Esger 40 mg Tablet belongs to the class of drugs known as Proton pump inhibitor, which reduces the amount of acid your stomach makes. It treats gastroesophageal reflux disease (GERD), stomach ulcers and Zollinger-Ellison syndrome (overproduction of acid due to pancreatic tumour).

Esger 40 mg Tablet helps in reducing the stomach acid by blocking the actions of an enzyme (H+/K+ ATPase or gastric proton pump). This proton pump lies in the cells of the stomach wall responsible for the release of gastric acid secretion damaging tissues in the food pipe, stomach, and duodenum. Esger 40 mg Tablet prevents the release of stomach acid and relieves symptoms of food pipe lining inflammation (esophagitis), and gastroesophageal reflux disease (GERD), or heartburn.

Take Esger 40 mg Tablet 1-2 hours prior to food. You are advised to take Esger 40 mg Tablet as long as your doctor has prescribed it for you, depending on your medical condition. In some cases, Esger 40 mg Tablet might cause common side effects like headache, diarrhoea, nausea, abdominal pain, and vomiting. Consult the doctor if the side effects persist or worsen. 

Esger 40 mg Tablet is safe for pregnant and breastfeeding mothers but should be taken only after consulting a doctor. Tell your doctor if you have stomach or intestinal cancer, liver problems, are allergic to Esger 40 mg Tablet , or will have an endoscopy in the future. Prolonged intake of Esger 40 mg Tablet may cause a deficiency of Vitamin B12 and low levels of calcium, magnesium, and Vitamin D, leading to osteoporosis.

Esger 40 mg Tablet is effective at healing erosive esophagitis (inflammation of food pipe), relieving symptoms of gastroesophageal reflux disease (heartburn), and Zollinger-Ellison syndrome. Esger 40 mg Tablet works by irreversibly blocking the proton pump gate (which secretes stomach acid). It can be prescribed to all age groups including special populations like the elderly, pregnant, lactating mothers, kidney, and liver disease patients. Usually, no dosage adjustment is required for these groups.

• Headache
• Diarrhoea
• Nausea
• Abdominal pain
• Vomiting

You should avoid taking Esger 40 mg Tablet if you are allergic to Esger 40 mg Tablet or proton pump inhibitors, have gastric cancer, liver disease, low magnesium level (osteoporosis), low vitamin B12, pregnant or planning for pregnancy, and breastfeeding mothers. Esger 40 mg Tablet may interact with a blood thinner (warfarin), antifungal (ketoconazole), anti-HIV drug (atazanavir, nelfinavir), iron supplements, ampicillin antibiotic, anti-cancer drug (methotrexate). Let your doctor know if you are taking these medicines. Prolonged intake of Esger 40 mg Tablet may cause lupus erythematosus (an inflammatory condition in which the immune system attacks its own tissues), Vitamin B12, and magnesium deficiency. Intake of Esger 40 mg Tablet may mask the symptom of gastric cancer, so if you have any severe stomach pain or gastric bleeding (blood in mucous or stool) immediately consult the doctor. 

Drug-Drug Interactions: Esger 40 mg Tablet may interact with a blood thinner (clopidogrel, warfarin), antifungal (ketoconazole, voriconazole, itraconazole, posaconazole), anti-HIV drug (atazanavir, nelfinavir, rilpivirine),  anti-viral drugs (nelfinavir), iron supplements, antibiotic (ampicillin, rifampicin), heart medicine (digoxin) and anti-cancer drug (methotrexate). Let your doctor know if you are taking these medicines.

Drug-Food Interactions: Esger 40 mg Tablet interact with St John's wort plant that is used as an anti-depressant. This plant may affect the working of Esger 40 mg Tablet . So avoid its intake with Esger 40 mg Tablet .

Drug-Disease Interactions: Esger 40 mg Tablet should be not given in patients with Clostridium difficile associated diarrhea, magnesium and Vitamin B-12 deficiency (increased risk of bone fracture), atrophic gastritis (inflammed lining of stomach), and acute interstitial nephritis (inflammed cells of kidney).

• CLOPIDOGREL
• WARFARIN
• KETOCONAZOLE
• VORICONAZOLE
• ITRACONAZOLE
• POSACONAZOLE
• ATAZANAVIR
• NELFINAVIR
• RILPIVIRINE
• AMPICILLIN
• RIFAMPICIN
• DIGOXIN
• METHOTREXATE

• Avoid intake of acid or heartburn triggering foods or drinks like onions, peppermint, chocolate, caffeinated beverages, citrus fruits or juices, tomatoes and high-fat and spicy foods.
• Before going to sleep try to raise your bedhead so that your head and chest are higher than your feet. Do not use piles of pillows, instead, one raised block is fine. This will not allow the stomach acid to backflow through your food pipe.
• Avoid taking alcohol and smoking cigarette. Alcohol can raise the level of production of stomach acid leading to heartburn and acid reflux. On the other hand, nicotine smoking damages the valve (sphincter) which prevents backflow of the stomach acid back into the food pipe.
• Include high fibre containing foods, berries, cherries, leafy green veggies (kale, spinach) and black peppers in your meal. These foods are full of antioxidant, calcium and vitamin B 12 that can help cope with the long term effects of the medicine. Fermented dairy products like miso, sauerkraut, and kimchi contain probiotics which help in the prevention of excess stomach acid production. Cranberry juice can be beneficial in the peptic ulcer and H Pyroli infection.
• Avoid regular sitting continuously, as it can increase stomach acid production. Try to take a break of 5 minutes in 1 hour by brisk walking or stretching.

Prolonged intake of Esger 40 mg Tablet may be associated with increased risk of Clostridium difficile associated diarrhea, magnesium and Vitamin B-12 deficiency (increased risk of bone fracture), atrophic gastritis (inflammed lining of stomach), and acute interstitial nephritis (inflammed cells of kidney).

Normally a thick layer of mucous protects the stomach against its own acid secretion. But, in long run, it gets eroded by excessive stomach acid production leading to complications like GERD, peptic ulcer, and Zollinger Ellison syndrome. Gastroesophageal reflux disease (GERD) is a gastrointestinal disorder that occurs when stomach acid frequently flows back into the food pipe (esophagus). This backflow (acid reflux) irritates the food pipe that causes heartburn. On the other hand, peptic ulcer is a painful condition followed by the development of sores or ulcers in the stomach lining or duodenum (first part of the small intestine) (the duodenum). Zollinger Ellison syndrome is a rare condition in which a gastrin-secreting tumor of the pancreas causes excessive acid production leading to peptic ulcers.