Product Information:

NEXUM 40mg Capsules contain Esomeprazole 40mg, a proton pump inhibitor (PPI) that provides potent and long-lasting suppression of gastric acid secretion by irreversibly inhibiting the H⁺/K⁺ ATPase enzyme (proton pump) in gastric parietal cells. Esomeprazole is the S-isomer of omeprazole, offering superior bioavailability and more consistent acid control compared to other PPIs.

This higher-strength formulation is used for moderate to severe acid-related disorders, erosive disease, or as part of H. pylori eradication therapy.

Uses of (NEXUM 40MG CAPSULES):

1. Treatment of moderate to severe gastroesophageal reflux disease (GERD) with erosive esophagitis
2. Healing and maintenance of erosive esophagitis
3. Management of refractory gastric or duodenal ulcers
4. Helicobacter pylori eradication (as part of triple or quadruple therapy)
5. Prevention of NSAID-induced ulcers in high-risk patients
6. Adjunct in Zollinger-Ellison syndrome (gastrinoma)

Key Benefits of (NEXUM 40MG CAPSULES):

1. Stronger and more sustained acid suppression than 20mg dose
2. Faster healing of esophageal erosions and ulcers
3. Once-daily dosing for improved adherence
4. Effective in conditions unresponsive to lower PPI doses

How To Use (NEXUM 40MG CAPSULES):

1. Take once daily, preferably 30–60 minutes before breakfast (or first meal of the day).
2. Swallow whole with water—do not crush, chew, or open the capsule (enteric-coated granules may be damaged).
3. For H. pylori eradication: Take 40mg twice daily (morning and evening) with antibiotics for 10–14 days.
4. Duration: Typically 4–8 weeks for erosive GERD; longer only under medical supervision.

When Not to Use (NEXUM 40MG CAPSULES):

Do not use if you have:

1. Hypersensitivity to esomeprazole or other benzimidazole PPIs (e.g., omeprazole, pantoprazole)
2. Concurrent use of atazanavir or nelfinavir (PPIs significantly reduce their absorption)
3. Severe hepatic impairment (use with caution; consider lower dose)

Side Effects of (NEXUM 40MG CAPSULES):

Common: Headache, diarrhea, abdominal pain, nausea, flatulence, constipation.

Rare: Dizziness, rash, dry mouth, vitamin B12 or magnesium deficiency (with prolonged use).

Serious (rare, usually with long-term use >1 year):

1. Clostridioides difficile-associated diarrhea
2. Increased risk of osteoporosis-related fractures (hip, wrist, spine)
3. Hypomagnesemia (muscle spasms, seizures, arrhythmias)
4. Acute interstitial nephritis (fever, rash, reduced urine output)
5. Discontinue and seek medical help if severe diarrhea, bone pain, or irregular heartbeat occurs.

Dosage: (NEXUM 40MG CAPSULES):

1. Erosive Esophagitis / Severe GERD: 40mg once daily for 4–8 weeks
2. H. pylori Eradication: 40mg twice daily + two antibiotics for 10–14 days
3. NSAID Ulcer Prophylaxis (high-risk): 40mg once daily
4. Zollinger-Ellison Syndrome: 40mg twice daily (dose individualized)
5. Elderly or mild hepatic impairment: No routine adjustment needed

Who It’s For (NEXUM 40MG CAPSULES):

Adults with severe GERD, erosive esophagitis, refractory ulcers, or those requiring high-dose PPI therapy as part of combination treatment. Not for mild heartburn or short-term self-medication.

Warnings & Precautions:

1. Use the lowest effective dose for the shortest duration necessary
2. Long-term use (>1 year) requires monitoring of serum magnesium, vitamin B12, and bone mineral density
3. May mask symptoms of gastric malignancy—investigate persistent dyspepsia
4. Avoid in patients on atazanavir or nelfinavir (HIV medications)

Drug Interactions:

1. Atazanavir, nelfinavir: ↓ Absorption—contraindicated
2. Clopidogrel: Esomeprazole has minimal interaction (preferred over omeprazole)
3. Methotrexate: PPIs may ↑ toxicity—monitor levels
4. Iron, ketoconazole, digoxin: Altered absorption due to increased gastric pH
5. Always inform your doctor about all medications.

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. Available by prescription in Pakistan.