Nexopraz 40 Dosage

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Dosage of Nexopraz 40 in details

The dose of a drug and dosage of the drug are two different terminologies. Dose is defined as the quantity or amount of medicine given by the doctor or taken by the patient at a given period. Dosage is the regimen prescribed by the doctor about how many days and how many times per day the drug is to be taken in specified dose by the patient. The dose is expressed in mg for tablets or gm, micro gm sometimes, ml for syrups or drops for kids syrups. The dose is not fixed for a drug for all conditions, and it changes according to the condition or a disease. It also changes on the age of the patient.
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Usual Adult Dose for Gastroesophageal Reflux Disease:

Nexopraz 40 Magnesium:

-20 mg orally once a day for 4 weeks

Nexopraz 40 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:

Nexopraz 40 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 Nexopraz 40 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:

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

-Nexopraz 40 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:

-Nexopraz 40 Magnesium: 20 mg orally once a day

-Nexopraz 40 Strontium: 24.65 mg orally once a daily

Comments:

-Nexopraz 40 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:

Nexopraz 40 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

Nexopraz 40 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 (Nexopraz 40 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:

Nexopraz 40 Magnesium:

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

Nexopraz 40 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:

Nexopraz 40 Magnesium:

-40 mg orally twice a day

Nexopraz 40 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:

Nexopraz 40 Magnesium:

-40 mg orally twice a day

Nexopraz 40 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:

Nexopraz 40 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:

Nexopraz 40 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:

Nexopraz 40 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

Nexopraz 40 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

Nexopraz 40 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:

Nexopraz 40 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

What other drugs will affect Nexopraz 40?

Nexopraz 40 should not be taken together with atazanavir (Reyataz) or nelfinavir (Viracept). Tell your doctor if you are taking either of these medications to treat HIV or AIDS.

Tell your doctor about all other medicines you use, especially:

This list is not complete and other drugs may interact with Nexopraz 40. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Nexopraz 40 interactions

Interactions are the effects that happen when the drug is taken along with the food or when taken with other medications. Suppose if you are taking a drug Nexopraz 40, it may have interactions with specific foods and specific medications. It will not interact with all foods and medications. The interactions vary from drug to drug. You need to be aware of interactions of the medicine you take. Most medications may interact with alcohol, tobacco, so be cautious.
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Nexopraz 40 is extensively metabolized in the liver by CYP2C19 and CYP3A4.

In vitro and in vivo studies have shown that Nexopraz 40 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 Nexopraz 40 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 Nexopraz 40 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.

Nexopraz 40 may potentially interfere with CYP2C19, the major Nexopraz 40 metabolizing enzyme. Coadministration of Nexopraz 40 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 Nexopraz 40 and a combined inhibitor of CYP2C19 and CYP3A4, such as voriconazole, may result in more than doubling of the Nexopraz 40 exposure. Dose adjustment of Nexopraz 40 is not normally required for the recommended doses. However, in patients who may require higher doses, dose adjustment may be considered.

Nexopraz 40 acts as an inhibitor of CYP2C19. Nexopraz 40 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 Nexopraz 40 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 Nexopraz 40.

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.

Nexopraz 40 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 Nexopraz 40 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 Nexopraz 40 (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 Nexopraz 40 (40 mg, qd, 2 hr before atazanavir), AUC was decreased by 94%, Cmax by 96%, and Cmin by 95%. Concomitant administration with Nexopraz 40 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 Nexopraz 40 40 mg qd coadministered days 11 to 15. Therefore, clinical and laboratory monitoring for saquinavir toxicity is recommended during concurrent use with Nexopraz 40.

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 Nexopraz 40.

Studies evaluating concomitant administration of Nexopraz 40 and either naproxen (non-selective NSAID) or rofecoxib (COX-2 selective NSAID) did not identify any clinically relevant changes in the pharmacokinetic profiles of Nexopraz 40 or these NSAIDs.

Nexopraz 40 inhibits gastric acid secretion. Therefore, Nexopraz 40 may interfere with the absorption of drugs where gastric pH is an important determinant of bioavailability (eg, ketoconazole, iron salts and digoxin).


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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. FDA/SPL Indexing Data. "N3PA6559FT: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).
  3. MeSH. "Proton Pump Inhibitors". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).

Reviews

The results of a survey conducted on ndrugs.com for Nexopraz 40 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 Nexopraz 40. 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

3 consumers reported frequency of use

How frequently do I need to take Nexopraz 40?
It was reported by ndrugs.com website users that Nexopraz 40 should ideally be taken Once in a day as the most common frequency of the Nexopraz 40. You should you adhere strictly to the instructions and guidelines provided by your doctor on how frequently this Nexopraz 40 should be taken. Get another patient's view on how frequent the capsule should be used by clicking here.
Users%
Once in a day3
100.0%


2 consumers reported doses

What doses of Nexopraz 40 drug you have used?
The drug can be in various doses. Most anti-diabetic, anti-hypertensive drugs, pain killers, or antibiotics are in different low and high doses and prescribed by the doctors depending on the severity and demand of the condition suffered by the patient. In our reports, ndrugs.com website users used these doses of Nexopraz 40 drug in following percentages. Very few drugs come in a fixed dose or a single dose. Common conditions, like fever, have almost the same doses, e.g., [acetaminophen, 500mg] of drug used by the patient, even though it is available in various doses.
Users%
11-50mg2
100.0%


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Information checked by Dr. Sachin Kumar, MD Pharmacology

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