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EZICO-L is a fixed-dose combination small molecule pharmaceutical developed by ARB Remedies for the treatment of gastroesophageal reflux disease (GERD). It consists of esomeprazole, a proton pump inhibitor (PPI), and levosulpiride, a prokinetic agent. Esomeprazole reduces gastric acid secretion by covalently binding to and irreversibly inhibiting the H+/K+ ATPase enzyme system (the proton pump) in the gastric parietal cells. Levosulpiride acts as a selective antagonist at dopamine D2 and D3 receptors in the gastrointestinal tract, which enhances the release of acetylcholine, thereby increasing lower esophageal sphincter tone and promoting gastric emptying. This dual mechanism addresses both acid overproduction and impaired motility, providing relief from symptoms such as heartburn and regurgitation. The product is approved and marketed in capsule form, typically featuring a sustained-release formulation of levosulpiride.
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