Reduces the absorption of ketoconazole and itraconazole. Esomeprazole inhibits CYP2C19 and CYP3A4, so the combined use of esomeprazole with other drugs in the metabolism of which involved CYP2C19 (diazepam, citalopram, imipramine, clomipramine, phenytoin, etc.) can lead to an increase in their concentrations in plasma and require dose reduction. Esomeprazole does not cause clinically significant changes in the pharmacokinetics of amoxicillin, quinidine, and warfarin. By sharing a 30 mg of esomeprazole and diazepam reduced by 45% clearance of the enzyme-substrate complex (CYP2C19-diazepam). In the plasma of patients with epilepsy minimum concentration of phenytoin increased by 13% when combined it with 40 mg esomeprazole. In this regard, it is recommended to control the concentration of phenytoin in the plasma at the beginning of treatment with esomeprazole and its Abolition. Simultaneous treatment with 40 mg esomeprazole with cisapride increases the values of the pharmacokinetic parameters of cisapride: AUC - 32% and T1 / 2 - 31%, but the concentration of cisapride in plasma at the same time did not significantly change, cisapride has no effect on electrophysiological parameters of heart at this combination. Joint application of esomeprazole with clarithromycin (500 mg 2 times a day), which inhibits CYP3A4, increases the AUC of esomeprazole 2 times. Correction dosing regimen of esomeprazole is not required.
Description of the drug Nexium is not intended for use without medical treatment.
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