Imported analogue of omeprazole is good. Effective analogues of omeprazole. Application during pregnancy

Proton pump inhibitors are drugs used to reduce the production of hydrochloric acid in the stomach.

They are the most commonly prescribed drugs. Between 2009 and 2013, the number of PPI prescriptions increased by 20 million.

The results of the study confirmed their safety. And the minimal adverse reactions that proton pump inhibitors caused did not require their treatment.

But, nevertheless, there are some side effects of drugs in this group. Let's talk about them in more detail. But first, let's analyze the principle of action of PPIs and indications for their use.

Mechanism of action of proton pump inhibitors

How do proton pump inhibitors work? Drugs in this group block the activity of an enzyme that promotes the production of hydrochloric acid in the stomach.

Also, proton pump inhibitors help eliminate H. pylori bacteria from the body.

Helicobacter pylori is one of the causes of gastritis, peptic ulcer of the stomach and duodenum and stomach cancer. The combined use of PPIs with an antibiotic allows you to remove the bacteria from the body.

The drugs of this group help to quickly stop the symptoms of ulcers, gastritis, GERD and, with a course of use, achieve a long-term remission.

Indications for the use of proton pump inhibitors

What diseases are PPIs prescribed for? Omeprazole and its analogues are indicated for gastroesophageal reflux disease, peptic ulcer of the stomach and duodenum, Zollinger-Ellison syndrome, reflux esophagitis.

Gastroesophageal reflux disease

GERD is a chronic disease with exacerbations and remissions. The pathological process occurs due to the reflux of gastric contents into the esophagus.

The disease is characterized by the presence of symptoms such as:

• heartburn. This term refers to a burning sensation in the chest that extends to the neck and throat. Heartburn occurs when stomach contents come into contact with the lining of the esophagus. It appears after taking alcohol, spicy, fried, hot foods, bending the torso down, after strong physical exertion;
• belching. Occurs in half of patients with GERD. This symptom is more pronounced after eating or drinking carbonated drinks. With prolonged physical exertion, regurgitation may appear;
• dysphagia - a violation of swallowing, and odynophagia - pain when swallowing. These symptoms occur due to a violation of the motor function of the esophagus. Pain when swallowing is a consequence of inflammation of the mucous membrane of the esophagus. Moreover, if the signs of impaired swallowing are pronounced, and at the same time heartburn has disappeared, this may indicate a narrowing of the lumen of the esophagus;
• pain along the esophagus. At the same time, patients feel that their heart hurts. But the pain syndrome in heart disease occurs after physical exertion, and discomfort in GERD is not associated with exercise;
• increased salivation.
• otorhinolaryngological syndromes (from the ENT organs). The patient complains of soreness or feeling of a coma in the throat, hoarseness of voice.
• dental syndrome is characterized by the appearance of caries due to acid damage to the enamel, the occurrence of sores in the oral cavity;
• bronchopulmonary syndrome - cough, bronchial asthma, shortness of breath.
• bloating;
• a feeling of "rapid satiety" while eating;
• nausea;
• pain in the epigastrium (in the navel and 2-3 cm above it).

Peptic ulcer of the stomach and duodenum

Peptic ulcer of the stomach and duodenum is a condition characterized by the presence of a peptic ulcer in the stomach or intestines. The disease proceeds with periods of exacerbation and remission.

• The main complaint of patients with ulcers is pain. It may be different. Patients characterize it as cutting, aching or burning. It should be noted that the periodicity of the pain syndrome is inherent in the ulcerative defect. That is, the pain goes away and then comes back. In addition, such symptoms are noted mainly in autumn and spring;
• for pain syndrome with an ulcer is characterized by a relationship with food intake ;
• belching. It can be sour in nature (with hypersecretion of gastric juice), along with belching, food can come out back;
• vomiting, after which the condition improves significantly;
• heartburn;
• weight loss, because patients are afraid of pain after eating and try to eat less.

Esophagitis

Esophagitis is an inflammation of the lining of the esophagus due to various causes. Patients complain of soreness in the chest and in the epigastrium (in the navel and 2-3 cm above it) after swallowing food.

The same symptoms can occur during physical exertion, wearing strongly tightening belts. Often, pain appears in the supine position.

In this case, the pain is paroxysmal and “gives” to the heart, neck or back. The pain syndrome is accompanied by an eructation of air. Sometimes belching can release gastric contents.

Also, patients complain of heartburn in the evening and at night. In addition, hiccups, excessive salivation, vomiting, nausea, and difficulty breathing are of concern.

Moreover, patients note that hiccups continue for a long time, and its occurrence is associated with belching.

Zollinger-Ellison Syndrome

This pathology is associated with the appearance of a tumor of the pancreas, which contributes to increased production of gastrin.

The latter, in turn, causes an increase in the formation of hydrochloric acid in the stomach, which leads to the appearance of ulcers in the stomach and intestines.

Patients note the presence of soreness in the epigastrium, heartburn, sour belching, diarrhea (fatty, copious and watery stools), and weight loss.

A characteristic feature of the disease is that ulcers do not heal for a long time, even with proper treatment. Characterized by signs of inflammation of the mucous membrane of the esophagus, sometimes its narrowing. Liver tumors are typical.

Contraindications to taking Omeprazole and its analogues

Under what conditions can not take Omeprazole? This drug and its analogues are contraindicated in:

• intolerance to the components of the drug;
• the period of pregnancy and breastfeeding;
• gastritis with low acidity;
• atrophic gastritis;
• tumor of the stomach or duodenum. The drug can mask the symptoms of oncology, which prevents its timely diagnosis;
• osteoporosis;
• infections - salmonellosis, campylocabter, etc.;
• chronic pathologies of the liver. Since the drug is metabolized in the liver, chronic insufficiency of the function of this organ leads to the accumulation of omeprazole in the liver cells and their toxic damage;
• impaired renal function.

Omeprazole preparations

What medicines can replace omeprazole? Omeprazole analogues include:

• Omeprazole Shtada - prevents the production of hydrochloric acid in the stomach, reduces the production of insulin, prevents the pathological effect of gastric juice on the esophageal mucosa;
• Gastrozole - is indicated for stomach ulcers, duodenal ulcers, heartburn, reflux of gastric contents into the esophagus, ulcers caused by long-term use of non-steroidal anti-inflammatory drugs (NSAIDs);
• Omeprazole Akri - contributes to the rapid reduction of night and day secretion of hydrochloric acid;
• Omeprazole Nika - indicated for GERD;
• Omez - reduces the secretion of hydrochloric acid by the stomach;
• Pylobact - in addition to Omeprazole, contains two antibiotics. The drug is effective in gastric ulcer caused by the bacterium Helicobacter pylori;
• Omitoks - the drug is used for peptic ulcer of the stomach and intestines. Indicated for anti-relapse treatment of the disease;
• Omeprazole Richter - the drug is contraindicated in liver pathologies;
• Ortanol - indications and contraindications are similar to those of Omeprazole;
• Ultop - normalizes the activity of hydrochloric acid in the stomach and reduces its production;
• Omeprazole Teva - the effect of the drug depends on the dose taken. Reduces the production of hydrochloric acid in the stomach, slows down the secretion of HCl;
• Bioprazol - indicated for peptic ulcer of the stomach and intestines;
• Omefez - in addition to reducing the production of hydrochloric acid in the stomach, protects the cells of the mucous membrane;
• Losek - when interacting with antibacterial agents, it quickly stops the symptoms of the pathology, promotes the speedy healing of the damaged gastric mucosa. Also, the drug reduces the likelihood of bleeding from an ulcer;
• Gasek – accelerates ulcer healing.

Other proton pump inhibitors and their analogues

Consider other available proton pump inhibitors and their analogues:

• Pantoprazole - Nolpaza, Sanpraz, Controloc, Panum;
• Esomeprazole - Nexium;
• Lansoprazole - Epicurus, Helicol, Lansofed, Lanzoptol, Lancid;
• Rabeprazole - Pariet.

Side effects

Side effects from taking omeprazole and its analogues appear infrequently, with prolonged use of a proton pump inhibitor:

• diarrhea or constipation;
• nausea and vomiting;
• dizziness and headache;
• flatulence;
• violation of hepatic functions;
• irritability;
• encephalopathy;
• depression;
• allergy;
• skin rashes;
• peeling and itching;
• redness;
• temperature rise;
• angioedema;
• anaphylactic shock;
• hives;
• decrease in the number of erythrocytes, leukocytes, platelets;
• soreness in muscles and joints;
• increased sensitivity to sunlight.

Now let's take a closer look at the side effects of other proton pump inhibitors.

Action during pregnancy

According to the results of studies that were conducted in 2010, the use of proton pump inhibitors a month before conception and in the first trimester of pregnancy was not accompanied by an increase in congenital malformations.

Therefore, proton pump inhibitors can be used early in pregnancy.

Development of oncology

In mice, it has been shown that long-term use of proton pump inhibitors can cause pancreatic or colon cancer.

Data from studies that took proton pump inhibitors continuously (from 5 to 15 years) showed that the number of stomach cells increased, which could later lead to cancer.

However, after discontinuation of the PPI, everything returned to normal within 2 weeks. There was no subsequent development of cancer.

It is also known that long-term use of Pantoprazole (Controloc) (more than 15 years) does not cause the development of any negative effects. The drug is well tolerated by patients.

Pantoprazole has shown its high efficiency in diseases accompanied by an increase in the acidity of gastric juice.

Development of infection

According to the results of studies, it is known that taking proton pump inhibitors can cause the development of pseudomembranous colitis, the causative agent of which is Clostridium difficile.

The disease appears more often in elderly patients, as well as those taking other drugs, in addition to PPIs (antibiotics, chemotherapy drugs).

Also, the risk of infection increases in the presence of inflammatory bowel disease or after organ transplantation.

Long-term use of proton pump inhibitors can lead to infections caused by Salmonella, Shigella, Escherichia, Campylobacter.

Vitamin B malabsorption 12

As a result of most studies, it became known that long-term use (more than 2 years) of proton pump inhibitors can lead to impaired absorption of vitamin B12.

This occurs as a result of a decrease in the acidity of gastric juice. This condition leads to the development of anemia.

Iron malabsorption

Iron absorption occurs in the small intestine. A large amount of iron that a person consumes with food must go through some transformations in order to be absorbed into the body.

This element is absorbed only after exposure to hydrochloric acid. Long-term use of PPIs causes a decrease in gastric acidity, impairs iron absorption and leads to anemia.

Osteoporosis and bone fractures

Osteoporosis is a decrease in bone mineral density. The condition develops with long-term (more than 7 years) intake of proton pump inhibitors.

The condition is associated with impaired absorption of vitamin B 12 and a decrease in the acidity of gastric juice.

The latter leads to an increase in the concentration of gastrin in the blood, due to which the parathyroid glands are stimulated. This process leads to the transfer of calcium from the bones into the blood.

A lack of vitamin B 12 and suppression of acidity in the stomach increases the risk of fractures.

According to the results of the study, the following conclusion was made: there is no likelihood of bone fracture when taking small doses of proton pump inhibitors.

The risk of developing fractures of the wrist, spine and hips increases with long-term use (more than 7 years) of high doses of PPIs, with the initial presence of osteoporosis, a sedentary lifestyle, and a lack of vitamin D.

Taking proton pump inhibitors with other drugs

Clopidogrel can be prescribed to patients with heart pathology. The drug reduces the likelihood of thrombosis.

According to the results of the study, the joint use of PPIs and clopidogrel increases the likelihood of developing myocardial infarction, unstable angina, coronary death. This effect is caused by omeprazole and esomeprazole.

Instead of Omeprazole and Esomeprazole, it is allowed to take Pantoprazole together with Clopidogrel. It does not interact with Clopidogrel, Diclofenac, Clarithromycin, Diazepam, Cyclosporine, Warfarin and some other drugs.

Thus, Pantoprazole is the safest drug if it is necessary to take several drugs at the same time.

Impact of PPI use on the development of dementia

Recently it became known that the likelihood of developing dementia increases in the elderly who take proton pump inhibitors for a long time.

In Germany, a study was conducted that confirmed that dementia and Alzheimer's developed more often in those who took proton pump inhibitors.

However, another study showed that in addition to taking PPIs, cognitive impairment could be caused by diabetes mellitus, stroke, Parkinson's disease, an increase in the level of low and very low density lipoproteins, traumatic brain injuries, heart disease, and excessive alcohol intake.

PPI use and systemic lupus erythematosus

When taking one proton pump inhibitor - Rabeprazole – in patients, the appearance of a cutaneous form of systemic lupus erythematosus was observed. But the disease developed only with prolonged exposure to the sun.

Proton pump inhibitors and diabetes

In 2009, studies appeared that showed a decrease in glucose levels in patients with type II diabetes mellitus when taking Pantoprazole.

At the moment, it is not known whether other proton pump inhibitors cause this effect or if such an effect is characteristic only of Pantoprazole.

What is the best proton pump inhibitor?

The effectiveness of proton pump inhibitors is the same. However, it is known that the effect occurs faster when taking Lansoprazole. It is suitable if PPIs are prescribed for a short period of time.

In diseases that require long-term use of proton pump inhibitors, such as GERD, it is recommended to take Pantoprazole.

It is this drug that is most safe when taken for a long time. Pantoprazole is also suitable for patients who take several drugs at the same time to treat other diseases.

Conclusion

Proton pump inhibitors are drugs used to reduce the production of hydrochloric acid in the stomach. Drugs in this group block the activity of an enzyme that promotes the production of hydrochloric acid in the stomach.

Due to this, the secretion of HCl decreases, the pathological effect of gastric juice on the gastric mucosa, esophagus (with the reflux of gastric contents into the esophagus) and on the duodenum decreases.

PPIs help to quickly stop the symptoms of ulcers, gastritis, GERD and achieve long-term remission with a course of use.

Medicines are contraindicated in late pregnancy, with breastfeeding, low acidity of gastric juice, tumors of the gastrointestinal tract, osteoporosis, the presence of infection in the body, kidney and liver failure.

Side effects occur only with long-term use of drugs. Also, the likelihood of developing adverse reactions increases if large doses of the drug are used.

Continuous use of proton pump inhibitors increases the risk of gastrointestinal cancer, osteoporosis and fractures, iron deficiency and B 12 deficiency anemia, the occurrence of an infectious process, myocardial infarction, unstable angina, cardiac death, dementia.

Rabeprazole can cause a cutaneous form of systemic lupus erythematosus. Pantoprazole reduces the concentration of glucose in the blood of patients with type II diabetes mellitus.

For short-term use of PPIs, Lansoprazole is suitable, since it is he who causes the most rapid effect.

Pantoprazole is considered the safest proton pump inhibitor. It is he who is prescribed if it is necessary to take PPI for a long time and the simultaneous treatment with other drugs.

Drugs for the treatment of excess stomach acid and peptic ulcer are very popular. Let's consider the most accessible and popular proton pump inhibitors (drugs of this class are usually called the abbreviation PPI or PPI for short), based on the active substance omeprazole and rabeprazole (a slightly modified analogue of the first).

The drug Omeprazole

10 popular analogues of omeprazole and rabeprazole

1. Omez (omeprazole). Indian product. Advantages: a variety of dosages, the presence of an injection form, which increases bioavailability, the cost is lower than other analogues, but higher than that of omeprazole. Disadvantages: the maximum concentration is reached for a long time, the half-life is short. The average price per pack is about 170 rubles.
2. Ultop (omeprazole). Producer Russia or Slovenia. Advantages: different dosages, injectable forms, high bioavailability, long half-life, relatively low cost (80-90 rubles). Disadvantages: long time to create maximum concentration.
3. Losek (omeprazole). Country Sweden. Advantages: injectable form, the maximum concentration is reached in a short time. Disadvantages: high price among all analogues - 1800 rubles.
4. Gastrozole (omeprazole). Russia. It is distinguished by high bioavailability, relatively low cost (100 rubles), varieties of packaging (jars, blisters). Disadvantages: only one dosage, shortened half-life.
5. Ortanol (omeprazole). Slovenia. Advantages: long half-life, variety of dosages, average price (90-100 rubles). Disadvantages: the maximum concentration is reached for a long time.
6. Helicide (omeprazole). Czech Republic. The bioavailability of capsules is higher than analogues, the presence of injection forms. Of the minuses - the high price (260-290 rubles).
7. Pariet (rabeprazole). Switzerland, Japan, Belgium. The disadvantage is the high price (1000-1300 rubles).
8. Rabelok (rabeprazole). India. Pros: Intravenous form (lyophilisate) providing high bioavailability. The cost is from 300 rubles.
9. Ontime (rabeprazole). Israel. It has the lowest bioavailability of all substitutes. The cost is 500 rubles.
10. Zolispan (rabeprazole). Spain. High bioavailability and half-life.

Each of us suffered from problems with the gastrointestinal tract. As a rule, the problem can be solved by removing the symptom (heartburn) or by changing your diet, eliminating everything harmful. However, quite often the problem is long-term in nature and for its treatment it is necessary to undergo an examination and drink a course of medicines.

In the treatment of various inflammatory processes of the mucosa of the housing and communal services, a special place is occupied by drugs that reduce the acidity of gastric juice. The most well-known substance is omeprazole, on the basis of which many drugs are produced. Consider how they work and how the main analogues differ from each other.

Having the same name as the active ingredient, this domestic drug begins to act half an hour to an hour after ingestion. It works at the cellular level, blocking the final phase of hydrochloric acid production, and in addition, it has a neutralizing effect on gastric juice, reducing its acidity.

"Ultop": brief information about the drug

The main active ingredient in this drug is omeprazole. The "Ultop" is absolutely similar to the above "Omeprazole". The minimum dosage of the drug (10 mg) is used in the prevention of exacerbations of peptic ulcer, in other cases, 20-40 mg are prescribed per day, depending on which disease the patient suffers from.

"Ultop" is prescribed for the following diseases:

1. Reflux esophagitis;
2. Stomach ulcer, duodenal ulcer, including stress ulcers and those caused by taking NSAIDs;
3. To relieve symptoms of dyspepsia;
4. Zollinger-Ellison syndrome.

The drug is prohibited to prescribe and take in the following cases:

• intolerance to omeprazole or other components of the drug;
• the patient's age is less than 18 years;
• pregnancy, breastfeeding;
• fructose intolerance;
• glucose-galactose malabsorption;
• sucrase/isomaltase deficiency.

"Ultop" is produced in Slovenia at the plant of the company "Krka", the price per pack (depending on the volume and dosage) ranges from 150-500 rubles. There are various forms of release of the drug: tablets, capsules, powder for the preparation of infusions.

"Ultop" is well tolerated, cases of severe adverse reactions are quite rare. Most often, you can observe abdominal pain, headaches, upset stool, nausea.

Cases of overdose are also extremely rare, the symptoms are as follows: pain in the abdomen and head, drowsiness, dizziness, dry mouth, tachycardia, arrhythmia, blurred vision, agitation, confusion, increased sweating, nausea; in rare cases - convulsions, shortness of breath, hypothermia. Symptomatic treatment is recommended.

"Ranitidine": brief information about the drug

This analogue of "Omeprazole" has a similar mechanism of action, but is based on another substance - ranitidine hydrochloride. Under its influence, both the volume of secretion and the concentration of pepsin decrease, resulting in favorable conditions for the healing of ulcers.

Indications for the use of "Ranitidine" are:

• peptic ulcer of the stomach and duodenum, both in the acute stage and for the prevention of relapse;
• inflammatory processes in the esophagus, including due to the ingress of stomach contents;
• a single dose before surgery to prevent aspiration of gastric juice.

Contraindications to taking the drug are pregnancy, lactation, and kidney pathology.

Side effects from treatment with Ranitidine are extremely rare, which is why Ranitidine is popular with doctors and patients. Occasionally, reactions such as fatigue, weakness, skin allergic reactions, and headaches occur.

Cases of severe side effects have been recorded against the background of serious illness, the use of potent drugs and general exhaustion of the body.

"Omez": brief information about the drug

Perhaps this Indian drug enjoys the greatest popular love due to its low price (although it is slightly more expensive than the domestic Omeprazole).

Omez contains a rather impressive amount of excipients, which, on the one hand, mitigates side effects, and on the other hand, makes the production process cheaper and slows down the onset of the maximum concentration of the active substance.

Nevertheless, although Omez begins to act a little later than Omeprazole, the total time of the effect from taking it is also one day.

Indications for the use of "Omez" are:

• Ulcer of the stomach and duodenum, including those that arose against the background of taking medications, infection with the bacterium Helicobacter pylori, stress;
• Gastroesophageal reflux disease;
• Ulcerogenic adenoma of the pancreas;
• Systemic mastocytosis;
• Pancreatitis.

"Omez" is available in the form of capsules of various dosages (10, 20, 40 mg) and powder for the preparation of a solution for droppers.

Contraindications to taking "Omez" are:

1. Allergy to one of the components of the drug;
2. Age under four years old. Until the age of fourteen, the appointment of "Omez" is possible only in exceptional cases.
3. Pregnancy and lactation.

Side effects include headaches, stool problems, nausea, and abdominal pain. Approximately one in ten patients face such problems. Syndromes of insomnia, malaise, dizziness, drowsiness, skin allergic reactions can be observed much less frequently.

In addition, you should be extremely careful to be those who suffer from diseases of the liver and kidneys. In this case, taking "Omez" will create an additional burden on these organs, which can lead to severe side effects.

"Losek": brief information about the drug

This Swedish drug is the first original anti-ulcer drug with omeprazole in the composition. Available in tablet form of various dosages (10, 20, 40 mg).

A noticeable disadvantage of Losek is its high price, which forces many patients to replace it with more affordable analogues.

The maximum effective work of the drug is achieved on the third or fourth day of administration, after the course of treatment is completed, the residual effect is observed for about another five to seven days.

Indications for the use of "Losek" are:

• Gastric and duodenal ulcer, including peptic ulcer (provoked by the bacterium H. pylori) and NSAID-associated mucosal erosion;
• Zollinger-Ellison syndrome;
• acid dyspepsia.

The only contraindication to taking "Losec" is hypersensitivity to the components of the drug. In all other cases (children, pregnant and lactating), it is recommended to prescribe the drug with caution, but this is not a direct contraindication.

Side effects occur in less than 10% of cases of admission, these are reactions from the gastrointestinal tract and nervous system:

• headache;
• general malaise dizziness;
• sleep disorder (both its absence and vice versa, increased drowsiness);
• stool disorder;
• stomach ache;
• nausea;
• vomiting, gases;

In case of side effects, it is recommended to stop taking the drug, no specific treatment is required. All negative reactions from taking "Losek" are quickly reversible.

"Pantoprazole": brief information about the drug

The basis of this drug is another active active ingredient - pantoprazole. According to the principle of action, it is identical to omeprazole, slows down the production of hydrochloric acid, reducing the level of its content in gastric juice. Accordingly, the indications for the use of "Pantoprazole" are exactly the same as those of "Omeprazole" and its analogues.

The dosage of pantoprazole is on average 40 mg per day (versus the average dose of 20 mg of omeprazole), however, the amount of pantoprazole needed by the body is calculated individually, based on the diagnosis and the results of the patient's tests.

If we compare omeprazole and pantoprazole in terms of effectiveness, then the time it takes for the latter to affect acid secretion is about three times longer than omeprazole.

"Pantoprazole" is produced by a Russian pharmaceutical company, the cost per package varies between 200-300 rubles.

Contraindications to the appointment of "Pantoprazole" are:

1. Intolerance to the components of the drug;
2. Age under 18;
3. Dyspepsia (neurotic genesis);
4. Malignant formations in the gastrointestinal tract;
5. One-time reception with the drug "Atazanavir".

Pantoprazole should not be taken simultaneously with drugs whose effectiveness depends on the pH level, since the effect of pantoprazole reduces their absorption.

All of the above drugs have a large number of analogues that differ from the originals in price, manufacturer and the ratio of active and excipients. Some have longer or shorter half-lives and slightly different levels of bioavailability.

In any case, all drugs of the proton pump inhibitor group are potent substances that are sold exclusively by prescription. Therefore, the decision on which drug to prescribe should be made by the attending gastroenterologist, taking into account the wishes of the patient regarding the form of release and affordability.

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The drug "Omeprazole" is a wonderful remedy for problems with the stomach and the digestive system as a whole. Its use not only helps in the fight against various diseases, but also prevents their reappearance. We will talk about this drug in our article.

general characteristics

The drug "Omeprazole", reviews of which will be discussed later, is one of the most modern antisecretory agents that help with peptic ulcer and erosive-inflammatory pathologies of the upper gastrointestinal tract. This medication is able to suppress the production of hydrochloric acid in the stomach and reduce its activity. A distinctive feature of the drug "Omeprazole" is that it acquires its therapeutic properties only after entering the acidic environment, which is characteristic of the stomach.

The drug "Omeprazole" is able to level the effect of the main "culprit" of peptic ulcer and gastritis - a microorganism called Helicobacter pylori. That is why it is necessarily included in the list of medicines that eliminate the effects of Helicobacter pylori infection in duodenal ulcers and stomach ulcers. The medicine "Omeprazole" not only significantly improves the patient's well-being, but also leads to a decrease in the likelihood of such pathologies in the future.

Dosage form

The drug "Omeprazole" (price, reviews on the use of this medication will be described below) is presented on the pharmaceutical market in different dosage forms. It can be purchased:

• In enteric capsules containing 10 mg or 20 mg of the main active ingredient - omeprazole. At the same time, they are usually placed in blister packs of seven pieces, and one pack with the drug can contain from one to four such plates. However, some manufacturers prefer to pack the capsules in plastic jars of 30 or 40 pieces.
• In tablets MACS (pellets), coated and containing 10, 20 or 40 milligrams of the active substance.
• In powders for infusion solutions, placed in vials of 40 milligrams. Each package of medicine usually contains 5 of these containers.

Those who wish to buy this medicine in pharmacies will be disappointed on their own. The drug "Omeprazole" is released only on prescription.

Indications for use

Reviews of the medication described in this article testify to its high efficiency. It is used to treat a wide variety of gastrointestinal pathologies, such as:

In each case, the patient is assigned a special dosage and treatment regimen. Therefore, it is so important to listen to the doctor's recommendations when taking the medicine "Omeprazole".

Instructions for use

Feedback on the use of this tool is mostly positive. However, its uncontrolled use can adversely affect the work of the digestive tract and lead to serious consequences. Therefore, you must strictly follow the instructions when taking this drug. "Omeprazole" must be drunk before meals or at breakfast. If repeated medication is necessary, then it is usually prescribed in the evening. In this case, the capsules are not recommended to be divided into parts or chewed, but it is prescribed to swallow whole with a small amount of clean water.

If Omeprazole pellets (tablets) are used as a healing agent, then they can be dissolved in acidified water, juice or yogurt. 15-20 milliliters of liquid will be enough. In this case, the diluted drug must be drunk within half an hour.

Dosage

Usually, in a volume not exceeding 20 milligrams per day, the drug "Omeprazole" is prescribed. Feedback from patients suggests that this dose is sufficient for effective treatment. However, the specialist can adjust it depending on the general condition of the patient and the severity of the pathology. Therapy with the drug "Omeprazole", as a rule, lasts no more than two months, after which a long break is necessary.

For severe diseases, such as Zollinger-Ellison syndrome, the minimum dose of the drug is 60 milligrams. In the future, the doctor can increase it to 120 mg / day, used in two doses - in the morning and in the evening. But patients with concomitant liver pathologies should not take Omeprazole more than 20 milligrams per day.

Side effects

Quite rarely, side effects from taking the medicine "Omeprazole" are observed. Patient reviews testify to this. As a rule, unpleasant consequences occur with prolonged or improper use of the drug. Such violations are fraught with numerous symptoms: nausea, bloating, abdominal pain, diarrhea or constipation. Some patients develop headaches and dizziness. Experts say that after stopping the intake, all side effects disappear on their own.

In addition, the drug "Omeprazole" may cause some more discomfort. Instructions, patient reviews indicate that its excessive use threatens:

The above symptoms indicate that the medication "Omeprazole" should be taken with great care and in no case should it be treated on its own.

Analogues

Patients call the drug "Omeprazole" very popular and highly effective. Reviews similar to these can be heard not only in Russia, but also in Europe. The fact is that this medicine has many generics, which contain an identical chemical compound in their composition, but differ significantly in price. The most popular analogues allowed in Russia are the following medicines:

• "Gastrozol";
• "Bioprazole";
• "Omephez";
• "Omez";
• "Omezol";
• "Ulzol";
• "Omeprazole-Richter";
• "Omeprazole-Acre";
• "Losek MAPS" (pellets);
• "Losek";
• "Gasek";
• "Omephez".

There are other analogues of the means described by us. True, they are not registered in Russia:

• "Omeprazole-Astrapharm" (Ukraine);
• Gasek (Switzerland);
• "Cerol" (India);
• "Omeprazole-Darnitsa".

Price

At a very moderate cost, you can buy the medicine "Omeprazole" in pharmacies. Reviews, its price are actively discussed on specialized forums, which indicates the popularity and demand for this tool. The cost of a domestically produced drug is low and quite affordable for every patient. So, capsules "Omeprazole" of 20 mg in the amount of 14 pieces cost customers 15-19 rubles, 28 capsules already cost 25-35 rubles. The maximum price for the Russian "Omeprazole" rarely exceeds 60 rubles per pack.

However, it should be remembered that the cost of drugs varies not only depending on the number of tablets or capsules in the package, but also on the recognition of the manufacturer. For example, for 10 capsules of the Indian analogue of "Omeprazole" - the drug "Omez" - you need to pay 65 rubles, and the Indian "Omez D" in capsules No. 30 is already estimated at 244 rubles. European analogues cost in pharmacies from 300 rubles and more. And for individual drugs, patients will have to pay up to 1,500 rubles per pack, which, as a rule, is enough for a full course of treatment.

Preparations containing Omeprazole (Omeprazole, ATC code (ATC) A02BC01):

Losek (original Omeprazole) - official instructions for use. Prescription drug, information intended for healthcare professionals only!

Clinico-pharmacological group:

H+-K+-ATPase inhibitor. Antiulcer drug

Indications for use of the drug LOSEK®

• peptic ulcer of the stomach and duodenum, incl. ulcers and erosions of the stomach and duodenum associated with taking NSAIDs;
• peptic ulcer of the stomach and duodenum, as well as erosive lesions of the gastroduodenal gastrointestinal tract in HIV-infected patients;
• gastric ulcer associated with Helicobacter pylori;
• gastroesophageal reflux (including symptomatic);
• acid-dependent dyspepsia;
• Zollinger-Ellison syndrome.

Dosing regimen of the tablet form of the drug:

Losec tablets are recommended to be taken in the morning, the tablet should be swallowed whole with liquid, without chewing. Tablets can be dissolved in water or a slightly acidic liquid such as fruit juice. This solution must be used within 30 minutes.

In case of duodenal ulcer in the acute phase, it is recommended to take the drug at a dose of 20 mg per day. The course of treatment averages 2 weeks. In cases where, after the first course of taking the drug, complete scarring does not occur, a second two-week course of therapy is usually prescribed.

With duodenal ulcer, resistant to therapy, the drug is prescribed 40 mg per day; scarring occurs within 4 weeks.

To prevent exacerbations of duodenal ulcer, the drug should be taken at a dose of 10 mg per day. If necessary, the dose can be increased to 20-40 mg.

With gastric ulcer in the acute phase, Losek is prescribed 20 mg per day. The course of treatment averages 4 weeks. In cases where, after the first course of taking the drug, the ulcer has not completely healed, a repeated 4-week course of treatment is usually prescribed, during which a cure is achieved.

With gastric ulcer, resistant to therapy, the drug is prescribed at 40 mg per day; healing usually occurs within 8 weeks.

For the prevention of exacerbations of gastric ulcer, it is recommended to take the drug at a dose of 20 mg per day. If necessary, the dose can be increased to 40 mg.

With erosive and ulcerative lesions of the gastroduodenal gastrointestinal tract in HIV-infected patients, Losek is prescribed 20 mg per day. Treatment can be carried out against the background of treatment for HIV infection. The course of treatment averages 4 weeks. In cases where, after the first course of taking the drug, a complete cure does not occur, a repeated 4-week course of treatment is usually prescribed, during which a cure is achieved.

To prevent exacerbations of gastric and duodenal ulcers, the occurrence of erosive lesions of the gastroduodenal region, as well as dyspeptic symptoms in gastric ulcers, it is recommended to take Losek 20 mg per day.

With gastric ulcer associated with Helicobacter pylori, it is possible to use various treatment regimens.

When conducting "triple therapy" it is possible to use Losec in a single dose of 20 mg, amoxicillin 1 g and clarithromycin 500 mg or Losec MAP 20 mg, metronidazole 400 mg (or tinidazole 500 mg) and clarithromycin 250 mg. All drugs should be taken 2 times a day for a week. It is also possible to use Losek 40 mg per day, in combination with amoxicillin 500 mg and metronidazole 400 mg 3 times a day for a week. When conducting "dual therapy" Losek appoint 40-80 mg per day, amoxicillin 1.5 g per day (the dose should be divided into parts) for 2 weeks. During clinical trials, Losec 40 mg per day and clarithromycin 500 mg 3 times a day for 2 weeks were used.

After Helicobacter pylori eradication, further treatment of gastric ulcer in the acute phase should be carried out according to the standard treatment regimen for duodenal ulcer and gastric ulcer. In cases where the test for Helicobacter pylori remains positive after therapy, the course of treatment can be repeated.

With esophageal reflux, the drug is prescribed at 20 mg per day. The course of therapy averages 4 weeks. In cases where a complete cure does not occur after the first course, a repeated 4-week course of treatment is usually prescribed, during which a cure is achieved.

Patients with severe esophageal reflux are prescribed Losek 40 mg per day; the course of treatment averages 8 weeks.

Patients with esophageal reflux in remission are prescribed Losec 10 mg per day in the form of long-term maintenance therapy. If necessary, the dose can be increased to 20-40 mg.

With symptomatic gastroesophageal reflux, the dosing regimen is set individually. The drug is prescribed at 10-20 mg per day. The course of treatment is 4 weeks. If after the end of therapy the symptoms do not disappear, it is recommended to change the treatment regimen.

For pain, heartburn or discomfort in the epigastric region associated with acid-dependent dyspepsia, the initial dose is 10 mg per day, if necessary, it is possible to increase the daily dose to 20 mg. If after 4 weeks of using Losek 20 mg per day, the symptoms do not disappear, it is recommended to change the treatment regimen.

With Zollinger-Ellison syndrome, the dosing regimen is set individually. The recommended starting dose is 60 mg per day. In all patients with a severe form of the disease, as well as in cases where other therapeutic methods did not lead to the desired result, the use of Losek was effective. More than 90% of patients received Losec 20-120 mg daily. In cases where the daily dose of the drug exceeds 80 mg, the dose should be divided into 2 parts and taken 2 times a day.

In case of impaired renal function, correction of the dosing regimen is not required.

In case of impaired liver function, the bioavailability and clearance of omeprazole increase. In this regard, the therapeutic dose usually does not exceed 10-20 mg per day.

Correction of the treatment regimen for elderly patients is not required.

Dosing regimen of the injection form of the drug:

If oral therapy is not possible, patients with gastric or duodenal ulcer or reflux esophagitis are prescribed Losek as an IV infusion at a dose of 40 mg 1 time per day.

With Zollinger-Ellison syndrome, the drug is prescribed at an initial dose of 60 mg per day.

If necessary, it is possible to increase the dose. If the daily dose exceeds 60 mg, it should be divided into 2 injections.

In case of impaired liver function, a daily dose of 10-20 mg may be sufficient, since in patients of this group the half-life of omeprazole increases.

In case of impaired renal function and in elderly patients, dose adjustment is not required.

The drug is administered intravenously over 20-30 minutes.

Rules for preparing a solution for intravenous infusion

The powder is dissolved in 100 ml of infusion solution (physiological saline or 5% dextrose solution).

Preparation of solution for infusion:

1. Draw up 5 ml of infusion solution from a vial or infusion bag with a syringe.
2. Introduce the infusion solution into a vial with omeprazole lyophilized powder, shake the vial until the drug is completely dissolved.
3. Draw up the resulting solution of omeprazole into the syringe.
4. Transfer the omeprazole solution into a vial or infusion bag.
5. Repeat steps 1-4 to transfer all of the drug from the vial.

Preparation of solution for infusion in a soft container:

1. To prepare the solution, use a double-sided needle (adapter). With one end of the needle, it is necessary to pierce the membrane of the infusion bag, connect the other end of the needle with a vial containing omeprazole lyophilized powder.
2. Dissolve the drug by pumping the infusion solution from the bag into the vial and back.
3. Make sure that the powder has completely dissolved, then disconnect the empty vial and remove the needle from the infusion bag.

Side effect

From the side of the central nervous system and peripheral nervous system: headache; rarely - dizziness, paresthesia, drowsiness, insomnia, blurred vision, impaired taste sensations; in some cases - reversible confusion, agitation, depression, hallucinations (mainly in patients with a severe form of the disease).

From the digestive system: diarrhea, constipation, abdominal pain, nausea, vomiting, flatulence; rarely - increased activity of liver transaminases; in some cases - dry mouth, stomatitis, gastrointestinal candidiasis, encephalopathy against the background of severe liver disease, hepatitis, jaundice, liver dysfunction.

From the endocrine system: in some cases - gynecomastia.

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

From the musculoskeletal system: in some cases - joint pain, muscle weakness, muscle pain.

Dermatological reactions: rarely - rash and / or itching; in some cases - photosensitivity, erythema multiforme, alopecia.

Allergic reactions: rarely - urticaria; in some cases - angioedema, fever, bronchospasm, interstitial nephritis, anaphylactic shock.

Other: rarely - malaise; in some cases - increased sweating, peripheral edema, lowering the concentration of sodium in the blood.

Side effects observed with the use of Losec are usually mild and transient. These side effects have been observed in clinical trials as well as in daily use, although in most cases the relationship of these phenomena with the treatment has not been established.

Contraindications to the use of the drug LOSEK®

• hypersensitivity to the drug.

The use of the drug LOSEK® during pregnancy and lactation

Losec MAPs should be used during pregnancy and lactation (breastfeeding) only if the potential benefit to the mother outweighs the possible risk to the fetus.

With the introduction of the drug Losek in doses up to 80 mg per day, women in labor did not experience any negative side effects in newborns.

In experimental studies on animals, no danger was found when using the drug during pregnancy and lactation. Fetal toxicity or teratogenicity was also not observed.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

The drug should be stored at a temperature not exceeding 25°C.

After opening the package, the tablets should be stored in a tightly closed vial.