Nexmezol Uses

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What is Nexmezol?

Nexmezol strontium is used to treat conditions where there is too much acid in the stomach. It is used to treat duodenal and gastric ulcers, erosive esophagitis, gastroesophageal reflux disease (GERD), and the Zollinger-Ellison syndrome. Nexmezol is also used with antibiotics (eg, amoxicillin, clarithromycin) to treat ulcers that are caused by the H. pylori bacteria. Nexmezol strontium is also used to prevent stomach ulcers and stomach irritation in patients taking pain and arthritis drugs called NSAIDs, such as aspirin or ibuprofen, for long periods of time.

Nexmezol strontium is a proton pump inhibitor (PPI). It works by decreasing the amount of acid that is produced by the stomach.

Nexmezol strontium is available only with your doctor’s prescription.

Nexmezol indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Treatment of Gastroesophageal Reflux Disease (GERD)

Healing of Erosive Esophagitis

Nexmezol Magnesium Delayed-Release Capsules are indicated for the short-term treatment (4 to 8 weeks) in the healing and symptomatic resolution of diagnostically confirmed erosive esophagitis. For those patients who have not healed after 4 to 8 weeks of treatment, an additional 4 to 8 week course of Nexmezol Magnesium Delayed-Release Capsules may be considered.

Maintenance of Healing of Erosive Esophagitis

Nexmezol Magnesium Delayed-Release Capsules are indicated to maintain symptom resolution and healing of erosive esophagitis. Controlled studies do not extend beyond 6 months.

Symptomatic Gastroesophageal Reflux Disease

Nexmezol Magnesium Delayed-Release Capsules are indicated for short-term treatment (4 to 8 weeks) of heartburn and other symptoms associated with GERD in adults and children 1 year or older.

Risk Reduction of NSAID-Associated Gastric Ulcer

Nexmezol Magnesium Delayed-Release Capsules are indicated for the reduction in the occurrence of gastric ulcers associated with continuous NSAID therapy in patients at risk for developing gastric ulcers. Patients are considered to be at risk due to their age (≥ 60) and/or documented history of gastric ulcers. Controlled studies do not extend beyond 6 months.

H. pylori Eradication to Reduce the Risk of Duodenal Ulcer Recurrence

Triple Therapy (Nexmezol Magnesium Delayed-Release Capsules plus amoxicillin and clarithromycin): Nexmezol Magnesium Delayed-Release Capsules, in combination with amoxicillin and clarithromycin, is indicated for the treatment of patients with H. pylori infection and duodenal ulcer disease (active or history of within the past 5 years) to eradicate H. pylori. Eradication of H. pylori has been shown to reduce the risk of duodenal ulcer recurrence.

In patients who fail therapy, susceptibility testing should be done. If resistance to clarithromycin is demonstrated or susceptibility testing is not possible, alternative antimicrobial therapy should be instituted.

Pathological Hypersecretory Conditions Including Zollinger-Ellison Syndrome

Nexmezol Magnesium Delayed-Release Capsules are indicated for the long-term treatment of pathological hypersecretory conditions, including Zollinger-Ellison Syndrome.

How should I use Nexmezol?

Use Nexmezol suspension as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Nexmezol suspension.

Uses of Nexmezol in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Use: Labeled Indications

Oral:

Nexmezol magnesium and Nexmezol strontium:

Gastroesophageal reflux disease (Rx only):

Healing of erosive esophagitis: Short-term (4 to 8 weeks) treatment of erosive esophagitis

Maintenance of healing of erosive esophagitis: Maintaining symptom resolution and healing of erosive esophagitis

Symptomatic gastroesophageal reflux disease: Short-term (4 to 8 weeks) treatment of symptomatic gastroesophageal reflux disease (GERD)

Helicobacter pylori eradication (Rx only): As part of a multidrug regimen for Helicobacter pylori eradication in patients with duodenal ulcer disease (active or history of within the past 5 years)

Risk reduction of nonsteroidal anti-inflammatory drug-associated gastric ulcer (Rx only): Prevention of gastric ulcers associated with continuous NSAID therapy in patients at risk (age ≥60 years and/or history of gastric ulcer)

Pathological hypersecretory conditions, including Zollinger-Ellison syndrome (Rx only): Treatment (long-term) of pathological hypersecretory conditions including Zollinger-Ellison syndrome

Nexmezol magnesium:

Heartburn (OTC labeling): Treatment of frequent heartburn (≥2 days per week).

IV: Nexmezol sodium:

Gastroesophageal reflux disease (Rx only): Short-term (≤10 days) treatment of gastroesophageal reflux disease (GERD) with erosive esophagitis in pediatric patients 1 month to 17 years of age and adults when oral therapy is not possible or appropriate

Risk reduction of ulcer rebleeding postprocedure (Rx only): Decrease the risk of rebleeding postendoscopy for acute bleeding gastric or duodenal ulcers in adults

Off Label Uses

Barrett esophagus

Data from a meta-analysis of observational studies evaluating acid suppressive therapy and the risk of esophageal adenocarcinoma or high-grade dysplasia in patients with Barrett esophagus showed that proton pump inhibitors were associated with a reduction in the risk of esophageal adenocarcinoma and high-grade dysplasia associated with Barrett esophagus; a longer duration of PPI use was associated with a greater protective effect.

Nexmezol description

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Each tablet contains 20 mg or 40 mg Nexmezol (as magnesium trihydrate).

Each tablet contains Esomeprazole as enteric-coated pellets (MUPS).

Nexmezol MUPS is a proton pump inhibitor. The active ingredient in Nexmezol MUPS is Nexmezol magnesium trihydrate, a substituted benzimidazole. Nexmezol is the S-isomer of omeprazole. It is optically stable in vivo, with negligible conversion to the R-isomer. The chemical name is di-(S)-5-methoxy-2-[[4-methoxy-3,5-dimethyl-2-pyridinyl)methyl] sulfinyl] -1H- benzimidazole magnesium salt trihydrate.

Its molecular formula is C34H36N6O6S2Mg·3H2O and has a molecular weight of 767.2 (trihydrate).

Excipients/Inactive Ingredients: Glycerol monostearate 40-55, hyprolose, hypromellose, iron oxide (E 172) (Tablet 20 mg, reddish-brown CI 77491, yellow, CI 77492) (Tablet 40 mg, reddish-brown CI 77491), magnesium stearate, methacrylic acid ethyl acrylate copolymer (1:1) dispersion 30 percent, cellulose microcrystalline, synthetic paraffin, macrogols, polysorbate 80, crospovidone, sodium stearyl fumarate, sugar spheres (sucrose and maize starch), talc, titanium dioxide (E 171), triethyl citrate.

Nexmezol 20 mg: Sucrose 28 mg.

Nexmezol 40 mg: Sucrose 30 mg.

Nexmezol dosage

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Usual Adult Dose for Gastroesophageal Reflux Disease:

Nexmezol Magnesium:

-20 mg orally once a day for 4 weeks

Nexmezol Strontium:

-24.65 mg orally once a day for 4 to 8 weeks.

Comment:

-If symptoms do not resolve after 4 weeks, an additional 4 weeks may be considered.

GERD with Erosive Esophagitis:

Nexmezol Sodium:

-20 mg or 40 mg IV injection once a day, over no less than 3 minutes; or IV infusion once a day, over no less than 10 to 30 minutes

Comment: Safety and efficacy of Nexmezol sodium IV for Injection for more than 10 days have not been demonstrated.

Uses: Short term treatment of heartburn and symptomatic gastroesophageal reflux disease; short term treatment of GERD with erosive esophagitis, inclusively as an alternative to oral therapy, if unable to use oral route

Usual Adult Dose for Erosive Esophagitis:

Healing:

-Nexmezol Magnesium: 20 to 40 mg orally once a day for 4 to 8 weeks

-Nexmezol Strontium: 24.65 to 49.3 mg orally once a day for 4 to 8 weeks

-An additional 4 to 8 week course of therapy may be considered in patients not healed after initial treatment.

Maintenance of healing:

-Nexmezol Magnesium: 20 mg orally once a day

-Nexmezol Strontium: 24.65 mg orally once a daily

Comments:

-Nexmezol Sodium injection may be used as an alternative to oral therapy, if unable to use oral route.

-Maintenance of healing: Controlled studies did not extend beyond six months.

Uses: Short-term treatment in the healing and symptomatic resolution of diagnostically confirmed erosive esophagitis; to maintain symptom resolution and healing of erosive esophagitis

Usual Adult Dose for Helicobacter pylori Infection:

Nexmezol Magnesium:

Triple therapy:

-40 mg orally once a day for 10 days, along with amoxicillin 1000 mg and clarithromycin 500 mg orally twice a day for 10 days

Nexmezol Strontium:

Triple therapy:

-49.3 mg orally once a day for 10 days, along with amoxicillin 1000 mg and clarithromycin 500 mg orally twice a day for 10 days

Comments:

-Susceptibility testing should be done in patients who fail therapy.

-If resistance to clarithromycin is demonstrated or susceptibility testing is not possible, alternative antimicrobial therapy should be instituted.

-Eradication of H. pylori has been shown to reduce the risk of duodenal ulcer recurrence.

Use: Triple therapy (Nexmezol plus amoxicillin and clarithromycin): Treatment of H. pylori infection and duodenal ulcer disease (active or history of within the past 5 years) to eradicate H. pylori

Usual Adult Dose for NSAID-Induced Gastric Ulcer:

Nexmezol Magnesium:

-20 mg to 40 mg orally once daily for up to 6 months

Nexmezol Strontium:

-24.65 mg to 49.3 mg orally once a day for up to 6 months

Comment:

-Patients older than 60 years and/or with history of gastric ulcers are considered to be at risk for developing gastric ulcers.

-Controlled studies do not extend beyond 6 months

Use: Reduction in the occurrence of gastric ulcers associated with continuous NSAID therapy in patients at risk for developing gastric ulcers.

Usual Adult Dose for Zollinger-Ellison Syndrome:

Nexmezol Magnesium:

-40 mg orally twice a day

Nexmezol Strontium:

-49.3 mg orally twice a day

Comment: Doses up to 240 mg daily have been used.

Use: Long term treatment of pathological hypersecretory conditions, including Zollinger-Ellison Syndrome

Usual Adult Dose for Pathological Hypersecretory Conditions:

Nexmezol Magnesium:

-40 mg orally twice a day

Nexmezol Strontium:

-49.3 mg orally twice a day

Comment: Doses up to 240 mg daily have been used.

Use: Long term treatment of pathological hypersecretory conditions, including Zollinger-Ellison Syndrome

Usual Adult Dose for Duodenal Ulcer Prophylaxis:

Nexmezol Sodium:

-Initial dose: 80 mg IV infusion over 30 minutes

-Maintenance dose: 8 mg/hr IV continuous infusion for a total of 72 hours (includes initial 30 minute dose plus 71.5 hours of continuous infusion)

Comments:

-Intravenous therapy is aimed solely at the acute initial management of bleeding gastric or duodenal ulcers and does not constitute full treatment.

-Intravenous therapy should be followed by oral acid-suppressive therapy.

Use: Risk reduction of rebleeding of gastric or duodenal ulcers following therapeutic endoscopy

Usual Adult Dose for Gastric Ulcer Prophylaxis:

Nexmezol Sodium:

-Initial dose: 80 mg IV infusion over 30 minutes

-Maintenance dose: 8 mg/hr IV continuous infusion for a total of 72 hours (includes initial 30 minute dose plus 71.5 hours of continuous infusion)

Comments:

-Intravenous therapy is aimed solely at the acute initial management of bleeding gastric or duodenal ulcers and does not constitute full treatment.

-Intravenous therapy should be followed by oral acid-suppressive therapy.

Use: Risk reduction of rebleeding of gastric or duodenal ulcers following therapeutic endoscopy

Usual Pediatric Dose for Gastroesophageal Reflux Disease:

Nexmezol Magnesium:

Less than 1 year:

-Data not available

1 to 11 years:

-10 mg once a day for up to 8 weeks

-Comment: Doses over 1 mg/kg/day have not been studied.

12 to 17 years:

-20 mg once a day for 4 weeks

Nexmezol Sodium:

GERD with Erosive Esophagitis:

Less than 1 month:

-Not recommended.

1 month to less than 1 year:

-0.5 mg/kg IV infused over 10 to 30 minutes

1 to 17 years:

-Less than 55 kg: 10 mg IV infused over 10 to 30 minutes

-55 kg or more: 20 mg IV infused over 10 to 30 minutes

Nexmezol Strontium: Not recommended.

Uses: Short term treatment of symptomatic GERD; short term treatment of GERD with erosive esophagitis, inclusively as an alternative to oral therapy, if unable to use oral route

Usual Pediatric Dose for Erosive Esophagitis:

Nexmezol Magnesium:

Healing:

Less than 1 year:

-Data not available

1 to 11 years:

-Less than 20 kg: 10 mg once a day for 8 weeks

-20 kg or more: 10 mg or 20 mg once a day for 8 weeks

12 to 17 years:

-20 or 40 mg once a day for 4 to 8 weeks

Comment: Doses over 1 mg/kg/day have not been studied.

Erosive Esophagitis due to acid-mediated GERD:

Less than 1 month:

-Data not available

1 month to less than 1 year old:

-3 kg to 5 kg: 2.5 mg once a day

-Greater than 5 kg to 7.5 kg: 5 mg once a day

-Greater than 7.5 kg to 12 kg: 10 mg once a day

Duration of therapy: For up to 6 weeks

Comment: Doses over 1.33 mg/kg/day have not been studied.

1 year and older:

-Data not available

Uses: Short-term treatment in the healing and symptomatic resolution of diagnostically confirmed erosive esophagitis; short term treatment of erosive esophagitis due to acid-mediated GERD in infants

Nexmezol interactions

See also:
What other drugs will affect Nexmezol?

Nexmezol is extensively metabolized in the liver by CYP2C19 and CYP3A4.

In vitro and in vivo studies have shown that Nexmezol is not likely to inhibit CYPs 1A2, 2A6, 2C9, 206, 2E1 and 3A4. No clinically relevant interactions with drugs metabolized by these CYP enzymes would be expected. Drug interaction studies have shown that Nexmezol does not have any clinically significant interactions with phenytoin, warfarin, quinidine, clarithromycin or amoxicillin. Post-marketing reports of changes in prothrombin measures have been received among patients on concomitant warfarin and Nexmezol therapy. Increases in INR and prothrombin time may lead to abnormal bleeding and even death. Patients treated with proton pump inhibitors and warfarin concomitantly may need to be monitored for increases in INR and prothrombin time.

Nexmezol may potentially interfere with CYP2C19, the major Nexmezol metabolizing enzyme. Coadministration of Nexmezol 30 mg and diazepam, a CYP2C19 substrate, resulted in a 45% decrease in clearance of diazepam. Increased plasma levels of diazepam were observed 12 hours after dosing and onwards. However, at that time, the plasma levels of diazepam were below the therapeutic interval, and thus this interaction is unlikely to be of clinical relevance.

Concomitant administration of Nexmezol and a combined inhibitor of CYP2C19 and CYP3A4, such as voriconazole, may result in more than doubling of the Nexmezol exposure. Dose adjustment of Nexmezol is not normally required for the recommended doses. However, in patients who may require higher doses, dose adjustment may be considered.

Nexmezol acts as an inhibitor of CYP2C19. Nexmezol given in doses of 40 mg daily for one week to 20 healthy subjects in cross-over study, increased Cmax and AUC of cilostazol by 18% and 26% respectively. Cmax and AUC of one of its active metabolites, 3,4-dihydro-cilostazol, which has 4-7 times the activity of cilostazol, were increased by 29% and 69% respectively. Co-administration of cilostazol with Nexmezol is expected to increase concentrations of cilostazol and its above mentioned active metabolite. Therefore a dose reduction of cilostazol from 100 mg b.i.d. to 50 mg b.i.d. should be considered.

Co-administration of' oral contraceptives, diazepam, phenytoin, or quinidine did not seen to change the pharmacokinetic profile of Nexmezol.

Antiretroviral Agents: Concomitant use of atazanavir and nelfinavir with proton pump inhibitors is not recommended. Co-administration of atazanavir with proton pump inhibitors is expected to substantially decrease atazanavir plasma concentrations and thereby reduce its therapeutic effect.

Nexmezol has been reported to interact with some antiretroviral drugs. The clinical importance and the mechanisms behind these interactions are not always known. Increased gastric pH during Nexmezol treatment may change the absorption of the antiretroviral drug. Other possible interaction mechanisms are via CYP2C19. For some antiretroviral drugs, such as atazanavir and nelfinavir, decreased serum levels have been reported when given together with omeprazole. Following multiple doses of nelfinavir (1250 mg, bid) and Nexmezol (40 mg qd). AUC was decreased by 36% and 92%, Cmax by 37% and 89% and Cmin by 39% and 75% respectively for nelfinavir and M8. Following multiple doses of atazanavir (400 mg, qd) and Nexmezol (40 mg, qd, 2 hr before atazanavir), AUC was decreased by 94%, Cmax by 96%, and Cmin by 95%. Concomitant administration with Nexmezol and drugs such as atazanavir and nelfinavir is therefore not recommended. For other antiretroviral drugs, such as saquinavir, elevated serum levels have been reported with an increases in AUC by 82%, in Cmax by 75% and in Cmin by 106% following multiple dosing of saquinavir/ritonavir (1000/100 mg) bid for 15 days with Nexmezol 40 mg qd coadministered days 11 to 15. Therefore, clinical and laboratory monitoring for saquinavir toxicity is recommended during concurrent use with Nexmezol.

Dose reduction of saquinavir should be considered from the safety perspective for individual patients. There are also some antiretroviral drugs of which unchanged serum levels have been reported when given with Nexmezol.

Studies evaluating concomitant administration of Nexmezol and either naproxen (non-selective NSAID) or rofecoxib (COX-2 selective NSAID) did not identify any clinically relevant changes in the pharmacokinetic profiles of Nexmezol or these NSAIDs.

Nexmezol inhibits gastric acid secretion. Therefore, Nexmezol may interfere with the absorption of drugs where gastric pH is an important determinant of bioavailability (eg, ketoconazole, iron salts and digoxin).

Nexmezol side effects

See also:
What are the possible side effects of Nexmezol?

Clinical Trials Experience With

Intravenous Nexmezol

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Adults

The safety of intravenous Nexmezol is based on results from clinical trials conducted in four different populations including patients having symptomatic GERD with or without a history of erosive esophagitis (n=199), patients with erosive esophagitis (n=160), healthy subjects (n=204) and patients with bleeding gastric or duodenal ulcers (n=375).

Symptomatic GERD and Erosive Esophagitis Trials

The data described below reflect exposure to Nexmezol I.V. for Injection in 359 patients. Nexmezol I.V. for Injection was studied only in actively-controlled trials. The population was 18 to 77 years of age; 45% Male, 52% Caucasian, 17% Black, 3% Asian, 28% Other, and had either erosive reflux esophagitis (44%) or GERD (56%). Most patients received doses of either 20 or 40 mg either as an infusion or an injection. Adverse reactions occurring in ≥ 1% of patients treated with intravenous Nexmezol (n=359) in clinical trials are listed below:

Table 2 : Adverse reactions occurring at an incidence ≥ 1% in the Nexmezol I.V. group

Adverse Reactions % of patients Nexmezol

Intravenous (n=359)

Headache 10.9
Flatulence 10.3
Nausea 6.4
Abdominal pain 5.8
Diarrhea 3.9
Mouth dry 3.9
Dizziness/vertigo 2.8
Constipation 2.5
Injection site reaction 1.7
Pruritus 1.1

Intravenous treatment with Nexmezol 20 and 40 mg administered as an injection or as an infusion was found to have a safety profile similar to that of oral administration of Nexmezol.

Pediatric

A randomized, open-label, multi-national study to evaluate the pharmacokinetics of repeated intravenous doses of once daily Nexmezol in pediatric patients 1 month to 17 years old, inclusive was performed. The safety results are consistent with the known safety profile of Nexmezol and no unexpected safety signals were identified.

Risk Reduction of Rebleeding of Gastric or Duodenal Ulcers in Adults

The data described below reflect exposure to Nexmezol I.V. for Injection in 375 patients. Nexmezol I.V. for Injection was studied in a placebo-controlled trial. Patients were randomized to receive Nexmezol I.V. for Injection (n=375) or placebo (n=389). The population was 18 to 98 years old; 68% Male, 87% Caucasian, 1% Black, 7% Asian, 4% other, who presented with endoscopically confirmed gastric or duodenal ulcer bleeding. Following endoscopic hemostasis, patients received either 80 mg Nexmezol as an intravenous infusion over 30 minutes followed by a continuous infusion of 8 mg per hour or placebo for a total treatment duration of 72 hours. After the initial 72-hour period, all patients received oral proton pump inhibitor (PPI) for 27 days.

Table 3 : Incidence (%) of adverse reactions that occurred in greater than 1% of patients within 72 hours after start of treatment*

Number(%)of patients
Nexmezol

(n=375)

Placebo

(n=389)

Duodenal ulcer haemorrhage 16 (4.3%) 16 (4.1%)
Injection site reaction# 16 (4.3%) 2 (0.5)
Pyrexia 13 (3.5%) 11 (2.8%)
Cough 4 (1.1%) 1 (0.3%)
Dizziness 4 (1.1%) 3 (0.8%)
*Incidence ≥ 1% in the Nexmezol group and greater than placebo group safety population

#Injection site reactions included erythema, swelling, inflammation, pruritus, phlebitis, thrombophlebitis and superficial phlebitis.

With the exception of injection site reactions described above, intravenous treatment with Nexmezol administered as an injection or as an infusion was found to have a safety profile similar to that of oral administration of Nexmezol.

Postmarketing Experience

The following adverse reactions have been identified during post-approval use of Nexmezol. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Postmarketing Reports - There have been spontaneous reports of adverse events with postmarketing use of Nexmezol. These reports occurred rarely and are listed below by body system:

Blood And Lymphatic System Disorders: agranulocytosis, pancytopenia;

Eye Disorders: blurred vision;

Gastrointestinal Disorders: pancreatitis; stomatitis; microscopic colitis;

Hepatobiliary Disorders: hepatic failure, hepatitis with or without jaundice;

Immune System Disorders: anaphylactic reaction/shock;

Infections and Infestations: GI candidiasis;

Metabolism and nutritional disorders: hypomagnesemia;

Musculoskeletal And Connective Tissue Disorders: muscular weakness, myalgia, bone fracture;

Nervous System Disorders: hepatic encephalopathy, taste disturbance;

Psychiatric Disorders: aggression, agitation, depression, hallucination;

Renal and Urinary Disorders: interstitial nephritis;

Reproductive System and Breast Disorders: gynecomastia;

Respiratory, Thoracic and Mediastinal Disorders: bronchospasm;

Skin and Subcutaneous Tissue Disorders: alopecia, erythema multiforme, hyperhidrosis, photosensitivity, Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN, some fatal).

Other adverse events not observed with Nexmezol, but occurring with omeprazole can be found in the omeprazole package insert, ADVERSE REACTIONS section.

Nexmezol contraindications

See also:
What is the most important information I should know about Nexmezol?

Nexmezol is rapidly absorbed after oral doses, with peak plasma levels occurring after about 1-2 hrs. It is acid labile and an enteric-coated formulation has been developed. Bioavailability of Nexmezol increases with both dose and repeated administration to about 68% and 89% for doses of 20 mg and 40 mg, respectively. Food delays and decreases the absorption of Nexmezol, but this does not significantly change its effect of intragastric acidity. Nexmezol is about 97% bound to plasma proteins. It is extensively metabolized in the liver by the cytochrome P450 (CYP450) isoenzyme CYP2C19 to hydroxy and desmethyl metabolites, which have no effect on gastric acid section. The remainder is metabolized by the CYP450 isoenzyme CYP3A4 to Nexmezol sulfone. With repeated dosage, there is a decrease in first-pass metabolism and systemic clearance, probably caused by an inhibition of the CYP2C19 isoenzyme. However, there is no accumulation during once daily use. The plasma elimination half-life (t½) is about 1.3 hrs. Almost 80% of an oral dose is eliminated as metabolites in the urine, the remainder in the feces.



Active ingredient matches for Nexmezol:

Esomeprazole in Estonia, Latvia, Lithuania.


List of Nexmezol substitutes (brand and generic names)

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Unit description / dosage (Manufacturer)Price, USD
Nexium DR-FC tab / MUPS 40 mg 14's (AstraZeneca)$ 33.89
Nexonav DR cap 40 mg 30's (XL Lab)
NEXOPIL 20 MG TABLET 1 strip / 10 tablets each (Psychotropics India Ltd)$ 1.96
NEXOPIL 40 MG TABLET 1 strip / 10 tablets each (Psychotropics India Ltd)$ 0.32
Nexopil 20mg Tablet (Psychotropics India Ltd)$ 0.20
Nexopil 40mg Tablet (Psychotropics India Ltd)$ 0.03
Nexopraz 40 EC tab 40 mg 100's (Saga Lab)
NEXPRO Capsule/ Tablet / 40mg / 15 units (Prima (Torrent Pharmaceuticals Ltd.))$ 1.10
NEXPRO Capsule/ Tablet / 20mg / 15 units (Prima (Torrent Pharmaceuticals Ltd.))$ 0.66
20 mg x 15's (Prima (Torrent Pharmaceuticals Ltd.))$ 0.66
40 mg x 15's (Prima (Torrent Pharmaceuticals Ltd.))$ 1.10
40 mg x 1's (Prima (Torrent Pharmaceuticals Ltd.))$ 0.94
Nexpro 20mg TAB / 15 (Prima (Torrent Pharmaceuticals Ltd.))$ 0.66
Nexpro 40mg TAB / 15 (Prima (Torrent Pharmaceuticals Ltd.))$ 1.15
Nexpro 40mg VIAL / 1 (Prima (Torrent Pharmaceuticals Ltd.))$ 0.94
Nexpro 40 mg Tablet (Prima (Torrent Pharmaceuticals Ltd.))$ 0.08
Nexpro 20 mg Tablet (Prima (Torrent Pharmaceuticals Ltd.))$ 0.04
NEXPRO 20MG TABLET 1 strip / 15 tablets each (Prima (Torrent Pharmaceuticals Ltd.))$ 0.84
NEXPRO 40MG TABLET 1 strip / 15 tablets each (Prima (Torrent Pharmaceuticals Ltd.))$ 1.63
NEXPRO FAST 20MG TABLET 1 strip / 10 tablets each (Prima (Torrent Pharmaceuticals Ltd.))$ 1.03
NEXPRO FAST 40MG TABLET 1 strip / 10 tablets each (Prima (Torrent Pharmaceuticals Ltd.))$ 1.46
NEXPRO JUNIOR 1000 MG SACHET 1 packet / 1 sachet each (Prima (Torrent Pharmaceuticals Ltd.))$ 0.21
NEXPRO IV INJECTION 1 vial / 1 injection each (Prima (Torrent Pharmaceuticals Ltd.))$ 1.35
NEXPRO tab 20 mg x 15's (Prima (Torrent Pharmaceuticals Ltd.))$ 0.68
NEXPRO tab 40 mg x 15's (Prima (Torrent Pharmaceuticals Ltd.))$ 1.21
Nexpro 20mg Tablet (Prima (Torrent Pharmaceuticals Ltd.))$ 0.11
Nexpro 40mg Tablet (Prima (Torrent Pharmaceuticals Ltd.))$ 0.16
Nexpro 40mg Injection (Prima (Torrent Pharmaceuticals Ltd.))$ 1.48
Nexpro 1000mg Granules (Prima (Torrent Pharmaceuticals Ltd.))$ 0.21
Nexpro Fast 20mg TAB / 15 (Torrent Pharmaceuticals Ltd.)$ 0.66
Nexpro Fast 40mg TAB / 15 (Torrent Pharmaceuticals Ltd.)$ 1.15
20 mg x 15's (Torrent Pharmaceuticals Ltd.)$ 0.66
40 mg x 15's (Torrent Pharmaceuticals Ltd.)$ 1.15
Nexpro Fast 40 mg Tablet (Torrent Pharmaceuticals Ltd.)$ 0.11
Nexpro Fast 20 mg Tablet (Torrent Pharmaceuticals Ltd.)$ 0.08
NEXPRO FAST film-coated tab 20 mg x 10's (Torrent Pharmaceuticals Ltd.)$ 0.81
NEXPRO FAST film-coated tab 40 mg x 10's (Torrent Pharmaceuticals Ltd.)$ 1.17
Nexpro Inj 40 mg Injection (Prima (Torrent Pharmaceuticals Ltd.))$ 0.94

References

  1. DailyMed. "ESOMEPRAZOLE STRONTIUM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "Esomeprazole". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "Esomeprazole". http://www.drugbank.ca/drugs/DB00736 (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Nexmezol are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Nexmezol. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

User reports

6 consumers reported useful

Was the Nexmezol drug useful in terms of decreasing the symptom or the disease?
According to the reports released by ndrugs.com website users, the below mentioned percentages of users say the drug is useful / not useful to them in decreasing their symptoms/disease. The usefulness of the drug depends on many factors, like severity of the disease, perception of symptom, or disease by the patient, brand name used [matters only to a certain extent], other associated conditions of the patient. If the drug is not effective or useful in your case, you need to meet the doctor to get re-evaluated about your symptoms/disease, and he will prescribe an alternative drug.
Users%
Not useful4
66.7%
Useful2
33.3%


7 consumers reported price estimates

Was the price you paid to purchase the drug reasonable? Did you feel it was expensive?
The below mentioned numbers have been reported by ndrugs.com website users about whether the Nexmezol drug is expensive or inexpensive. There is a mixed opinion among users. The rating about the cost of the drug depends on factors like which brand drug the patient purchased, how effective it was for the price paid, the country or place the drug is marketed, and the economic condition of the patient. The users who feel the drug is expensive can look for an alternative brand drug or a generic drug to save the cost.
Users%
Expensive5
71.4%
Not expensive2
28.6%


23 consumers reported time for results

To what extent do I have to use Nexmezol before I begin to see changes in my health conditions?
As part of the reports released by ndrugs.com website users, it takes 1 day and a few days before you notice an improvement in your health conditions.
Please note, it doesn't mean you will start to notice such health improvement in the same time frame as other users. There are many factors to consider, and we implore you to visit your doctor to know how long before you can see improvements in your health while taking Nexmezol. To get the time effectiveness of using Nexmezol drug by other patients, please click here.
Users%
1 day5
21.7%
2 weeks5
21.7%
1 month5
21.7%
> 3 month4
17.4%
2 days2
8.7%
3 days2
8.7%


67 consumers reported age

Users%
> 6029
43.3%
46-6014
20.9%
30-4514
20.9%
16-299
13.4%
6-151
1.5%


Consumer reviews

Deborah P Mbatha15 Jun 2016 01:35
I am suffering from the severe erosive GERD feel like vomitting I was admitted at the hospital for gastroscop the results were sores that caused by stomach acid and something like stomach bug in the bile which causes acid problem I was given nexmezol tablets 40MG to be taken daily it's been 12days now but my chest is still aching but the oesofugus is now better than before thank you for the word of encouragement that I must continue to take the drug because the problem won't go in a day


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