GI Care

Esomeprazole is the S-isomer of omeprazole, a proton pump inhibitor (PPI) that suppresses gastric acid secretion by inhibiting the H+/K+ ATPase enzyme system at the surface of the gastric parietal cells. It acts by irreversibly binding to the proton pump, leading to inhibition of the final step in acid production. 

• Onset of action: Within 1 hour 
• Peak effect: 1–2 hours 
• Duration of action: Up to 24 hours

Coolgi 40 is indicated for: 

• Gastroesophageal Reflux Disease (GERD) 
• Erosive esophagitis 
• Zollinger-Ellison Syndrome 
• Peptic ulcer disease (PUD) 
• H. pylori eradication (as part of triple therapy) 
• NSAID-associated gastric ulcer prevention and healing
  

Adults (Typical Dose): 

• GERD: 20–40 mg once daily for 4–8 weeks 
• Erosive esophagitis: 40 mg once daily for 4–8 weeks 
• Zollinger-Ellison Syndrome: 40 mg twice daily (adjustable) 
• H. pylori eradication: 40 mg twice daily for 10 days (in combination with antibiotics) 
• NSAID ulcers: 20–40 mg once daily 

Administration: Should be taken at least 1 hour before meals. Tablets should be swallowed whole, not crushed or chewed.

General 

• Use with caution in patients with severe hepatic impairment. 
• Long-term use may be associated with vitamin B12 deficiency, hypomagnesemia, and increased risk of osteoporotic fractures.
  

Warnings 

• Clostridium difficile infection risk in hospitalized patients 
• Prolonged use may cause gastric malignancy masking 
• May lead to fundic gland polyps during long-term use 
• Risk of acute interstitial nephritis

Contraindications 

• Known hypersensitivity to esomeprazole, substituted benzimidazoles, or any component of the formulation.
  

Drug Interaction 

• Decreased absorption of drugs like ketoconazole, iron, and atazanavir 
• May interfere with clopidogrel activation (monitor effectiveness) ∙
• ncreases plasma concentration of drugs like diazepam, warfarin, phenytoin 
• Risk of methotrexate toxicity when used concurrently in high doses 
  

• Symptoms: Confusion, drowsiness, blurred vision, tachycardia, nausea. 
• Management: Symptomatic and supportive treatment. No specific antidote. Haemodialysis is unlikely to be effective. ​ 

Treatment: 

• Supportive care and gastric lavage if necessary. 
• Activated charcoal to reduce drug absorption. 
• Electrolyte correction if hypomagnesemia or arrhythmias occur.
  

• Store below 25°C 
• Protect from moisture and light 
• Keep in original packaging until use

Esomeprazole: A proton pump inhibitor (PPI) that irreversibly inhibits the H⁺/K⁺-ATPase enzyme in the gastric parietal cells, reducing gastric acid secretion.
Domperidone: A dopamine D₂ receptor antagonist with prokinetic properties. It enhances gastric motility, accelerates gastric emptying, and reduces nausea and vomiting. 

• Immediate-release (IR) Domperidone (10mg): Provides rapid relief from nausea and dyspepsia. 
• Sustained-release (SR) Domperidone (20mg): Maintains prolonged prokinetic activity to ensure long- lasting gastric emptying effects.

• Gastroesophageal reflux disease (GERD) 
• Dyspepsia (indigestion) 
• Nausea & vomiting due to delayed gastric emptying 
• Erosive esophagitis 
• Peptic ulcer disease (PUD) 
• Non-ulcer dyspepsia
  

General 

• Use with caution in patients with hepatic impairment and moderate to severe renal impairment. 
• Long-term use of PPIs like Esomeprazole may lead to vitamin B12 deficiency and bone fractures due to calcium malabsorption. 
• Domperidone should be used with caution in elderly patients and those at risk of QT prolongation.
  

Warnings 

• Domperidone may increase the risk of cardiac arrhythmias, especially in patients with underlying heart conditions. 
• Long-term Esomeprazole use may cause hypomagnesemia and Clostridium difficile infection. 
• Avoid abrupt discontinuation to prevent acid rebound.
  

Contraindications 

• Hypersensitivity to Esomeprazole, Domperidone, or any excipients. 
• Severe hepatic impairment (Domperidone is extensively metabolized in the liver). 
• Prolonged QT interval or known cardiac arrhythmias. 
• Gastrointestinal bleeding, mechanical obstruction, or perforation.
  

• Store at below 30°C in a cool, dry place. 
• Protect from moisture and direct sunlight. 
• Keep out of reach of children.
  

Sodium Alginate: A natural polysaccharide that reacts with gastric acid to form a viscous gel ("raft"). This raft floats on top of the stomach contents, creating a mechanical barrier to prevent reflux into the oesophagus. 

Sodium Bicarbonate: A fast-acting antacid that neutralizes stomach acid and releases carbon dioxide (CO₂), which helps the raft float. It provides rapid relief from acidity. 

Calcium Carbonate: A potent and longer-acting antacid that neutralizes excess gastric acid. It also strengthens the raft structure and helps maintain a near-neutral gastric pH. 

Together, the combination provides dual action: neutralization of acid and prevention of reflux.

Coolgi Suspension is indicated for the relief and prevention of: 

• Gastroesophageal reflux disease (GERD) 
• Heartburn 
• Acid indigestion 
• Reflux during pregnancy 
• Post-meal acid reflux 
• Hiatal hernia-related symptoms
  

Adults & Children >12 years: 

• 10–20 mL after meals and at bedtime, or as directed by a physician 
• Maximum: 4 doses (80 mL) in 24 hours 
• Shake well before use 

Children 6–12 years (under physician supervision): 

• 5–10 mL after meals and at bedtime

General 

• Use with caution in patients with renal impairment, especially due to calcium and sodium load. 
• Monitor serum calcium and electrolytes in prolonged therapy. 
• Sugar-free formulation is suitable for diabetics. 
• Gluten-free – safe for celiac or gluten-sensitive patients.
  

Warnings 

• Long-term or excessive use may cause alkalosis or hypercalcemia. 
• In patients with a low-salt diet, sodium content should be considered. 
• May interfere with absorption of essential nutrients and other medications.
  

Contraindications 

• Hypersensitivity to any ingredient 
• Severe renal failure 
• Hypercalcemia, nephrolithiasis, or calcium metabolism disorders 
• Hypophosphatemia
  

Drug Interaction 

May reduce absorption of:  

• Tetracyclines 
• Fluoroquinolones 
• Iron supplements 
• Thyroid hormones 
• It is advised to administer other medications 2 hours before or after Coolgi Suspension.
  

• Symptoms: Nausea, vomiting, Confusion, Muscle weakness, Hypercalcemia and alkalosis. 
• Management: Discontinue use, Hydration and electrolyte monitoring, symptomatic and supportive care. ​
  

• ∙Store below 25°C 
• Protect from moisture and light 
• Keep tightly closed and out of reach of children 
• Do not freeze 
• Shake well before use.
  

Norflora Capsule is indicated for: 

• Dysbiosis due to antibiotic use 
• Irritable Bowel Syndrome (IBS) 
• Constipation, bloating, and flatulence 
• Traveler’s diarrhoea or mild gastrointestinal infections 
• General gut health and immune support
  

Adults: 1 capsule daily, preferably with meals or as directed by a healthcare professional. Suitable for long-term use

General 

• Use under medical supervision, especially in immunocompromised patients 
• Safe for daily use and suitable for vegetarians 

Warnings 

• Do not exceed the recommended dose 
• In case of persistent GI symptoms, consult a physician 

Contraindications 

• Hypersensitivity to any component of the formulation 
• Severe immunocompromised conditions (e.g., neutropenia) without medical advice 

• No major drug interactions 
• Safe to take alongside antibiotics (preferably with a time gap of 2 hours)

Drug Interaction 

• No major drug interactions 
• Safe to take alongside antibiotics (preferably with a time gap of 2 hours)
  

• No known risk of toxicity or overdose 
• Excessive use may cause mild GI discomfort due to prebiotic fiber
  

• Store in a cool, dry place below 25°C 
• Do not refrigerate unless specified 
• Protect from direct sunlight and moisture
• Keep out of reach of children