AMALGARD-LSR Capsules

Rabeprazole 20 mg + Levosulpiride 75 mg (Sustained Release)

RABEPRAZOLE Rabeprazole belongs to a class of antisecretory compounds (substituted benzimidazole proton-pump inhibitors) that do not exhibit anticholinergic or histamine H 2 -receptor antagonist properties, but suppress gastric acid secretion by inhibiting the gastric H + /K + ATPase at the secretory surface of the gastric parietal cell. Because this enzyme is regarded as the acid (proton) pump within the parietal cell, rabeprazole has been characterized as a gastric proton pump inhibitor.

Rabeprazole blocks the final step of gastric acid secretion. In gastric parietal cells, rabeprazole is :rotonated, accumulates, and is transformed to an active sulfenamide.

ITOPRIDE HYDROCHLORIDE

Itopride promotes gastrointestinal motility through synergism of its dopamine D 2 -receptor antagonistic action and its acetylcholine esterase-inhibitory action. In addition to these actions, Itopride has an antiemetic action, which is based on its dopamine D 2 -receptor antagonistic action at CTZ.

LEVOSULPIRIDE

Levosulpiride is the levorotatory enantiomer of sulpiride, a substituted benzamide. Levosulpiride is a prokinetic agent which increases the lower esophageal sphincter pressure more rapidly and effectively than other therapeutic agents.

MECHANISM OF ACTION

As a prokinetic:

The prokinetic effect of Levosulpiride is mediated through the blockade of enteric (neuronal and muscular) inhibitory dopamine D2 receptors. Results also show that levosulpiride also acts as a moderate agonist at the 5-HT4 receptor.

The serotonergic (5-HT4) component of levosulpiride may enhance its therapeutic efficacy in gastrointestinal disorders. This property, together with antagonism at D2 receptors, may contribute to Its gastrointestinal prokinetic effect.

As an antiemetic:

The antiemetic effect of levosulpiride is due to inhibition of dopamine transmission and antagonism with D2 receptors of the neurons in the area postrema of the vomiting center (IV ventricle) or chemoreceptor trigger zone in the CNS, blocking the inhibitory effect of dopamine on cholinergic neurons and therefore permitting a sustained cholinergic induced contraction of smooth muscle cell in the myenteric plexus of the esophagus, stomach and intestine.

Indications

AMALGARD-IT / LSR is indicated for relief from:

Symptoms of dysmotility associated with:

i.) Acid peptic disorders
ii.) GERD
iii.) Dyspepsia Chronic gastritis

DOSAGE AND ADMINISTRATION

One capsule once a day.