How long to take omez without a break. Omeprazole capsules - instructions for use

H + -K + -ATPase inhibitor. Antiulcer drug

Active substance

Release form, composition and packaging

Capsules gelatinous, with a white body and a yellow lid; the contents of the capsules are spherical microgranules, coated, white or white with a creamy tint.

10 pieces. - cellular contour packings (3) - packs of cardboard.

pharmachologic effect

Omeprazole is an antiulcer drug, an inhibitor of the enzyme H + /K + -adenosine triphosphate (ATP) -phase. Inhibits the activity of H + / K + - adenosine triphosphate (ATP-phase (H + / K + -adenosine triphosphate (ATP) -phase, it is also a "proton pump" or "proton pump") in the parietal cells of the stomach, thereby blocking the transfer of ions hydrogen and the final stage of the synthesis of hydrochloric acid in the stomach.Omeprazole is a prodrug.In the acidic environment of the tubules of parietal cells, omeprazole is converted to the active metabolite sulfenamide, which inhibits the membrane H + / K + - adenosine triphosphate (ATP) -phase, connecting to it due to the disulfide bridge This explains the high selectivity of the action of omeprazole specifically on parietal cells, where there is a medium for the formation of sulfenamide.Biotransformation of omeprazole into sulfenamide occurs quickly (after 2-4 minutes).Sulfenamide is a cation and is not absorbed.

Omeprazole suppresses basal and stimulated by any stimulus secretion of hydrochloric acid at the final stage. Reduces the total volume of gastric secretion and inhibits the release of pepsin. Omeprazole has a gastroprotective activity, the mechanism of which is not clear. It does not affect the production of the internal factor of Castle and the rate of transition of the food mass from the stomach to the duodenum. Omeprazole does not act on acetylcholine and histamine receptors.

Omeprazole capsules contain coated microgranules, gradual release and onset of action of omeprazole begins 1 hour after ingestion, reaches a maximum after 2 hours, persists for 24 hours or more. Inhibition of 50% of maximum secretion after a single dose of 20 mg of the drug lasts 24 hours.

A single dose per day provides a rapid and effective inhibition of day and night gastric secretion, reaching its maximum after 4 days of treatment. In patients with duodenal ulcer, taking 20 mg of omeprazole maintains pH=3 inside the stomach for 17 hours. After stopping the drug, secretory activity is completely restored after 3-5 days.

Pharmacokinetics

Absorption is high. Bioavailability of 30-40% (with liver failure increases to almost 100%), increases in the elderly and in patients with impaired liver function, renal failure has no effect. TC max - 0.5-3.5 hours.

Possessing high lipophilicity, it easily penetrates into the parietal cells of the stomach. Communication with proteins - 90-95% (albumin and acid alpha 1-glycoprotein).

T 1/2 - 0.5-1 h (with liver failure - 3 h), clearance - 500-600 ml / min. Almost completely metabolized in the liver with the participation of the CYP2C19 enzyme system, with the formation of 6 pharmacologically inactive metabolites (hydroxyomeprazole, sulfide and sulfonic derivatives, etc.). It is an inhibitor of the CYP2C19 isoenzyme. Excretion by the kidneys (70-80%) and bile (20-30%) as metabolites.

In chronic renal failure, excretion decreases in proportion to the decrease in creatine clearance. In elderly patients, excretion is reduced.

Indications

- peptic ulcer of the stomach and duodenum (in the acute phase and anti-relapse treatment), incl. associated with Helicobacter pylori (as part of combination therapy);

- reflux esophagitis (including erosive).

- hypersecretory conditions (Zollinger-Ellison syndrome, stress ulcers of the gastrointestinal tract, polyendocrine adenomatosis, systemic mastocytosis);

- gastropathy caused by taking non-steroidal anti-inflammatory drugs.

Contraindications

- childhood;

- pregnancy;

- lactation period;

- hypersensitivity.

FROM caution: renal and / or liver failure.

Dosage

Inside, capsules are usually taken in the morning, without chewing, with a small amount of water (just before meals).

At exacerbation of peptic ulcer, reflux esophagitis and gastropathy caused by NSAIDs- 20 mg 1 time per day. For patients with severe reflux esophagitis, the dose is increased to 40 mg 1 time per day. The course of treatment for duodenal ulcer - 2-4 weeks, if necessary - 4-5 weeks; with gastric ulcer, with reflux esophagitis, with erosive and ulcerative lesions of the gastrointestinal tract caused by taking NSAIDs - within 4-8 weeks.

Reducing the symptoms of the disease and scarring of the ulcer in most cases occurs within 2 weeks. Patients who do not have complete scarring of the ulcer after a two-week course should continue treatment for another 2 weeks.

Patients resistant to treatment with other antiulcer drugs are prescribed 40 mg per day. The course of treatment for duodenal ulcer - 4 weeks, for gastric ulcer and reflux esophagitis - 8 weeks.

At Zollinger-Elisson syndrome- usually 60 mg once a day; if necessary, the dose is increased to 80-120 mg / day (the dose is divided into 2 doses).

For prevention of recurrence of peptic ulcer- 10 mg 1 time per day.

For eradication of Helicobacter pylori use "triple" therapy (for 1 week: omeprazole 20 mg, 1 g, clarithromycin 500 mg - 2 times a day; or omeprazole 20 mg, clarithromycin 250 mg, metronidazole 400 mg - 2 times a day; or omeprazole 40 mg 1 time per day, amoxicillin 500 mg and 400 mg - 3 times a day)
or "double" therapy (for 2 weeks: omeprazole 20-40 mg and amoxicillin 750 mg - 2 times a day or omeprazole 40 mg - 1 time per day and 500 mg - 3 times a day or amoxicillin 0.75-1.5 g - 2 times a day).

At liver failure appoint 10-20 mg 1 time per day (with severe liver failure, the daily dose should not exceed 20 mg); at kidney dysfunction and at elderly patients correction of the dosing regimen is not required.

Side effects

From the side of the digestive system: diarrhea or constipation, abdominal pain, nausea, vomiting, flatulence; in rare cases - increased activity of liver enzymes, taste disturbances, in some cases - dry mouth, stomatitis, in patients with previous severe liver disease - hepatitis (including jaundice), impaired liver function.

From the nervous system: in patients with severe concomitant somatic diseases - headache, dizziness, agitation, depression, in patients with previous severe liver disease - encephalopathy.

From the musculoskeletal system: in some cases - arthralgia, myasthenia gravis, myalgia.

From the hematopoietic system: in some cases - leukopenia, thrombocytopenia, agranulocytosis, pancytopenia.

From the side of the skin: rarely - skin rash and / or itching, in some cases, photosensitivity, erythema multiforme exudative, alopecia.

Allergic reactions: urticaria, angioedema, fever, bronchospasm, interstitial nephritis and anaphylactic shock.

Others: rarely - visual disturbances, malaise, peripheral edema, increased sweating, gynecomastia, the formation of gastric glandular cysts during long-term treatment (a consequence of inhibition of hydrochloric acid secretion, is benign, reversible).

Overdose

Symptoms: confusion, blurred vision, drowsiness, dry mouth, nausea, tachycardia, arrhythmia, headache.

Treatment: symptomatic. Hemodialysis is not effective enough. There is no specific antidote.

drug interaction

May reduce the absorption of esters, iron salts, itraconazole and ketoconazole (omeprazole increases the pH of the stomach).

Being inhibitors of cytochrome P450, it can increase the concentration and reduce the excretion of diazepam, indirect action, phenytoin (drugs that are metabolized in the liver through cytochrome CYP2C19), which in some cases may require a reduction in the doses of these drugs. May increase plasma concentrations of clarithromycin.

Instructions for the use of omeprazole capsules, a description of the action of the drug, indications for the use of omeprazole capsules, interaction with other drugs, the use of omeprazole (capsules) during pregnancy. Instructions: ;

Instruction content:

Composition of omeprazole capsules

One capsule contains

Bir capsuleany ishinde

The active ingredient in omeprazole

omeprazole 20.00 mg (as omeprazole pellet 8.5%)

20.00 mg omeprazole (8.5% omeprazole pellets turinde)

Excipients in omeprazole

mannitol (E 421), disodium hydrogen phosphate, calcium carbonate, sodium lauryl sulfate, sucrose, hydroxypropyl methylcellulose, copolymer of methacrylic acid and ethyl acrylate (1:1), 30% dispersion (Eudragit L30D), capsule shell composition: titanium dioxide (E 171) , gelatin

mannitol (E 421), disodium hydrophosphates, calcium carbonates, sodium lauryl sulfates, sucrose, hydroxypropyl methylcellulose, methacryl kyshkylymen ethyl acrylate copolymer (1:1), 30% dispersion (Eudragit L30D), capsule of kabygynyn kuramy: titanium gelatin (E 171

Indications for use of omeprazole capsules

• treatment and prevention of recurrence of peptic ulcer of the stomach and duodenum

• eradication of Helicobacter pylori (H. pylori) in peptic ulcer disease in combination with appropriate antibiotics

• treatment and prevention of NSAID-associated peptic ulcer of the stomach and duodenum in patients at risk

• reflux esophagitis treatment

• long-term prevention of relapse in patients with cured reflux esophagitis

• treatment of symptomatic gastroesophageal reflux disease

• treatment of Zollinger-Ellison syndrome

• askazan zhane he ekі elі іshektіn oyyk zharaly aurularyn emdeude zhane kaitalanuynyn aldyn aluda

• oyyk zharaly aurularda tiistі antibioticthermen bіrіktіrіlіmderde Helicobacter pylori (H. pylori) eradication

• kauip tobyndagy emdelushilerdegi ҚҚSD –astaskan askazan zhane he ekі eli іshektin oyyқ zharaly aurularyn emdeude zhane aldyn aluda

• reflux esophagitis emdeude

• reflux esophagitis emdelgen emdelushіlerdegi kaitalanuynyn ұzaқ merzіmdi aldyn aluda

• symptomatic gastroesophageal reflux aurular emdeude

• Zollinger-Ellison Syndrome in Emdeude

Contraindications for omeprazole capsules

• hypersensitivity to omeprazole, components of the drug

• pregnancy and lactation

• children and adolescents up to 18 years of age

• neoplasms of the gastrointestinal tract

• hereditary fructose intolerance or glucose-galactose malabsorption or sucrose-isomaltase deficiency

• concomitant use with nelfinavir and / or atazanavir

Carefully: renal and / or liver failure.

• omeprazole, the drug component of the drug zhogary sezimtaldyk

• zhuktilik zhane lactation kezen

• 18 zhaska deyingі balalar

• askazan-ishek zholdarynyn zhana tuzіlіmi

• tukym kualaityn fructose zhakpaushylygy nemese glucose-galactose malabsorption nemese sucrose-isomaltase zhetkіlіksіzdіgі

• nelfinavirmen zhane/nemese atazanavirmen bir mezgіlde koldanyluy

Saktykpen: bүyrek zhane/nemese bauyr zhetkіlіksіzdіgі.

Side effects of omeprazole capsules

Adverse reactions according to the frequency of development are classified as follows: very often ≥1/10, often from ≥1/100 to<1/10, нечасто от ≥1/1000 до <1/100, редко от ≥ 1/10000 до < 1/1000, очень редко < 1/10000, не-известно (по имеющимся на сегодняшний момент данным частота не может быть определена).

Often:

• headache

• abdominal pain, constipation, diarrhea, flatulence, nausea, vomiting

infrequently:

• dizziness, paresthesia, drowsiness, insomnia

• increased activity of liver enzymes

• dermatitis, itching, rash, urticaria

• fractures of the hip, wrist, spine

• discomfort, peripheral edema

rarely:

• leukopenia, thrombocytopenia

• hypersensitivity reactions (fever, angioedema, anaphylactic reactions/shock)

• hyponatremia

• agitation, confusion, depression

• distortion of taste sensations

• blurred vision

• bronchospasm

• dry mouth, stomatitis. candidiasis of the gastrointestinal tract

• hepatitis with or without jaundice

• alopecia, photosensitivity

• arthralgia, myalgia

• interstitial nephritis

• excessive sweating

very rarely:

• agranulocytosis, pancytopenia

• aggression, hallucinations

• liver dysfunction, hepatic encephalopathy (in patients with pre-existing liver disease)

• erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis

• muscle weakness

• gynecomastia

unknown:

• colitis

Zhagymsyz reactionary to the lady zhiіlіgі boyinsha tömendegіshe zhіkteledі: өte zhiі ≥1/10, zhiі ≥1/100-den<1/10 дейін, жиі емес ≥1/1000-ден <1/100 дейін, сирек ≥ 1/10000-ден < 1/1000 дейін, өте сирек < 1/10000, белгісіз (қазіргі кезде қолда бар деректер бойынша жиілігі анықталуы мүмкін емес).

• bass auiruy

• ishtin auyruy, ish katuy, diarrhea, flatulence, zhurek ainuy, kusu

living time:

• bass ainaluy, paresthesia, ұyқyshyldyқ, ұykysyzdyқ

• bauyr fermenterinin belsendіlіginіn artuy

• dermatitis, kyshynu, börtpe, esekzhem

• sannyn, bilektin, omyrtkanyn sons

• zhaysyzdyk, shetkergі isinuler

Sirek:

• leukopenia, thrombocytopenia

• asa zhogary sezimtaldyk reactionary (kyzba, angioneuroticalyk isinu, anaphylactical reactionary/shock)

• hyponatremia

• kozu, sananyn shatasuy, depression

• däm sezudin burmalanuy

• anyқ kormeu

• bronchus tuyilui

• auyz kurgauy, stomatitis, askazan-ishek zholdarynyn candidiasis

• sargayuy bar nemese sargayusyz hepatitis

• alopecia, photosensitivity

• arthralgia, myalgia

• interstitial nephritis

• zhogary tershendik

өte sirek:

• agranulocytosis, pancytopenia

• aggression, elesteuler

• bauyr funktionsynyn buzyluy, bauyr encephalopathy (burynnan bauyr auruy bar emdelushilerde)

• erythema multiformals, Stevens-Johnson syndromes, epidermal necrolysis

• bұlshyқet әlsіzdіgі

• gynecomastia

Belgian:

• hypomagnesemia, hypocalcemia, hypokalemia

• colitis

Special instructions for use

Before starting treatment with the drug, the presence of a malignant tumor of the stomach should be excluded, since treatment can mask its symptoms and delay the establishment of a correct diagnosis.

In patients with severe hepatic impairment during treatment with omeprazole, the level of liver enzymes in the blood plasma should be regularly monitored and, if their levels increase, the drug should be discontinued. In patients with impaired liver function, the recommended daily dose should not exceed 20 mg.

For eradication of Helicobacter pylori, it is prescribed in combination with antibiotics, metronidazole, bismuth preparations and other drugs.

The diagnosis of reflux esophagitis must be confirmed endoscopically. Omeprazole for the long-term treatment of reflux esophagitis should be used only in patients with a tendency to frequent relapses of the disease, as well as in those in whom prevention by separate courses is not effective.

There have been reports of the development of symptomatic and asymptomatic hypomagnesemia in patients taking proton pump inhibitors for at least 3 months, in most cases after 1 year of therapy. Serious side effects include tetany, arrhythmias, and seizures. Most patients required magnesium salts and discontinuation of proton pump inhibitors.

Patients contemplating long-term use of proton pump inhibitors or concomitant use of digoxin or other medicinal products that may cause magnesium depletion (eg, diuretics) should have their serum magnesium levels determined prior to initiation of proton pump inhibitors and periodically during use. .

Research data suggest that the use of proton pump inhibitors (PPIs) may be associated with an increased risk of hip, wrist, and spine fractures. The risk of fractures was increased in patients who received high-dose PPIs (multiple daily doses) and/or long-term therapy (one year or more). It is recommended to take PPIs in the minimum therapeutic dosage, in accordance with the indications for use, the duration of the course of therapy should be minimal. Patients at risk of fracture should be treated according to approved guidelines.

Impact on lab data

When taking Omeprazole, an increase in the concentration of chromogranin A (CgA) is possible. Elevated levels of CgA may affect the results of examinations to detect neuroendocrine tumors. To prevent this effect, treatment with omeprazole should be temporarily suspended five days before CgA measurements.

Treatment with proton pump inhibitors may lead to a slight increase in the risk of gastrointestinal infections caused by Salmonella spp. and Campylobacter spp.

As with all long-term treatment regimens, especially when the treatment period exceeds 1 year, patients should be under regular medical supervision.

Application in pediatrics

Due to insufficient knowledge of the safety and efficacy of omeprazole in pediatric practice, it is recommended to refrain from prescribing it in childhood.

Use during pregnancy and lactation

Due to insufficient knowledge of the safety and efficacy of omeprazole for pregnant and lactating women, the use of omeprazole during pregnancy and lactation is not indicated.

Features of the influence of the drug on the ability to drive vehicles or potentially dangerous mechanisms
Omeprazole in therapeutic doses does not affect the speed of psychomotor reactions and concentration. However, given the possibility of adverse reactions such as dizziness and blurred vision, patients should be careful when driving or operating potentially dangerous machinery.

Preparation I eat bastaganga deyin askazannyn katerlі іsіgі baryn zhokқa shygaru kerek, өytkenі I eat onyn symptomdaryn bүrkemeleuі mүmkіn zhane dұrys diagnosis of anyқtaudy keyinge қaldyruy mүmkіn.

Bauyr funktsiyasynyn auyr bұzyluy bar emdelushіlerde omeprazolmen em uақytynda қan plazmasyndaғы bauyr fermenterіnің deңgeyіn ұdayy baқylau kerek zhane olardyң deңgeyі joғarylaganda preparaty toқтаtu kerek.

Bauyr funktsiyasy bұzyluy bar emdelushіlerde ұsynylatyn tauliktik dose of 20 mg aspauy tiіs.

Helicobacter pylori eradication ushіn antibioticthermen, metronidazolemen, bismuth drug tarymen zhane baska da darilik zattarmen keshende taғayyndaydy.

Reflux esophagitis endoscopy diagnoses turde rastaluy tiіs. Omeprazole preparations for reflux-esophagitis ұzak merzіmdі emdeu үshіn tek aurudyn zhiі kaytalanuyna beyim emdelushіlerde ғana, sonday-ak aldyn alu kurstary tiіmsіz bulgan adamdarda ғana paidalanu kerek.

Protondyk pompanyn tezhegishterin en kemi 3 ai kabyldagan, köp zhagdaylarda 1 zhyl emnen keyingі emdelushіlerde symptomatically zhane asymptomatic hypomagnesemia of damygany turaly khabarlamalar alyndy.

Kurdeli zhagymsyz әserlerge tetany, arrhythmia, құrysular zhatady. Emdelushilerdin kobine magnesium tuzyn engizu zhane protondyk pompanyn tezhegishterin koldanudy toktatu talap etildi.

Протондық помпаның тежегіштерін ұзақ уақыт қолдану, дигоксинді немесе магний құрамының төмендеуін туындататын басқа дәрілік заттарды (мысалы, диуретиктерді) бірге қолдану жоспарланған емделушілерге протондық помпаның тежегіштерін қолдануды бастағанға дейін және қолдану кезінде ауық-ауық қан сарысуындағы магний концентрациясын анықтау керек.

Bül zertteuler protondyk pompanyn tezhegishterin (PPT) koldanudyn sannyn, bileziktinңғ omyrtkanyn sons of tuyndau kaupі zhogarylauymen baylanysty boluy mүmkіndіgіn ayғaktaydy. PPT zhogary dozalarda (kөp ret kүn sayyn) zhane/nemese ұzaқ uaқyttyқ emde (bіr zhyl zhәne odan astam) қabyldaғan emdelushіlerde synyқ tuyndau қаupі zhogarylagan. PPT en tömen emdіk dozalauda körsetіlіmіne saikes kabyldaudy zhuzege asyru kerek, emdeu kursynyn ұzaқtygy en az boluy tiіs. Synyktar tuyndau kaupі bar emdelushіlerdi bekіtіlgen ұsynystarғa sәykes emdeu kerek.

Zerthanalyk zertteuler derekterіne aseri

Omeprazole kabyldagananda chromogranin A (CgA) concentrations of artuy mumkin. CgА Bul аserdі boldyrmau ushіn omeprazolmen em CgA өlsherdin aldynda bes kүn bұryn uaқytsha toқtatyluy tiііs.

Protondyk pump tezhegishterimen emdeu Salmonella spp. not Campylobacter spp. bacteriumarynan tuyndagan askazan-ishek zhұkpalarynyn tuyndau kaupinin eleuli artuyna alyp kelui mүmkin

Emnin barlyk ұzak merzіmdі rezhimderіndegi siyaқty, аsіrese emdeu kezenіn 1 zhylғa deiіn arttyrganda, emdelushіler darіgerdin ұdayy baқylauynda boluy tiіs.

Pediatrics koldanyluy

Pediatricians tazhiribede omeprazoldyn kauipsizdigі men tiimdіlіgіnіn zhetkіlіksіz zertteluіne baylanysty ony balalyk zhasta tagayyndaudan bas tartu kerek.

Zhuktilik zhane lactation kezende koldanyluy

Zhuktі zhane bala emіzetіn аyelderde omeprazoldyң kauіpsіzdіgі men tiііmdіlіgіnіn zhetkіlіksіz zertteluіne baylanysty, Omeprazole preparations zhuktіlik zhаne lactation kezenіnde қoldanu kөrsetіlmegen.

Dаrіlіk zattyn kөlіk құralyn nemese қauіptіlіgі zor mechanism derdi baskaru kabіletіne аser etu erekshelіkterі

Omeprazole emdik dozalarynda psychomotorly reactional zhyldamdygy men zeyin shogyrlandyruga aser etpeydi. Alaida bas ainaluy zhane kөrudіn bұzyluy siyaқty zhagymsyz reactionlardyң tuyndau mүmkіndіgіn eskere otyryp, emdelushіler avtokolіk basқarganda nemese қauiptіlіgі zor mechanismdermen zhұmys іstegende sakerek.

Dosage and method of application

Treatment of duodenal ulcer

The recommended dose for patients with an exacerbation of duodenal ulcer is 20 mg once daily. In most patients with duodenal ulcer, the ulcer heals within 2 weeks, but some patients may need an additional 2-week course of treatment for ulcers to heal. For patients with duodenal ulcer resistant to other treatments, a daily dose of 40 mg is recommended for 4 weeks.

Prevention of recurrence of duodenal ulcer

For the prevention of recurrence of duodenal ulcer in patients with poor healing, it is recommended to prescribe 20 mg of the drug 1 time per day. In some patients, a daily dose of 10 mg may be sufficient. If necessary, the dose can be increased to 40 mg.

Treatment of gastric ulcer

The recommended dose for patients with gastric ulcer is 20 mg once daily. Most patients with gastric ulcers heal within 4 weeks, but some patients may need an additional 4 weeks of treatment for the ulcer to heal. Patients with poor healing of the ulcer are recommended to prescribe 40 mg of the drug once a day and healing is usually achieved within eight weeks.

Prevention of recurrence of gastric ulcer

For the prevention of recurrence of gastric ulcer in patients with poor healing, it is recommended to prescribe 20 mg of the drug 1 time per day. If necessary, the dose can be increased to 40 mg 1 time per day.

H. pylori eradication in peptic ulcer disease

For the eradication of Helicobacter pylori for a particular patient, the choice of antibiotics should be made in accordance with national, regional and local resistance data and treatment principles.

• Omeprazole 20 mg + clarithromycin 500 mg + amoxicillin 1000 mg twice daily for 1 week, or

• Omeprazole 20 mg + clarithromycin 250 mg (alternatively 500 mg) + metronidazole 400 mg (or 500 mg or tinidazole 500 mg) twice daily for 1 week, or

• Omeprazole 40 mg once daily with amoxicillin 500 mg and metronidazole 400 mg (or 500 mg or tinidazole 500 mg), both 3 times daily for 1 week.

Treatment of NSAIDs - associated peptic ulcer of the stomach and duodenum

For the treatment of NSAIDs - associated peptic ulcer of the stomach and duodenum, the recommended dose is 20 mg 1 time per day. Most patients heal within 4 weeks, but some patients may require an additional 4-week treatment for the ulcer to heal.

Prevention of NSAID-associated peptic ulcer of the stomach and duodenum

For the prevention of NSAID-associated peptic ulcer of the stomach and duodenum in patients at risk (persons over 60 years of age, people who have had peptic ulcer of the stomach and duodenum, gastrointestinal bleeding), the recommended dose is 20 mg once a day.

Treatment of reflux esophagitis

Long-term relapse prevention in patients with cured reflux esophagitis

Treatment of symptomatic gastroesophageal reflux disease

The recommended dose is 20 mg per day. Patients may respond adequately to a dose of 10 mg daily, therefore individual dosage needs to be re-evaluated. If symptoms do not disappear after 4 weeks of treatment with Omeprazole 20 mg daily, then an additional examination of the patient should be carried out.

Treatment of Zollinger-Ellison Syndrome

The dose is selected individually. The recommended starting dose is 60 mg per day. The condition of more than 90% of patients with severe disease and with insufficient response to other types of therapy was successfully stabilized when used at a dose of 20-120 mg / day. If there is a need to use doses exceeding 80 mg / day, the daily dose should be divided into 2 doses. Duration of treatment - according to clinical indications.

Dosage in special populations

Impaired kidney function

In patients with impaired renal function, dose adjustment is not required.

Impaired liver function

Old age (> 65 years old)

In the elderly, dose adjustment is not required.

Do not chew or crush capsules.

Patients with difficulty swallowing who can drink or swallow only semi-solid foods may open the capsule and swallow the contents with half a glass of water, or mix it with a slightly acidic liquid (such as fruit juice or applesauce, or still water). This mixture should be taken immediately (or within 30 minutes) and always mixed before taking, then drink half a glass of water.

Alternatively, patients can suck on the capsules and swallow the pellets with half a glass of water. Do not chew pellets.

He ekі eli іshektіn oyyk zharaly aurularyn emdeu

He ekі elі іshektіn oyyk zharaly aurularynyn askynuy bar emdelushіler үshin ұsynylatyn dose of kүnіne bir ret 20 mg құraida. He is eki ekhkutіkitіyki aurulay aurulars bar Emdelashіyledi Kөbynde oyyk Zharanya Zhazyluy 2 Apta izhinde Zhredi, birak Kaybir Emdelashіler үyyk Zhisymshah 2 Aptions He ekі elі іshektіn oyyk zharasy emnіn baska аdіsterіne resistentі emdelushіler ushіn 4 apta boyina kүn saiyn 40 mg kabyldau ұsynylady.

He ekі elі іshektіn oyyk zharaly aurularynyn kaytalanuynyn aldyn alu

Zhazyluy nashar naukastarda he ekі elі іshektіn oyyk zharaly aurularynyn kaitalanuynyn aldyn alu ushіn 20 mg preparation kүnіne 1 retten tagayyndau usynylody. Keibir emdelushilerde 10 mg tauliktik dose of zhetkіlіktі bolus mүmkin. It seems that the Bulgarians were dosed with 40 mg of deyin ulgaytuga bolada.

Askazannyn oyyk heat auruyn emdeu

Askazannyn oyyk heat aura bar emdelushiler ushіn ұsynylatyn dose kүnіne 1 ret 20 mg құraida. Askazannyn oyyk heat of the aura bar emdelushіlerdіn kobіnde zhazyla bastau 4 apta ishіnde zhuredi, biraq keibir emdelushіlerge oyyk heat zhazyluy үshin preparatpen kosymsha 4 aptalyқ emdeu courses kazhet bolukі. Oyyk zharasynyn zhazyluy nashar naukastarda 40 mg preparations kүnine 1 ret taғayyndau ұsynylady zhane zhazyl bastauyna adette segіz apta ishіnde қol zhetkіzіledі.

Askazan oyyk zharaly aurularynyn kaitaluynyn aldyn alu

Zhazyluy nashar naukastarda askazan oyyk zharaly aurularynyn kaitalanuynyn aldyn alu ushin 20 mg preparation kunine 1 ret tagaiyndau kerek. It seems that Bolganda was dosed with kunine 1 ret 40 mg of deyin arttyruga bolada.

Oyyk zharaly aurulardagy H. pylori eradication

Naқty bіr emdelushіlerdegi Helicobacter pylori eradikatsiyasy үshіn emdeudің resistentіlіgі zhane ұstanymdary boyinsha ұlttyқ, aimaktyқ zhane zhergіlіktі derekterge seykes antibioticterdi taңdaudy zhүrgizu kerek.

• Omeprazole 20 mg + clarithromycin 500 mg + amoxicillin 1000 mg

• Omeprazole 20 mg + clarithromycin 250 mg (alternative turde 500 mg) + metronidazole 400 mg (nemese 500 mg nemese tinidazole 500 mg), 1 apta boyina kunine 2 ret, nemese

• Omeprazole 40 mg kunine 1 ret 500 mg amoxicillinmen zhane 400 mg metronidazolemen (Nemese 500 mg Nemse tinidazole 500 mg), ekeuinde de 1 apta boyina kunine 3 ret.

ҚҚSD –astaskan askazan zhane he ekі eli іshektіn oyyk zharaly aurularyn emdeu

ҚҚSD –astaskan askazan zhane he ekі elі іshektіn oyyk zharaly aurularyn emdeu үshin ұsynylatyn dose kүnіne 1 ret 20 mg құraydy. Emdelushilerdіn kobіnde zhazyla bastau 4 apta іshіnde zhүredі, birak keibіr emdelushіlerge oyyk heat zhazyluy үshin preparatpen kosymsha 4 aptalyқ emdeu courses kazhet boluy mukіn.

ҚҚSD –astaskan askazan zhane he ekі eli іshektіn oyyk zharaly aurularynyn aldyn alu

Қауіп тобындағы емделушілердегі (60 жастан асқан адамдар, асқазан және он екі елі ішектің ойық жаралы ауруларын, гастроинтестинальді қан кетулерді өткерген адамдар) ҚҚСД –астасқан асқазан және он екі елі ішектің ойық жаралы ауруларының алдын алу үшін ұсынылатын доза күніне бір рет 20 мг құрайды.

Reflux esophagitis emdeu

Ұsynylatyn dose kүnіne bіr ret 20 mg kuraida. Emdelushilerdіn kobіnde zhazyla bastau 4 apta іshіnde zhүredі, birak keibіr emdelushіlerge oyyk heat zhazyluy үshin preparatpen kosymsha 4 aptalyқ emdeu courses kazhet boluy mukіn. Auyr esophagitis bar naukastarga kүnіne bir ret 40 mg preparation tagaiyndau usynylody, zhaziluyna adette segіz apta ishinde kol zhetkіzіledі.

Reflux esophagitis bar emdelushilerde kaitalanudyn ұzak merzіmdi aldyn alu

Emdelgen reflux esophagitis bar emdelushilerdi emdeu ushіn ұsynylatyn dose kүnіne 1 ret 10 mg kabyldagananda zheke taңdalada. It seems that the Bolganda is dosed with kunine 1 ret 20-40 mg of deyin arttyruga bolada.

Symptoms of gastroesophageal reflux aurulardy emdeu

Ұsynylatyn dose kүnіne 20 mg құrayda. Emdelushiler kүn saiyngy 10 mg dose talapka sai reaction beruі mүmkin, tiіsіnshe zheke dozany kaita karau kerek. Eger symptomdar Omeprazole preparations 20 mg kүn saiyngy emnin 4 aptasynan keyin zhoyylmasa, onda emdelushіge kosymsha zertteuler zhurgizu kerek.

Zollinger-Ellison syndromes in emdeu

Dozany zheke tandaydy. Ұsynylatyn bastapky dose kүnіne 60 mg құraida. Aurudyn auyr tүri bar zhane emnіn baska tүrіne reactionalary zhetkіlіksіz 90% astam nauқastardyn zhai-kuyi taulіgіne 20-120 mg dose of coldananda zhaқsy tұraқtanғan. Taulіgіne 80 mg asatyn dose of coldanu қazhettigі bolsa, taulіktіk dosed 2 ret kabyldauғa bөlu kerek. Emnin ұzaқtygy -clinical kөrsetіlіmder boyinsha.

Turgyndardyn arnayy toptarynyn dozalary

Buyrek function son buzyluy

Buyrek is a function of synyn buzyluy bar emdelushilerde dose tuzetu talap etilmeydi.

Bauyr function son buzyluy

Bauyr funktsiyasynyn buzyluy bar emdelushіlerde ұsynylatyn tәuliktik dose of 10-20 mg kuraida.

Where is zhas (> 65 zhas)

Where zhastagy adamdard dose tuzetu talap etilmeydi.

Қoldanu tаsіlі

Ishke. Capsulans tanerten, durysy tamaққa deyin tұtas zhұtyp, staқan sudyn zhartysymen іshe otyryp, kabyldau kerek.

Capsulans of shainamaida zhane ұsaktamaida.

Тек жартылай қатты тамақты ғана ішіп немесе жұта алатын, жұтуы қиын емделушілер капсуланы ашып және оның ішіндегісін жарты стақан сумен немесе оны қышқылдығы әлсіз сұйықтықпен араластырып, іше отырып жұтуына болады (мысалы, жеміс шырынымен немесе алма езбесімен, немесе газдалмаған сумен). Bundai kospalardy dereu kabyldau kerek (nemesse 30 minutes ishinde) zhane barlyk uakytta kabyldar aldynda aralastyru kerek zhane zharty staқan sumen ishu kerek.

Emdelushiler balamaly turde capsulans soruyna zhane jarty staқan sumen pelletterdi zhutuyna bolada. Pelletterdi shainauga bolmaida.

Drug Interactions

Preparations with pH-dependent absorption.

The decrease in intragastric acidity during treatment with omeprazole may increase or decrease the absorption of some drugs with pH-dependent absorption.

With the simultaneous use of the drug Omeprazole with ketoconazole, itraconazole, ampicillin, vitamin B12 or iron, the absorption of these drugs is reduced.

Caution should be exercised while using the drug Omeprazole with certain drugs.

Carbamazepine: Omeprazole can cause a significant prolongation of the half-life, an increase in the area under the concentration curve (AUC) and a decrease in the concentration of a single dose of carbamazepine.

Clarithromycin: plasma concentrations of the drug omeprazole and clarithromycin increase with the simultaneous use of drugs.

Cyclosporine: The effect of omeprazole on ciclosporin has not yet been determined. Studies have shown only a slight change in the concentration of cyclosporine in plasma. In some cases, both an increase and a decrease in plasma levels of cyclosporine in plasma were noted. Therefore, systematic monitoring of the concentration of cyclosporine in patients with simultaneous treatment with omeprazole and cyclosporine should be carried out.

Diazepam and other benzodiazepines: with the simultaneous use of the drug Omeprazole and diazepam, there was a decrease in the metabolism of diazepam, its later release, leading to an increase and prolongation of the benzodiazepine effect.

Disulfiram: the simultaneous use of the drug omeprazole can lead to an increase in the plasma concentration of disulfiram, which can cause mental disorders - confusion, disorientation.

Methotrexate: it is assumed that omeprazole can inhibit the active secretion of methotrexate in the kidneys, which, with simultaneous treatment with omeprazole and methotrexate, can lead to an increase in the level of methotrexate in plasma.

Phenytoin: Omeprazole inhibits the metabolism of phenytoin in healthy volunteers, however, the simultaneous use of omeprazole does not affect plasma concentrations in patients treated with phenytoin for a long time

Ticlopidin: ticlopidine inhibits the metabolism of omeprazole in people with a rapid metabolism in relation to cytochrome P 450 2C19 (CYP2C19).

Patients taking omeprazole and warfarin at the same time should be under constant medical supervision, because. there is a decrease in thrombotest values ​​by approximately 11%.

Interactions with propranolol or theophylline have not been established, but interactions with other drugs also metabolized by the cytochrome P450 enzyme system cannot be ruled out.

Omeprazole, like other proton pump inhibitors (PPIs), should not be co-administered with nelfinavir and/or atazanavir.

Influence of other active substances on the pharmacokinetics of omeprazole.

CYP2C19 and/or CYP3A4C inhibitors: omeprazole is metabolized by CYP2C19 and CYP3A4 isoenzymes, drugs that inhibit CYP2C19 or CYP3A4 (for example, clarithromycin and voriconazole) can lead to an increase in plasma concentrations of omeprazole by reducing the rate of metabolism of omeprazole. High doses of omeprazole are well tolerated, dose adjustment of omeprazole is usually not required. However, the need for dose adjustment should be considered in patients with severe hepatic impairment and if long-term treatment is required.

CYP2C19 and/or CYP3A4 inducers

Drugs that induce CYP2C19 or CYP3A4 isoenzymes, or both (for example, rifampicin and St.

: Omeprazole preparations for cyclosporine aserі azirge anyktalmagan. Zhүrіzіlgen sertteuler plasmadғy cyclosporine concentration son tek eleusіz özgerіsіn korsetti. Zheke dara zhagdaylarda plasmadagy cyclosporine plasmalyk deңgeyіninіn zhogarylagany yes, sondai-ak tөmendegenі de anyқtaldy. Sondyқtan emdelushіlerde Omeprazole preparationsmen zhәne tsiklosporinmen bir mezgіlde emdegende tsiklosporin concentrationsyn zhүyeli turde baқylau zhүrgizu kerek.

Diazepam zhane baska and benzodiazepinder: Omeprazole drugs men diazepamdy bіr mezgіlde koldanganda, diazepamnyn metabolismі tоmendegenі, onyn benzodiazepindi aserdіn kүsheyuі zhәne ұzaruyna alyp keletin keyіngі bөlіnulerі anyқtaldy.

Disulfiram: Omeprazole preparations bir mezgіlde koldanganda disulfiramnyn plasma concentrationsynyn zhogarylauyn alyp kelui mүmkin, bul psikhikalyk buzylystar - abyrzhu, bagdardan zhanyludy tuyndatuy mүmkin.

Methotrexate: Omeprazole bүirekte methotrexattyn belsendі secretion tezheuі mүmkinіn dep bolzhanady, bul omeprazole zhәne methotrexatpen bir mezgіlde emdegende plasmadaғy methotrexat deңgeyіnіn zhoғarylauyna alyp keluіn.

Phenytoin: Omeprazole denі sau erіktilerde phenytoin metabolismіn tezheydі, alaida omeprazoledy bir mezgіlde koldanu phenytoinmenu ұzaқ vaқyt emdelgen emdelushіlerdegi plasma concentration son aser etpeydi.

Ticlopidin: ticlopidine P 450 2C19 (CYP2C19)

Omeprazole zhane warfarin drug taryn bіr mezgіlde kabyldaytyn emdelushіler үnemі darіger baқylauynda boluy tiіs, өytkenі thrombotest kөrsetkіshterіnіn shamamen 11% -а tоmendeuі bolady.

Propranololmen nemese theophyllinmen ozara әrekettesulerі anyқtalmagan, biraq baska drugtarmen, sonday-ak P450 cytochromes enzymes zhüyesimen metabolizdenetin drugtarmen ozara аrekettesulerіn joққа shyғaruғa bolmaidy.

Omeprazole, protondyk pompanyn baska and tezhegishteri (PPT) siyakty nelfinavirmen zhane / nemese atazanavirmen bir uaқytta paydalanylmauy tiіs.

Omeprazole pharmacokinetics asyna baska belsendi zattardyn aseri.

CYP2C19 female/nemesis CYP3A4С tezhegishterі: омепразол CYP2C19 және CYP3A4 изоферменттерінің көмегімен метаболизденеді, CYP2C19 немесе CYP3A4 дәрілік препараттары-тежегіштері (мысалы, кларитромицин және вориконазол) омепразол метаболизмінің жылдамдығы азаюы есебінен қан плазмасындағы омепразол концентрациясының артуына алып келуі мүмкін.

Symptoms: Zhurek Ainuy, құsu, auyz құrғauy, diarrhea, tachycardia, bass auyruy, kөrudin bұzyluy, ұyқyshyldyқ, қozu, zhogary tersheңdіk.

Emі: symptomatic. Specifics at kaytargysy zhok.

Pharmacological properties

Pharmacokinetics

After taking on an empty stomach, it is rapidly and completely absorbed; when taken after a meal, the absorption process may be longer. Cmax in plasma is reached after 3-3.5 hours. Bioavailability is 30-40%. Plasma protein binding is about 90%. Omeprazole is almost completely metabolized in the liver with the formation of 6 metabolites that do not have pharmacological activity. The half-life is 1.5 hours. It is excreted mainly by the kidneys (77%) and bile (23%). In chronic renal failure, excretion decreases in proportion to the decrease in creatinine clearance. In hepatic insufficiency, bioavailability is 100%, the half-life is 3 hours. In elderly patients, excretion slows down, bioavailability increases.

Ashkarynga kabildagannan keyin zhyldam zhane tolyk sinedi; tamaқtan keyin kabyldaganda sinu үderіsi ұzaқtau boluy mүmkin. Kan plasma syndagy Сmax 3-3.5 sagattan keyin zhetedi. Biozhetimdіlіgі 30-40% kuraida. Plasma akuyzdarymen baylanysuy 90% zhuykty kuraydy. Omeprazole іs zhuzinde 6 metabolite tyze otyryp, bauyrda tolyk metabolizdenedi, olardyn pharmacology belsendіlіgі zhok. Zhartylai shygarylu kezeny 1.5 sagatty kuraydy. Negizinen bүyrekpen (77%) zhane өtpen (23%) shygarylady. Sozylmaly bүyrek zhetkіlіkіkіzdіgіnde shyғaryluy creatinine clearance tөmendeuіne proportional to tоmendeydі. Where zhastagy emdelushilerde shygaryluy bayaulaydy, biozhetіmdіlіgі zhogarylaidy.

Pharmacodynamics

Omeprazole is a proton pump inhibitor that effectively suppresses basal and stimulus-induced secretion of hydrochloric acid. Omeprazole is a prodrug - it enters the parietal cells through the blood and, being a weak base, accumulates in the secretory tubules, in the acidic environment of which it is activated to form sulfenamide. Sulfenamide covalently binds to cysteine ​​residues included in the extracellular domain of H +, K + - ATPase, irreversibly inactivates it and stops the secretion of H + ions. After a single oral administration of the drug, the effect occurs within the first hour and lasts for 24 hours, the maximum effect is achieved after 3 hours. h. Omeprazole, 20 mg / day for one week, inhibits the secretion of hydrochloric acid by more than 95%. After stopping the drug, secretory activity is completely restored after 3-5 days.

Omeprazole - protondyk sorgy tezhegishi, tuz kyshkylynyn basald zhane kez kelgen titirkendirgishinen tuyndagan secretion bәsendetedі. Omeprazole іzashar darі bolyp tabylady – kan arkyly parietalі zhasushalarғa tүsedі, аlsіz negіz bolғаndyқtan қyshқyl ortada sulfenamide tүze otyryp, belsendіrіletіn secretorlyқ өzekshelerlady zhinaқtaly. Sulfenamide zhasushadan tys domain H+, K+ - ATPase kіretіn cysteine ​​kaldyқtarymen covalent baylanysady, one kaytymsyz belsendіlіgіn zhoyady zhane H+ iondary secretion toktatady. Preparations іshke bir ret қabyldaғannan keiіn аserі birіnshі sағаt іshіnde bastalady zhane 24 sағаt boyyna zhalғаsаdy, ең zhogary әserіne 3 sағата zhetedі. He ekі elі іshektіn oyyk zharali aurulary bar emdelushilerde omeprazole 20 mg dosad kabyldau askazan solinіn pH 3 dengeyde 17 sagat boyina demep turady. Bir apta boyyna tәulіgіne 20 mg omeprazole kabyldau tuz қyshkylynyn secretion 95%-dan astamғa bәsendetedі. The drug kabyldaudy toktatkannan keyin secretorlyk belsendіlіgі 3-5 taulіkten keyіn tolyk kalpyna keledі.

Packaging and release form

10 capsules are placed in a blister pack made of PVC film and aluminum foil. 3 blister packs, together with instructions for medical use in the state and Russian languages, are placed in a cardboard pack.

Polyvinylchloride ulbirden zhane aluminum foildan zhasalgan pishindі yashhykty kaptamada 10 capsuladan salyngan. 3 pіshіndі ұyashyқty қaptamadan medicina қoldanyluy қoldanyluy zhөnіnde memlekettіk zhane orys tіlderіndegі nұsқaulyқpen birge cardboard қorapshaғa salynғan.

The drug Omeprazole is the most effective active ingredient against inflammatory processes in the stomach. Its action lies in the fact that it reduces the production of hydrochloric acid and lowers its effect. Omeprazole begins to act as soon as it enters an acidic environment.

After we have taken a dose of medicine, it penetrates into special cells that are in the stomach and are responsible for the production of hydrochloric acid. In these cells, it accumulates, thereby affecting the production of gastric juice and the enzyme pepsin.

Also, this drug affects the main pathogen and ulcers. Therefore, doctors always prescribe it for peptic ulcers and inflammation of the duodenum. In addition to the fact that the drug helps to improve well-being, it also suppresses the further development of the disease, and also reduces the risk of the onset of the disease. It acts within one day, is excreted through the kidneys and intestines.

Omeprazole is intended for both adults and children from 5 years of age.

The drug is prescribed for children from 5 years old and adults during such diseases:

1. For prophylaxis if the patient has a chronic, stressful peptic ulcer or aspirin peptic ulcer
2. Treatment of polyendocrine adenomatosis together with other drugs, that is, in complex treatment
3. Treatment of gastropathy that formed after prolonged use of anti-inflammatory drugs
4. During heartburn, if it has been bothering the patient for more than two days
5. For the treatment of inflammation of the gastric tract, duodenum and ulcers.

Contraindications

Omeprazole should not be taken by those patients who do not tolerate at least one of the components of this drug. In addition, it should not be taken during pregnancy, or rather, it is not recommended, since in some cases it is also prescribed for pregnant women. But in the first trimester, the drug is strictly forbidden to take, as it can cause a violation in the development of the fetus. Therefore, omeprazole is prescribed to pregnant women only when the benefits of its use are much higher than possible.

The drug is not prescribed to nursing mothers, as it very quickly penetrates into the bloodstream, and, accordingly, into breast milk. As already mentioned, the drug lowers the level of acidity in the stomach, so it is not recommended to take it if the patient is worried about gastritis with low acidity or atrophic gastritis. Also, this medicine should not be taken by those who have suspicions of oncological diseases of the gastrointestinal tract.

Since omeprazole can cause misdiagnosis which will lead to misdiagnosis. Therefore, if you are on examination, then avoid taking this drug. Also, in the course of research, it was found that this medicine contributes to the growth of oncological neoplasms. Before taking the drug, make sure that you do not experience any of the following symptoms:

• Tumor in the digestive tract
• Liver failure
• : salmonella, compylobacter.

Side effects

One of the side effects can be nausea after eating.

Like any drug, omeprazole can cause side effects, but they are very rare in patients. They arise, as a rule, if they have been used incorrectly or have been used for a very long time.

In such cases, the most pronounced side effects are, or, conversely, bloating and various abdominal pains. Sometimes there are severe headaches and even severe dizziness. In addition, it may be:

1. The patient loses taste sensations, worries about dryness in the oral cavity
2. Constant nausea, after eating, abrupt changes in the stool (constipation, diarrhea)
3. The liver begins to function poorly
4. The activity of the nervous system is disturbed: depression, constant irritability and indifference, fatigue
5. Skin inflammation, itching
6. , which is manifested by an increase in temperature, the appearance of urticaria
7. Joint pain, muscle weakness.

If you do not have intolerance to one of the components, then side effects may be caused due to improper use.

How to take this medicine correctly?

Omeprazole should be taken with a small amount of warm water.

Omeprazole should be taken before meals or with meals. If on a special occasion you need to repeat the medication, then do it in the evening, that is, take one dose in the morning and the second in the evening. In no case do not chew the capsule, and even more so do not divide it into parts.

Omeprazole is washed down with warm water in a small amount, it is enough to take a couple of sips. If Omeprazole is prescribed in the form of tablets, then it can be dissolved to a mushy state in yogurt or juice, but in a small amount. The resulting mixture must be taken within half an hour.

Dosage

Each capsule or tablet of the drug usually contains 20 mg. Doctors often prescribe one dosage of the drug per day, but in rare cases, if the patient is in a very serious condition, this dose is increased. Omeprazole is prescribed to take courses, which should last no more than two months, if there is a need to continue treatment, then you need to take a break and take the course again.

Omeprazole for children

As a rule, this drug is prescribed for children from 5 years old, however, if the child has a disease such as Zollinger-Ellis syndrome or another, this medication may be prescribed. In this case, the dose of Omeprazole is calculated according to the weight of the child:

• Child weight up to 10 kg - 5 mg
• Child weight from 10 to 20 kilograms - 10 mg
• A child weighing 20 or more kilograms - 20 mg.

Omeprazole during pregnancy

Omeprazole is not recommended for pregnant women. The drug is contraindicated in the first three months of pregnancy, as its use can disrupt the development of the fetus or lead to serious disorders. In other cases, if this medicine is prescribed, it is very rare and very careful if

Omeprazole is an effective modern drug used to treat gastric erosions, certain types of gastritis and peptic ulcer with high acidity.

The active substance of the drug successfully fights various inflammatory processes in the gastrointestinal tract. Only once in an acidic gastric environment, the drug shows its properties - it reduces the effect of acids on the walls of organs, restores the acid-base balance of gastric juice, and reduces the symptoms of diseases.

After taking this drug, patients not only feel better, but also reduce the risk of getting sick again. The first effect is felt already within an hour and lasts for 24 hours.

Clinical and pharmacological group

H+-K+-ATPase inhibitor. Antiulcer drug.

Terms of dispensing from pharmacies

Released by prescription.

Prices

How much does Omeprazole cost in pharmacies? The average price is at the level of 35 rubles.

Release form and composition

In the pharmacy network, the drug Omeprazole is sold in tablets, capsules and solutions for intravenous administration.

1. Enteric capsules contain 10 mg or 20 mg of the main active ingredient - omeprazole (7 capsules in a blister pack, there can be from 1 to 4 blister plates in a pack); some manufacturers pack capsules in polymer jars of 30 or 40 pieces;
2. MAPS tablets (pellets), coated with 10 mg, 20 mg or 40 mg of the active substance (No. 7, 14, 28);
3. Powder for infusion solutions in 40 mg vials (5 vials per pack).

Pharmacological effect

Omeprazole is a proton pump inhibitor that reduces the production of hydrochloric acid by inhibiting the H + / K + -ATPase of the parietal cells of the stomach. The drug is a prodrug that is activated in the acidic biological environment of the secretory tubules of the parietal cells of the gastric mucosa.

As a result of the action of the drug, basal and stimulated secretion decreases, regardless of the nature of the stimulus. After taking Omeprazole at a dose of 20 mg, the antisecretory effect appears within the first hour (maximum after 2 hours). During the day, 50% of the maximum secretion is inhibited. As a result of a single dose, a rapid effective suppression of nocturnal and daytime gastric secretion is provided, reaching a maximum after 4 days of therapy and disappearing 3-4 days after the end of the dose.

In duodenal ulcer after taking omeprazole at a dose of 20 mg for 17 hours, intragastric pH is maintained at 3.

Indications for use

Omeprazole: what does it treat and what is it prescribed for? The tool is indicated for the treatment and prevention of pathologies of the digestive tract. Indications for the use of Omeprazole Akri are no different from the indications that are listed in the annotation of Omeprazole produced by another pharmaceutical company (Sandoz, Gedeon Richter Plc., STADA CIS, etc.).

The medicine is effective in the following cases:

1. For the treatment of Zollinger-Ellison syndrome;
2. In the combined treatment of polyendocrine adenomatosis;
3. As a course treatment of endoscopically confirmed erosive esophagitis;
4. To eliminate uncomplicated heartburn, which lasts more than 2 days during the week;
5. For the treatment of gastropathy, which was formed from the reception;
6. For relief of manifestations (reflux of gastric contents into the lower part of the esophagus);
7. In the complex treatment of the active phase and duodenal ulcer associated with Helicobacter pylori infection;
8. Prophylactically, to prevent recurrence in chronic duodenal ulcers, aspirin and stress ulcers;
9. For the correction of hypersecretory disorders in the upper digestive tract.

Contraindications

With caution appoint a group of patients with renal or hepatic insufficiency. The instructions for use of omeprazole indicate absolute contraindications to treatment:

1. Pregnancy;
2. Lactation;
3. Childhood;
4. Hypersensitivity.

Use during pregnancy and lactation

In other cases, if this medicine is prescribed, then very rarely and very carefully, if the effect from it is much greater than the harm, that is, the risk must be justified.

Dosage and method of application

The instructions for use indicate that Omeprazole capsules are taken orally, usually this is done in the morning, without chewing, with a small amount of water (immediately before meals).

1. For the prevention of recurrence of peptic ulcer - 10 mg 1 time per day.
2. With Zollinger-Elisson syndrome, usually 60 mg 1 time per day; if necessary, the dose is increased to 80-120 mg / day (the dose is divided into 2 doses).
3. With exacerbation of peptic ulcer, reflux esophagitis and gastropathy caused by taking NSAIDs - 20 mg 1 time per day. For patients with severe reflux esophagitis, the dose is increased to 40 mg 1 time per day. The course of treatment for duodenal ulcer - 2-4 weeks, if necessary - 4-5 weeks; with gastric ulcer, with reflux esophagitis, with erosive and ulcerative lesions of the gastrointestinal tract caused by taking NSAIDs - within 4-8 weeks. Reducing the symptoms of the disease and scarring of the ulcer in most cases occurs within 2 weeks. Patients who do not have complete scarring of the ulcer after a two-week course should continue treatment for another 2 weeks. Patients resistant to treatment with other antiulcer drugs are prescribed 40 mg per day. The course of treatment for duodenal ulcer - 4 weeks, for gastric ulcer and reflux esophagitis - 8 weeks.

For eradication, one of two therapy regimens is used:

• "Triple" therapy: 20 mg of omeprazole, 500 mg of clarithromycin and 1000 mg of amoxicillin 2 times a day; or 20 mg of omeprazole, 250 mg of clarithromycin and 400 mg of metronidazole 2 times a day; or 40 mg of omeprazole 1 time per day, 400 mg of metronidazole and 500 mg of amoxicillin 3 times a day. Course duration - 1 week;
• "Double" therapy: 20-40 mg of omeprazole and 750 mg of amoxicillin 2 times a day; or 40 mg 1 time per day and 500 ml and 500 mg of clarithromycin 3 times a day or 750-1500 mg of amoxicillin 2 times a day. The duration of the course is 2 weeks.

In case of liver failure, 10-20 mg is prescribed 1 time per day (in case of severe liver failure, the daily dose should not exceed 20 mg); in case of impaired renal function and in elderly patients, correction of the dosing regimen is not required.

Omeprazole for heartburn

Omeprazole effectively eliminates the symptoms of heartburn in various diseases of the gastrointestinal tract. However, its independent reception is allowed only as an exception, as a means of ambulance. Its dose in this case should not exceed 10 mg per day. The therapeutic effect of Omeprazole develops after 4-5 days, and the full course of treatment should not exceed 14 days. It is possible to repeat treatment with Omeprazole not earlier than after 4 months.

If at the end of treatment heartburn returns, it is necessary to consult a doctor for advice and examination. The same should be done with frequently recurring heartburn, especially if they occur more than 2 days a week. In this case, appropriate treatment with Omeprazole in appropriate dosages will be prescribed.

Side effects

As a rule, the drug is well tolerated. The exception is a long period of use - more than two months, but doctors do not prescribe a medicine for such a long period, the optimal course of treatment is 30 days. After a break, you can resume the use for preventive purposes.

The main adverse reactions that may occur with the incorrect use of Omeprazole are the following symptoms:

1. Musculoskeletal system: rarely develop myasthenia gravis, arthralgia, myalgia.
2. Hematopoietic system: rarely - leukopenia, agranulocytosis, thrombocytopenia, pancytopenia.
3. Allergic reactions: angioedema, urticaria, fever, bronchospasm, anaphylactic shock.
4. Skin: in rare cases - skin itching or rash, photosensitivity, exudative erythema multiforme, alopecia.
5. Digestive organs: abdominal pain, diarrhea or constipation, nausea and vomiting, flatulence. Rarely, the activation of liver enzymes increases, there is a perversion of taste, stomatitis, dryness of the mucous membranes of the mouth. Patients with severe liver disease may develop hepatitis.
6. Nervous system: With concomitant somatic diseases in severe form, dizziness, headaches, depression, agitation occur. Encephalopathy is possible in patients with severe liver pathologies.
7. Others: rarely possible visual impairment, swelling of the extremities, malaise, increased sweating, gynecomastia, the formation of benign gastric glandular cysts of a reversible nature with long-term treatment.

Overdose

The instruction describes the symptoms of an overdose if the medicine is used incorrectly. Headache, nausea, drowsiness may occur. There is confusion, visual impairment, tachycardia.

If the above symptoms appear, you should immediately consult a doctor. He will prescribe symptomatic treatment - that is, he will eliminate the consequences as they occur. Omeprazole is absorbed into the blood within an hour - that is, dialysis is not effective.

special instructions

Before starting therapy, it is necessary to exclude the presence of a malignant process (especially with a stomach ulcer), since treatment, masking the symptoms, may delay the correct diagnosis.

Taking it with food does not affect its effectiveness.

drug interaction

When using the drug, it is necessary to take into account the interaction with other drugs:

1. There was no interaction with concomitantly taken antacids.
2. May reduce the absorption of ampicillin esters, iron salts, itraconazole and ketoconazole (omeprazole increases the pH of the stomach).
3. Enhances the inhibitory effect on the hematopoietic system and other drugs.
4. At the same time, long-term use of omeprazole at a dose of 20 mg 1 time per day in combination with caffeine, theophylline, piroxicam, diclofenac, naproxen, metoprolol, propranolol, ethanol, cyclosporine, lidocaine, quinidine and estradiol did not lead to a change in their plasma concentration.
5. Being inhibitors of cytochrome P450, it can increase the concentration and reduce the excretion of diazepam, indirect anticoagulants, phenytoin (drugs that are metabolized in the liver by cytochrome CYP2C19), which in some cases may require a reduction in doses of these drugs. May increase plasma concentrations of clarithromycin.

"Omeprazole" is used for the treatment of peptic ulcer in various manifestations. In particular, the drug is used to treat gastric ulcer, duodenal ulcer, peptic ulcer caused by Helicobacter pylori, reflux esophagitis. Also, the drug is prescribed for a benign tumor of the pancreas in combination with a stomach ulcer (Zollinger-Ellison syndrome).

The drug "Omeprazole" is available in the form of capsules with a dosage of 10, 20 and 40 mg.

Instructions for use "Omeprazole"

With reflux, the daily dosage is 20 mg of Omeprazole, the course of treatment lasts 4 weeks; in severe cases, take 40 mg of the drug for 8 weeks. In the treatment of peptic ulcers, 20-40 mg of the drug "Omeprazole" is prescribed twice a day for 2-4 weeks. With Zollinger-Ellison syndrome, the dosage is determined at 60 mg of Omeprazole 1 time per day, in severe cases, 40-60 mg 2 times per day.

"Omeprazole" is taken before meals.

Contraindications and warnings

Before starting therapy with this drug, it is necessary to exclude the presence of malignant tumors in the patient, since taking Omeprazole can mask the signs of the disease and thus delay its timely diagnosis.

Side effects