.

Nexum Capsule 40mg formula

• Esomeprazole

Available forms

• Capsules
• Infusion

How to use Nexum Capsule 40mg?

• Nexum tablet should be taken at least one hour before a meal.
• The tablet should be swallowed whole with a glass of water and should not be crushed or chewed.
• Nexum tablet is usually taken once daily, though some conditions call for twice daily dosing.
• Treatment courses commonly last four to eight weeks depending on the condition being treated.
• The dose should not be increased or the course extended beyond what a doctor has recommended.

Drug Interactions

Esomeprazole has a more active liver enzyme interaction profile than some other proton pump inhibitors. The following should be noted:

• Clopidogrel: Nexum tablet can reduce Clopidogrel's antiplatelet effect, unlike some other proton pump inhibitors with less impact on this interaction.
• Rilpivirine and Atazanavir: Reduced stomach acid lowers the absorption of these HIV medicines, which may reduce their effectiveness.
• Methotrexate: Nexum tablet may reduce the clearance of Methotrexate at higher doses, raising the risk of toxicity.
• Warfarin: Concurrent use can raise INR and prothrombin time, increasing the risk of abnormal bleeding.

Risks and warnings

• Long-term use: Continuous daily use for a year or longer has been linked to a higher risk of low vitamin B12, low magnesium, and bone fractures.
• Kidney disease: Nexum tablet should be used cautiously in patients with reduced kidney function.
• Liver disease: Esomeprazole is processed in the liver, so patients with significant impairment may need a lower dose.
• Gastrointestinal infection risk: Lower stomach acid may slightly raise the risk of infections such as Salmonella and C. difficile.
• Pregnancy: Nexum tablet should only be used during pregnancy when the expected benefit clearly outweighs the potential risk.
• Breastfeeding: Esomeprazole passes into breast milk in small amounts, so a doctor should be consulted before use while nursing.
• Elderly patients: Older adults face a higher risk of bone fractures and intestinal infections with long term use and should be monitored accordingly.

Nexum Tablet Side Effects

As a delayed release proton pump inhibitor, Nexum tablet's side effects mirror those of the wider PPI class, most commonly:

• Headache.
• Diarrhea.
• Nausea.
• Stomach pain.

Effects that call for prompt medical attention are less common but include:

• Signs of low magnesium such as muscle cramps, irregular heartbeat, or seizures.
• Severe, watery diarrhea that does not improve, which may indicate a bowel infection.
• Severe allergic reaction including swelling of the face or throat, or difficulty breathing.

Storage Conditions

• Store at room temperature, below 30°C.
• Keep away from direct sunlight, heat, and moisture.
• Store in the original packaging until ready to use.
• Keep out of reach and sight of children.
• Do not use after the expiry date printed on the packaging.
• Do not store in the bathroom or near a kitchen sink.