Nexpro RD 40mg Capsule 10'S

Introduction About NEXPRO RD 40MG CAPSULE

Nexpro RD 40mg Capsule is a highly effective medication used for the management of acid reflux, gastroesophageal reflux disease (GERD), and stomach ulcers. The active ingredient, Domperidone and Esomeprazole, helps to reduce stomach acid and promotes healing in the digestive system.

Nexpro RD 40 Capsule should be taken without food, following the dosage and duration prescribed by your doctor. The dosage will depend on your condition and how you respond to the medication. It is important to continue taking the medicine for the full duration recommended by your doctor. Stopping management prematurely may cause your symptoms to return or worsen your condition. Be sure to inform your healthcare team about any other medications you are taking, as some may interact with this medication.

Common side effect of this medication includes headache, abdominal pain, and diarrhea, flatulence, dryness in the mouth. Most of these side effects are temporary and typically improve with time. However, if you are concerned about any side effects, contact your doctor immediately. This medication may also cause drowsiness and dizziness, so refrain from driving or engaging in activities that require focus until you are aware of how it affects you. It is best to avoid alcohol while taking this medicine, as it can increase drowsiness. Making lifestyle changes, such as drinking cold milk and avoiding hot tea, coffee, spicy foods, or chocolate, can help improve your results.

Before taking this medication, inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding. Additionally, let your doctor know if you have any liver conditions so they can determine the appropriate dose for you.

Uses Of NEXPRO RD 40MG CAPSULE

• Acid reflux
• Gastroesophageal reflux disease (GERD)
• Stomach ulcers

Benefits of NEXPRO RD 40MG CAPSULE

1.Reduces Acid Reflux and GERD Symptoms: Esomeprazole, a proton pump inhibitor (PPI), helps reduce the amount of stomach acid produced, effectively relieving symptoms of acid reflux and GERD (Gastroesophageal Reflux Disease). This alleviates heartburn, chest pain, and regurgitation.

2.Promotes Healing of Stomach Ulcers: The combination of Esomeprazole and Domperidone works together to decrease stomach acid and promote gastric motility. This aids in healing peptic ulcers by reducing irritation from stomach acid and speeding up recovery.

3.Effective in Managing Chronic Acid-Related Conditions: It helps manage conditions like Zollinger-Ellison syndrome and other acid-related disorders by reducing stomach acid production over an extended period, providing relief from symptoms and preventing complications.

How NEXPRO RD 40MG CAPSULE Works

Nexpro RD 40mg capsule contains two active ingredients: Domperidone and Esomeprazole. Domperidone helps by increasing the movement of the stomach and intestines, which helps relieve symptoms like nausea and vomiting. Esomeprazole reduces the amount of acid produced in the stomach, helping to treat acid reflux, heartburn, and ulcers. Together, these medicines work to improve digestion, reduce acid-related problems, and prevent discomfort in the stomach and esophagus.

How to use NEXPRO RD 40MG CAPSULE

Follow your doctor's instructions regarding the exact dosage. Do not exceed the recommended daily dosage.

How to Take Nexpro RD 40mg capsule?

• Take one capsule daily, preferably before a meal in the morning
• Swallow the tablet whole with a glass of water. Do not crush or chew the medication.
• For best results, take the tablet at the same time each day.

What if I forgot to take NEXPRO RD 40MG CAPSULE

If you forget to take a dose, take it as soon as you remember unless it is almost time for your next dose. In that case, skip the missed dose, do not take two doses at once to make up for a missed dose.

Overdose

If you or anyone else accidentally took more Nexpro RD 40 Capsule, contact your doctor immediately or go to a hospital straight away. Symptoms of overdosage might include sleepiness, confusion, uncontrollable body movements (including eye and tongue), twisted neck and abnormal posture.

Side Effects Of NEXPRO RD 40MG CAPSULE

Like all medicines, Nexpro RD 40 may cause certain side effects in some individuals, although not everybody gets them.

The most common side effects of taking Nexpro RD 40 are:

• Headache
• Abdominal pain
• Diarrhea
• Flatulence
• Dryness in the mouth

When to consult your doctor?

• Allergic reactions symptoms such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.
• Heart problems symptoms such as chest pain, irregular heartbeats, or feeling faint.
• Severe digestive problems symptoms such as persistent abdominal pain, nausea, or vomiting.
• Electrolyte imbalance symptoms such as muscle spasms or tremors
• Clostridium difficile infection (a serious gastrointestinal infection) symptoms such as severe diarrhea
• Severe Skin Reactions symptoms such as blisters, peeling skin, or rashes.
• Excessive Drowsiness or Fatigue
• Liver problems symptoms such as yellowing of the skin or eyes (jaundice), dark urine, or unusual fatigue.

How To Manage Side Effects

Diarrhea

• Drink Fluids: Drink clear fluids such as water, broths, and oral rehydration solutions (ORS).
• Electrolytes: If you are losing a lot of fluids (for example, from frequent diarrhea), consider drinking an electrolyte solution to help replenish lost minerals like potassium and sodium.
• BRAT Diet: Try to take Bananas, Rice (white rice), Apple sauce and Toast (plain, without butter) to control diarrhoea management.
• Avoid Certain Foods: While recovering avoid the following food items such as fatty, greasy, or fried foods, spicy foods, dairy products (especially if you have a temporary lactose intolerance), caffeinated drinks and alcohol and artificial sweeteners like sorbitol.
• Over-the-Counter Medications: You can take over-the-counter anti-diarrheal medications such as loperamide, Bismuth subsalicylate if appropriate for you. Follow the recommended dosage.

Headache

• Rest in a Quiet, Dark Room: Find a calm, quiet space away from bright lights and loud noises. Lie down and close your eyes.
• Hydrate: Dehydration can contribute to headaches, so drink plenty of water.
• Apply a Cold or Warm Compress: A cold pack on your forehead may reduce pain, or a warm compress on your neck or shoulders can relieve tension.
• Over-the-Counter Pain Relief: You can take over-the-counter pain relievers like acetaminophen or ibuprofen if appropriate for you. Follow the recommended dosage.
• Practice Relaxation Techniques: Deep breathing exercises, meditation, or gentle stretching can help reduce stress and alleviate headache symptoms.

Warning & Precautions

Pregnancy

Monitoring required

Nexpro RD 40mg Capsule should be used in pregnant women only if it is considered necessary by the physician. Therefore, consult your doctor before taking it.

Breastfeeding

Monitoring required

Nexpro RD 40mg Capsule may pass through breast milk. Therefore, it is not recommended for use in breastfeeding women unless considered necessary by the physician.

Driving and Using Machines

Use with Caution

Do not drive or operate machines if you experience dizziness or drowsiness.

Alcohol

Consult your doctor

Avoid alcohol consumption while on Nexpro RD 40, as it may increase the risk of stomach irritation or side effects.

Kidney

Use with Caution

Nexpro RD 40 should be used with caution in patients with kidney problems. Therefore, consult your doctor before taking it.

Liver

Consult your doctor

Nexpro RD 40 is not recommended for use in patients with moderate or severe liver impairment. It should be used with caution in patients with other mild liver problems. Therefore, consult your doctor before taking it.

Allergy

Contraindicated

Do not take Nexpro RD 40mg Capsule if you are allergic to Domperidone or Esomeprazole or any other proton pump inhibitors (such as rabeprazole, pantoprazole).

Heart Disease

Contraindicated

Nexpro RD 40mg Capsule is not recommended for use in patients having heart problems (such as prolongation of QT wave, congestive heart failure or arrhythmia). Therefore, consult your doctor before taking it.

Use In Pediatrics

Contraindicated

Nexpro RD 40mg Capsule is not recommended for use in children and adolescents (aged below 18 years) due to lack of safety data. Consult your pediatrician before giving it.

Use In Geriatrics

Use with Caution

Nexpro RD 40mg Capsule should be used with caution in elderly patients (aged 65 years and above). Therefore, consult your doctor before taking it.

Other Warnings for NEXPRO RD 40MG CAPSULE

Before taking Nexpro RD 40mg Capsule inform your doctor if you:

• have osteoporosis
• have vitamin B12 deficiency (sore tongue, mouth ulcers, pale skin, depression)
• are going to test Chromogranin A level

Who should not take [GBNKEYWORD

Nexpro RD 40mg Capsule is not recommended for use if you:

• have bloody stools or bleeding in the gut
• have blockage or tear in the intestines
• have severe fluid or electrolyte disturbances
• have prolactinoma (a non-cancerous tumor of pituitary gland)
• have low blood potassium or magnesium levels
• have hyperkalemia (high blood potassium levels)

Safety Advice

• Follow your doctor's instructions regarding the exact dosage.
• Do not exceed the recommended daily dosage. 
• Take one capsule daily, preferably before a meal in the morning.
• Swallow the tablet whole with a glass of water. Do not crush or chew the medication.
• For best results, take the tablet at the same time each day.
• Do not take Nexpro RD 40 or change your dosage without talking to your doctor, especially if you have not been diagnosed with a condition that needs this management.
• If you have a history of allergies to Esomeprazole, Domperidone, or similar medications, make sure to inform your doctor before taking this capsule.
• If you have impaired kidney or liver function, it is important to consult your doctor before using Nexpro RD 40. Your doctor may modify your dosage or recommend a different medication.
• Let your doctor know If you are pregnant or planning to become pregnant or breastfeeding women.
• Let your doctor know about any other medications you are taking, including over-the-counter medicines and herbal supplements. Some medications, such as antifungal drugs, antibiotics, or blood thinners, may interact with Nexpro RD 40.
• Long-term use of Esomeprazole (a key component) may raise the risk of bone fractures or vitamin B12 deficiency. If you need to use it for an extended period, it is important to undergo regular monitoring.
• Domperidone can sometimes cause dizziness or drowsiness. If you feel lightheaded or sleepy, avoid driving or operating heavy machinery until you feel better.
• It is best to limit alcohol consumption while on Nexpro RD 40, as it may increase the risk of stomach irritation or side effects.
• If you do not feel better after taking it for 14 days, let your doctor know, as it could indicate another underlying issue that requires attention

Diet and Lifestyle Advice

Drug - Drug interaction

Inform your physician if you are taking any of the following medicine before taking Nexpro RD 40mg Capsule:

1. Clopidogrel (Antiplatelet Drug)

• Interaction: Esomeprazole, the proton pump inhibitor (PPI) component of Nexpro RD, can reduce the activation of clopidogrel in the liver.
• Effect: This may decrease the effectiveness of clopidogrel, leading to a higher risk of cardiovascular events.
• Management: If clopidogrel and Nexpro RD must be co-administered, it's generally recommended to choose a different PPI or closely monitor for signs of cardiovascular issues.

2. Warfarin (Anticoagulant)

• Interaction: Esomeprazole can alter the metabolism of warfarin, potentially leading to increased blood levels of warfarin.
• Effect: Increased INR (International Normalized Ratio), raising the risk of bleeding.
• Management: Regular monitoring of INR is advised when using these drugs together. The warfarin dose may need adjustment.

3. Diazepam (Benzodiazepine)

• Interaction: Esomeprazole can increase the concentration of diazepam in the blood.
• Effect: This can lead to an increased sedative effect, resulting in drowsiness, dizziness, and impaired motor skills.
• Management: Dose adjustments of diazepam may be required. Close monitoring for signs of excessive sedation is essential.

4. Methotrexate (Chemotherapy and Immunosuppressive Drug)

• Interaction: High doses of esomeprazole may increase methotrexate levels by inhibiting its elimination.
• Effect: This can increase the risk of methotrexate toxicity, leading to severe side effects like kidney damage or bone marrow suppression.
• Management: Temporarily discontinuing Nexpro RD during high-dose methotrexate therapy may be advised. Alternatively, a dose reduction of methotrexate may be considered.

5. Itraconazole / Ketoconazole (Antifungal Drugs)

• Interaction: Esomeprazole reduces stomach acid production, which can affect the absorption of certain antifungals, like itraconazole and ketoconazole.
• Effect: Decreased absorption of these antifungals, leading to reduced efficacy.
• Management: Take antifungals at a different time of day than Nexpro RD, or consider using a different PPI or alternative antifungals if necessary.

6. Cyclosporine (Immunosuppressant)

• Interaction: Esomeprazole may increase blood levels of cyclosporine, as it inhibits its metabolism.
• Effect: Higher cyclosporine levels can lead to kidney toxicity or other side effects associated with immunosuppression.
• Management: Monitor cyclosporine levels regularly and adjust its dose accordingly.

7. Digoxin (Heart Medication)

• Interaction: Domperidone (the prokinetic agent in Nexpro RD) may increase the absorption of digoxin.
• Effect: Elevated digoxin levels can cause toxicity, leading to heart arrhythmias or other serious effects.
• Management: Monitor digoxin levels regularly and adjust the dose as needed.

8. HIV Protease Inhibitors (e.g., Atazanavir, Lopinavir)

• Interaction: Esomeprazole may reduce the effectiveness of protease inhibitors by decreasing their absorption due to lower stomach acidity.
• Effect: Decreased plasma concentrations of protease inhibitors, leading to reduced antiviral efficacy.
• Management: Avoid combining these drugs with Nexpro RD if possible. If necessary, monitor viral load and consider alternative treatments.

9. Phenytoin (Anti-Seizure Drug)

• Interaction: Esomeprazole can increase blood levels of phenytoin by inhibiting its metabolism.
• Effect: Increased phenytoin levels, leading to the risk of toxicity (e.g., nystagmus, ataxia).
• Management: Regularly monitor phenytoin levels and adjust its dosage accordingly.

10. Antacids or H2-receptor antagonists (e.g., Ranitidine)

• Interaction: Combining Nexpro RD with other acid-reducing drugs may further reduce stomach acidity.
• Effect: This could decrease the effectiveness of Nexpro RD and lead to increased gastric pH.
• Management: Avoid combining Nexpro RD with other PPIs or H2-receptor antagonists. If necessary, adjust the timing between doses to avoid interactions.

11.Antibiotics (e.g., Clarithromycin)

• Interaction: Esomeprazole can increase the blood levels of certain antibiotics like Clarithromycin, which is often used for bacterial infections.
• Effect: This may increase the risk of side effects from the antibiotic, including QT prolongation (a heart rhythm disturbance), especially in individuals with pre-existing heart conditions.
• Management: Monitor for signs of heart problems, including irregular heartbeats. If you are using Clarithromycin or similar antibiotics, the dosage of Esomeprazole may need adjustment. Alternative antibiotics should be considered in some cases.

12.Blood Pressure Medication (e.g., Amlodipine)

• Interaction: Esomeprazole can increase the absorption of Amlodipine (a calcium channel blocker used for controlling blood pressure), potentially increasing its effects.
• Effect: This may lead to excessive lowering of blood pressure, causing symptoms like dizziness, fainting, or light-headedness.
• Management: If you experience symptoms of low blood pressure, consult your healthcare provider. Your doctor may adjust the dosage of Amlodipine or consider a different blood pressure medication.

Drug - Food interaction

Synopsis

More Information

01.Why Choose Nexpro RD 40mg Capsule for GERD and Ulcers?

• Reduces Stomach Acid Production: Nexpro RD works by reducing the production of stomach acid, which is beneficial in managing conditions like GERD, where acid reflux can cause heartburn and irritation of the esophagus, or ulcers, where acid can worsen the condition.
• Heals Ulcers: For gastric and duodenal ulcers, reducing the acid levels helps promote healing by creating a less acidic environment, which can help protect the stomach lining.
• Relieves GERD Symptoms: In GERD, Nexpro RD helps alleviate symptoms such as heartburn, regurgitation, and discomfort by preventing stomach acid from flowing back into the esophagus.
• Effective and Well-Tolerated: Nexpro RD is well-tolerated by many people and has a good safety profile when used as directed for acid-related conditions.
• Long-Lasting Effects: The 40mg dosage of Nexpro RD provides significant relief for up to 24 hours with just one dose per day, making it convenient for patients.

02. Product Comparison

Nexpro RD 40mg Capsule Vs Nexium Capsule

Nexpro RD 40mg Capsule Vs Omez

03. Alternative to Nexpro RD 40mg Capsule:

Nexpro RD 40mg (esomeprazole with domperidone) is commonly prescribed for managing conditions such as gastroesophageal reflux disease (GERD), acid reflux, and certain stomach disorders. I have included some of the top alternative medications for the Nexpro RD 40mg capsule.

1. For GERD and Acid Reflux (Proton Pump Inhibitors & Antacids):

• Omeprazole: A common PPI, works similarly to Nexpro to reduce stomach acid.
• Pantoprazole: Another PPI, often used for similar conditions.
• Lansoprazole: Also a PPI, similar to Nexpro in terms of reducing acid production.
• Rabeprazole: Another proton pump inhibitor, effective in reducing gastric acid.

2. For Nausea and Gastric Motility (Prokinetics):

• Metoclopramide: A prokinetic agent similar to domperidone, it helps in increasing stomach motility and reducing nausea.
• Cisapride: Another prokinetic, though it's less commonly used due to potential side effects.

3. Antacids:

• Ranitidine: Though now less commonly used due to safety concerns, it's an H2 blocker that reduces acid production.
• Antacids like Tums, Mylanta, or Gelusil: Provide immediate relief for acid reflux but do not address long-term acid reduction.

4. Herbal Alternatives:

• Ginger: Known for reducing nausea and improving digestion.
• Chamomile: Can help soothe an irritated stomach.
• Licorice root: Sometimes used to soothe stomach ulcers and esophageal issues.

If you are looking for a specific alternative for your condition, it would be best to consult with your doctor to choose the most appropriate medication or management, as they can vary in effectiveness and safety based on individual health conditions.

FAQs About NEXPRO RD 40MG CAPSULE

References

1. KD. Tripathi. Antiemetic, Prokinetic and Digestant drugs & Drugs for Peptic Ulcer and Gastroesophageal Reflux Disease. Essentials of medical pharmacology. Seventh edition. 2013. Page-666 & 651-653.

2. Keith A. Sharkey and John L. Wallace. Treatment of disorders of bowel motility and water flux; Antiemetics; Agents used in biliary and pancreatic disease and Pharmacotherapy of gastric acidity, peptic ulcer, and gastroesophageal reflux disease. Goodman & Gilman’s: The Pharmacological basics of Therapeutics. 12th Edition. New York McGraw Hill Medical 2011. Page-1326 & 1311-1313.

3. Gerald G. Briggs and Roger K. Freeman. D & E. A reference guide to fetal and neonatal risk: Drugs in Pregnancy and Lactation. Tenth Edition. 2015. Page-1232 & 1427-1431.

4. KY Marakhouski, GA Karaseva, DN Ulasivich and Y Kh Marakhouski. Omeprazole-Domperidone Fixed Dose Combination vs Omeprazole Monotherapy: A Phase 4, Open-Label, Comparative, Parallel Randomized Controlled Study in Mild to Moderate Gastroesophageal Reflux Disease. NIH. National Library of Medicine. National Center for Biotechnology Information. PMC. PubMed Central. May 2017. [Accessed on 24th Feb 2025] 

5. TORRENT PHARMACEUTICALS LTD. IZRA D. Torrentian.com. [Revised in February 2022] [Accessed on 24th Feb 2025] 

6. Cipla Ltd. ESOMAC-D Capsules (Esomeprazole magnesium + Domperidone). Ciplamed. [Revised in April 2020] [Accessed on 24th Feb 2025] 

7. Sun Pharmaceutical Industries Europe B.V., and Terapia SA. Electronic Medicines Compendium (EMC). [Revised in July 2022] [Accessed on 24th Feb 2025] 

8. Vibcare Pharma Pvt Ltd. ESOVIB DSR. [Accessed on 24th Feb 2025] 

Author Details

Written By Dr. Karthikeyan Rajagopal - M.Pharm (Pharmacology)

Reviewed For Accuracy By Dr. Vrushabhakumar Jitendra Shah. - MBBS

Last updated on 26 Feb 2025 | 09:32 AM(IST)