Product Information:

CORE 24 (Getz) is a fixed-dose combination tablet containing Esomeprazole 40mg and Domperidone 30mg, designed for the management of gastroesophageal reflux disease (GERD), especially in patients with inadequate response to proton pump inhibitor (PPI) monotherapy. Esomeprazole, a proton pump inhibitor, reduces gastric acid production, while Domperidone, a dopamine antagonist, enhances gastric motility and accelerates gastric emptying—thereby reducing reflux episodes and improving symptom control.

Uses of (CORE 24):

1. Treatment of gastroesophageal reflux disease (GERD) with persistent symptoms
2. Management of heartburn, regurgitation, and epigastric pain
3. Functional dyspepsia with delayed gastric emptying
4. Adjunctive therapy in patients with non-erosive reflux disease (NERD)

Key Benefits of (CORE 24):

1. Dual-action therapy targets both acid secretion and gastric motility
2. Superior symptom relief compared to PPI alone in refractory GERD
3. Once-daily dosing improves patient compliance
4. Reduces postprandial reflux and bloating
5. Domperidone minimizes nausea and early satiety

How To Use (CORE 24):

Take one tablet once daily, preferably 30 minutes before breakfast. Swallow whole with water—do not crush or chew. Use for the shortest duration necessary (typically 4–8 weeks). Do not use continuously for more than 14 days without medical supervision.

When Not to Use (CORE 24):

Do not use if you have:

1. Hypersensitivity to esomeprazole, domperidone, or any excipients
2. Prolactin-secreting pituitary tumor (prolactinoma)
3. Known QT prolongation, significant cardiac arrhythmias, or electrolyte imbalances
4. Concomitant use of strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin)
5. Moderate to severe hepatic impairment
6. History of gastrointestinal hemorrhage, obstruction, or perforation

Side Effects of (CORE 24):

Common: Headache, dry mouth, diarrhea, abdominal pain, dizziness.

Serious (rare): QT prolongation, ventricular arrhythmias (especially with high doses or in elderly), hyperprolactinemia (galactorrhea, gynecomastia), extrapyramidal symptoms (in children—though not approved for pediatric use). Discontinue and seek medical help if palpitations, fainting, or abnormal breast changes occur.

Dosage: (CORE 24):

1. Standard adult dose: One tablet (Esomeprazole 40mg + Domperidone 30mg) once daily before breakfast
2. Maximum duration: 4–8 weeks; not for long-term maintenance without review
3. Not recommended for patients over 60 years unless benefits outweigh cardiac risks

Who It’s For (CORE 24):

Adults aged 18–60 years with moderate to severe GERD unresponsive to standard PPI therapy. Not for children, pregnant women, or elderly patients with cardiac risk factors.

Warnings & Precautions:

Domperidone carries regulatory restrictions due to cardiac risks (QT prolongation, arrhythmias). Avoid in patients >60 years, those on other QT-prolonging drugs, or with underlying heart conditions. Limit dose and duration. Esomeprazole may mask gastric malignancy—rule out cancer in persistent dyspepsia. Long-term PPI use may increase risk of fractures, hypomagnesemia, and C. difficile infection.

Drug Interactions:

1. CYP3A4 inhibitors (e.g., ketoconazole, erythromycin): ↑ Domperidone levels → ↑ cardiac risk
2. Antacids: May reduce esomeprazole absorption—administer 2 hours apart
3. Clopidogrel: Esomeprazole may reduce antiplatelet effect (use pantoprazole if needed)
4. Always disclose all medications to your physician.

Additional Information:

Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children. Do not use after the expiration date on the blister pack. Available by prescription only in Pakistan.