Medicine Overview of Epra Capsule
Side Effects of Epra are Headache, Stomach pain, Nausea, Flatulence, Diarrhoea.
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Epra 20 mg Capsule may be taken with or without food, but it is better to take it at a fixed time.
Epra 20 mg Capsule is a proton pump inhibitor (PPI). It works by reducing the amount of acid in the stomach which helps in relief of acid related indigestion and heartburn.
In Depth Information on Epra Capsule
- Inform your doctor if you get watery diarrhea, fever, or stomach pain that does not go away.
- Inform your doctor if you do not feel better after taking it for 14 days as you may be suffering from some other problem that needs attention.
- Long-term use can cause weak bones and deficiency of minerals such as magnesium. Take adequate dietary intake of calcium and magnesium or their supplements as prescribed by your doctor.
- You have been prescribed Epra 20 mg Capsule to reduce stomach acid and heal stomach ulcers.
- Take it one hour before the meal, preferably in the morning.
- It is a well-tolerated medicine and provides relief for a long time.
Epra Capsule related warnings
WEIGH RISKS VS BENEFITS
Epra 20 mg Capsule may be unsafe to use during pregnancy.
Animal studies have shown adverse effects on the foetus, however, there are limited human studies. The benefits from use in pregnant women may be acceptable despite the risk. Please consult your doctor.
Epra 20 mg Capsule is probably safe to use during lactation.
Limited human data suggests that the drug does not represent a significant risk to the baby.
Do not drive unless you are feeling well.
Epra 20 mg Capsule may cause dizziness and visual disturbances. This may affect your driving ability.
Epra 20 mg Capsule is safe to use in patients with kidney disease. No dose adjustment of Epra 20 mg Capsule is recommended.
Epra 20 mg Capsule should be used with caution in patients with severe liver disease. Dose adjustment of Epra 20 mg Capsule may be needed. Please consult your doctor.
A lower dose may be advised in patients with liver disease and who have to take this medicine for a long time.
If you miss a dose of Epra 20 mg Capsule, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Frequently asked questions about Epra Capsule
Q. Can I take Epra with domperidone?
Epra can be safely taken with domperidone as no harmful effects have been reported clinically. A fixed-dose combination of these two medicines is also available. Domperidone works by increasing the gut motility and Rabeprazole decreases the acid production in the stomach. So, this combination is very effective in the treatment of reflux esophagitis associated with acidity, heartburn, intestinal and stomach ulcers.
Q. What are the various conditions in which the use of Epra is contraindicated?
Use of Epra is contraindicated if you are allergic to this medicine or any other medicine belonging to the same class of drugs. Also, do not take Epra if you are already taking a medicine containing nelfinavir (used for the treatment of HIV infection).
Q. What if I miss my dose of Epra?
If you miss a dose of Epra, take it as soon as you remember and the next dose as scheduled. However, if it is almost the time for your next dose, skip the missed dose and take your next dose and then follow the regular schedule. Do not take double the dose.
Q. Can I take Epra along with oral contraceptive pills (birth control pills)?
Epra can be safely taken with oral contraceptive pills (birth control). They do not affect each other's action and no harmful effects have been seen when they are used together.
Epra belongs to the group of medicines known as proton pump inhibitors (PPIs). This drug decreases the acid production in your stomach and is indicated for the treatment of conditions caused by excess acid secretion in the stomach.
Q. Can Epra cause subacute cutaneous lupus erythematosus?
Epra has been reported to cause subacute cutaneous lupus erythematosus in many studies. Common signs and symptoms of this disease include painful joints, tiredness, weakness, rash, fever, anemia, mouth ulcers, hair loss, and many others and these may get aggravated again and again. Talk to your doctor if you experience these side effects as you may need to discontinue this medicine.
Q. Can I take Epra with ondansetron?
Ondansetron is an anti-emetic medicine which helps in relieving nausea (feeling sick) or vomiting. No harmful effects have been seen when Epra is used with ondansetron. So, these two medicines can be taken together.
Q. Can Epra cause lactose intolerance?
Lactose intolerance has been reported with the use of Epra in some patients. Many Epra preparations contain lactose as an ingredient. This is a digestive problem in which the patient cannot digest lactose, a type of sugar mainly found in milk and dairy products. The patient may complain of symptoms like flatulence (gas), diarrhea, bloating, stomach pain and feeling of being sick (nausea). Read the ingredients mentioned on the pack before taking the medicine.
Q. Can I take Epra with Vitamin E?
Epra can be taken with vitamin E. The combinations seems to have a beneficial effect in terms of better maintenance of moderate to severe esophagitis. However, there are not many studies or reports on this subject. Talk to your doctor for more information on this.
Q. Can I take Epra with levosulpiride?
Epra can be safely taken with levosulpiride as no harmful effects have been reported clinically. A fixed-dose combination of these two medicines is also available. Levosulpiride works by increasing the gut motility and Epra decreases the acid production in the stomach. So, this combination is very effective in the treatment of reflux esophagitis associated with acidity, heartburn, intestinal and stomach ulcers.
Q. Does Epra use increase the risk of clostridium difficile infection?
Use of proton pump inhibitors (PPIs) like Epra may be associated with an increased risk of Clostridium difficile–associated diarrhea (CDAD) as reported in few studies and informed by the US FDA as well. A possibility of CDAD can be there in patients taking PPIs and developed diarrhea that does not improve.
Q. Can Epra be used in cancer patients?
Epra can be taken by cancer patients as prescribed by a doctor. Since cancer patients may also take many other medicines for the primary cancer treatment or for other symptoms and infections, there are chances of drug interactions with Epra.
Q. For how long can Epra be taken?
Take Epra for as long as advised by your doctor. The duration of taking Epra would vary depending on your condition. Do not stop taking this medicine without talking to your doctor.
Q. Can Epra cause calcium deficiency and osteoporosis?
Epra can cause osteoporosis (thinning of bones) as it decreases the calcium absorption leading to calcium deficiency. This leads to an increased risk of bone fractures on long-term use, like hip, wrist or spine fractures. Inform your doctor if you have osteoporosis or if you are taking corticosteroids (these can increase the risk of osteoporosis) before starting your therapy. Take enough calcium and vitamin D to reduce the risk.
Q. What are the rare side effects of Epra?
Rare side effects seen with the use of Epra includes a decrease in white cells or platelets, allergic reactions, problems like blurred vision, wheezing, shortness of breath (bronchospasm), dry mouth, thrush, liver problems like jaundice, hair loss (alopecia), skin rash on exposure to sunshine, joint pains (arthralgia) or muscle pains (myalgia), severe kidney problems (interstitial nephritis), increased sweating and inflammation of the gut causing diarrhoea.
Proton (acid) pumps are found on the stomach mucosa and they are responsible for secreting acid in the stomach. Epra works by blocking this gastric acid pump and this unique mechanism of action helps in decreasing the acid secretion in the stomach.
Q. Does Epra cause hepatitis B and can a patient of hepatitis take Epra?
Epra can rarely cause hepatitis with or without jaundice and very rarely it can lead to hepatic failure and encephalopathy in patients with the underlying liver disease. Epra does not cause hepatitis B or any other viral hepatitis. However, there are studies showing an increased occurrence of hepatic encephalopathy in hepatitis B patients using PPIs. These medicines should be used with caution in patients with the underlying liver disease.
Q. Does Epra increase chromogranin levels?
Use of proton pump inhibitors like Epra has been seen to be associated with an increase in chromogranin levels. This increase in chromogranin levels can be due to the effect of these drugs on enterochromaffin cells and this could also falsely increase the levels in patients with neuroendocrine tumours.
Q. Does Epra cause dementia?
Use of proton pump inhibitors like Epra has been recently linked with the development of dementia in elderly patients. As this risk of developing dementia is not confirmed, talk to your doctor for more information on this effect.
Q. Does Epra cause vitamin deficiencies?
Epra may cause vitamin B12 and vitamin C deficiency. When taken orally, vitamin B12 requires an acidic environment for its absorption from the stomach while Epra causes a decrease the gastric acid secretion. You may need to take vitamin B12 supplements from outside. The clinical significance of the decrease in vitamin C levels is not known, so vitamin C supplementation is not recommended.
Q. Does Epra have an expiry date?
Yes, Epra does expire. Please check the expiry date written on the pack and it refers to the last day of that month. Do not use Epra after the expiry date.
Q. What is the role of Epra before endoscopy in patients with gastrointestinal bleeding?
Epra before endoscopy in patients with gastrointestinal bleeding reduces the need for endoscopic therapy, the rate of post-endoscopy bleeding, and shortens hospital stays. Hence Epra is given before endoscopy in patients with gastrointestinal bleeding.
Q. Are there any withdrawal symptoms associated with the use of Epra?
There are no withdrawal symptoms seen when patients stop using Epra as it has no habit forming tendencies.
Q. Can Epra cause magnesium deficiency?
Epra can cause magnesium deficiency in the blood. Low magnesium levels is a rare side effect seen in patients treated with Epra for at least three months and in most cases after a year of therapy. The patient may have symptoms like tetany, arrhythmias, and seizures and may need to stop this medicine and take magnesium from outside. Magnesium levels should be tested at regular intervals in the patients taking Epra for a long duration.
Q. Is Epra a controlled substance?
Epra is not a controlled substance. It is available when prescribed by a doctor.
Q. Can Epra be used in cardiac patients?
Patients with cardiac disease can take Epra. However, Epra can interact with certain drugs (e.g clopidogrel, digoxin) which might be used by a patient with an underlying cardiac disease. Patients taking Epra and digoxin may need to be monitored for digoxin toxicity. Epra decreases the activation of clopidogrel, thus reducing its effects. Patients taking these medicines together needs to be monitored closely by a doctor.
Q. Can the use of Epra cause iron deficiency?
Use of Epra can cause iron deficiency and a decrease in hemoglobin levels as it decreases the acidic environment of the stomach needed for the absorption of iron. However, there are no recommendations on the regular monitoring of iron levels or taking iron supplements when the patient is taking Epra.
Q. Is Epra a narcotic substance?
Epra is a not a narcotic substance and has not been reported to have any abuse potential. Epra does not get you high and does not cause any addiction as no withdrawal symptoms have been reported when you stop taking this drug.
Q. Is Epra available without a prescription as an over the counter product?
Epra is a prescription medicine and you can buy this drug by providing a doctor's prescription. Epra is not available as an over the counter (OTC) product.
Q. How is Epra metabolised in the body?
Epra is metabolized in the liver by the cytochrome P450 enzymes mainly CYP2C19. There could be an increase in the level of Epra in patients with underlying liver disease because of a decrease in its metabolism. However, the amount of drug does not increase if given once a day.
Q. Can Epra be used in stroke patients?
Epra can be used in stroke patients. There are studies suggesting that proton-pump inhibitors (PPIs) as a class are not associated with an increased short-term risk of recurrent stroke or death among older adults treated with clopidogrel after stroke.
Severely interacts with other drugs like
Taking Epra with any of the following medicines can modify the effect of either of them and cause some undesirable side effects
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