ESOMIPRAZOLE‘S‘S

ESOMIPRAZOLE
COMPETETIVE EDGE
COMPETETIVE EDGE OVER
OVER OTHER PPI’S
OTHER PPI’S
AND
HOW TOAND
MARKET THIS
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HOW
Esomeprazole
Esomeprazole is a proton pump inhibitor used in the
treatment of dyspepsia, peptic ulcer disease (PUD),
gastroesophageal reflux disease (GORD/GERD) and
Zollinger-Ellison syndrome.
Esomeprazole is one of the most widely prescribed
drugs internationally and is available over the counter
in some countries.
Chemical strusture
MECHANISM OF ACTION
Esomeprazole (and omeprazole) is a proton pump
inhibitor which reduces gastric acid secretion through
inhibition of H+/K+-ATPase in gastric parietal cells.
The inhibition of this enzyme the drug prevents
formation of gastric acid.
Clinical use

Use in Helicobacter pylori eradication

Esomeprazole is combined with the antibiotics
clarithromycin and amoxicillin (or metronidazole in
penicillin-hypersensitive patients) in the 7-14 day
eradication triple therapy for Helicobacter pylori.
 Infection by H. pylori is the causative factor in the
majority of peptic and duodenal ulcers
Evidence of efficacy
AstraZeneca claims that esomeprazole provides
improved efficacy, in terms of stomach acid control,
over the R enantiomer of omeprazole.
the (S)-isomer is more potent in humans,
the (R)-isomer is more potent in the testing of rats,
the enantiomers are equipotent in dogs.
How to use Esomeprazole:

Esomeprazole is usually given as an injection at your

doctor's office, hospital, or clinic
Esomeprazole should only be used for a short time (up to
10 days), until you are able to take medicine by mouth.
Continue to use Esomeprazole even if you feel well. Do
not miss any doses.
If you miss a dose of Esomeprazole, use it as soon as
possible. If it is almost time for your next dose, skip the
missed dose and go back to your regular dosing schedule.
Do not use 2 doses at once.
Controversy

There has been some controversy about AstraZeneca's behaviour in creating,

patenting and marketing of the drug. Esomeprazole's successful predecessor
omeprazole is a mixture of two mirror-imaged molecules and that the
company was trying to "evergreen" its patent by patenting the pure
esomeprazole and aggressively marketing to doctors that it is more effective
than the mixture,[12] claiming that omeprazole has no beneficial effects on the
patient. However, in the acidic environment of the parietal cells both
esomeprazole and omeprazole are converted to the same active drug which
stops the gastric acid production.
Thomas A. Scully, head of the Federal Centers for Medicare and Medicaid
services .At a conference of the American Medical Association he said"You
should be embarrassed if you prescribe Nexium," he claimed, "because you're
screwing your patients and you're screwing the taxpayers."
An AstraZeneca sponsored study showed that 40 mg of esomeprazole provided
more effective acid control than 40 mg of omeprazole.[14]
ESOMIPRAZOLE ‘S COMPETETIVE EDGE
OVER OTHER PPI’S
As compared with other PPIs, esomeprazole confers a
statistically significant improvement, yet, clinically,
only a modest overall benefit in 8-week healing and
symptom relief in all-comers with EE.
The clinical benefit of esomeprazole appears
negligible in less severe erosive disease but might be
important in more severe disease.
Financial impact

Between the launch of esomeprazole in 2001 and 2005,

the drug has netted AstraZeneca about $14.4 billion.[11]
HOW TO MARKET…!!