Instructions for use OMEPRAZOLE

Omeprazole is an antisecretory drug used in the treatment of peptic ulcers and erosive-inflammatory diseases of the upper gastrointestinal tract. Acting at the molecular level, Omeprazole suppresses the production and reduces the damaging effect of hydrochloric acid on the gastric mucosa, restores the pH of gastric juice and reduces its activity after meals.

The drug is used for stomach ulcers

By provoking a persistent decrease in acidity, the drug creates optimal conditions for the destruction of H. pylory, which is often the cause of gastritis and peptic ulcers. It is worth noting that Omeprazole becomes active only when it enters the acidic environment of the stomach.

Omeprazole not only significantly improves the well-being of patients, causes a rapid regression of diseases of the stomach and/or duodenum caused by acid disorders, and reduces the likelihood of relapse and the development of complications. Its action begins within 1 hour after ingestion and continues throughout the day.

Pharmacological properties of the drug Omez d

A combined drug whose effect is determined by the components included in its composition. Omeprazole is an antisecretory antiulcer agent that reduces spontaneous and stimulated gastric secretion due to inhibition of H+/K+-ATPase (proton pump), necessary for the transport of hydrogen ions, and inhibits the final phase of basal and stimulated secretion of hydrochloric acid, regardless of the nature of the stimulus. Domperidone is a dopamine receptor antagonist, prokinetic. Practically does not penetrate the BBB. Increases the motor-evacuation function of the stomach and duodenum and the tone of the lower esophageal sphincter. Does not increase the secretion of glands of the digestive tract. Has an antiemetic effect. Omeprazole is quickly and completely absorbed from the gastrointestinal tract after oral administration on an empty stomach; when taken after meals, absorption may increase. Although the half-life of omeprazole is short (0.5–1.5 hours), the antisecretory effect persists for ≥24 hours. Omeprazole quickly (within 4 hours) distributes to the gastric mucosa, liver and gallbladder tissues. After 48 hours, omeprazole is detected only in the gastric mucosa. Approximately 90–95% of omeprazole is bound to plasma proteins. A small amount penetrates the BBB. The majority (77%) is excreted in the urine in the form of metabolites (of which hydroxyomeprazole and the corresponding carboxylic acid are identified). The remaining amount is excreted in the feces (a significant part of the metabolites is excreted in the bile). Three metabolites of omeprazole have been identified in blood plasma - sulfide and sulfone derivatives of omeprazole. They have weak antisecretory activity or none at all. The active metabolite is sulfonomeprazole. In patients with chronic liver diseases, the bioavailability of the drug increases to 100%, and the half-life increases to 3 hours. In patients with chronic kidney diseases and elderly patients, the elimination of omeprazole decreases in proportion to the decrease in creatinine clearance, and the concentration in the blood plasma increases. Domperidone is well absorbed from the gastrointestinal tract after administration. It undergoes intensive metabolism in the wall of the stomach and liver and has low bioavailability (15%). The maximum concentration in blood plasma is achieved 1 hour after application. A decrease in gastric acidity reduces the absorption of domperidone. Binds to plasma proteins by 91–93%. Excreted in feces (66%) and urine (33%). The half-life is 9 hours, and increases with severe renal failure.

Indications

Omeprazole has wide indications for diseases of the upper gastrointestinal tract. The drug is usually prescribed to adults and children over 5 years of age in the following cases:

• stomach and duodenal ulcers;
• erosive and ulcerative esophagitis;
• NSAID gastropathy (ulcerative process resulting from potentiated use of non-steroidal anti-inflammatory drugs);
• Zollinger-Ellinson syndrome;
• systemic mastocytosis;
• polyendocrine adenomatosis;
• stress, aspirin and chronic duodenal ulcers of the digestive tract;
• therapy for reflux esophagitis (including long-term treatment of patients with an inactive form of the disease);
• treatment of symptomatic GERD;
• treatment of ulcerogenic adenoma of the pancreas;
• eradication of H. pylori in peptic ulcer disease (in combination with appropriate antibacterial agents);
• to eliminate uncomplicated heartburn that lasts more than 2 days during the week.

Side effects of the drug Omez d

most patients tolerate the drug well. With prolonged use, skin reactions may occur (skin rash, itching, urticaria, erythema multiforme), dry mouth, diarrhea, constipation, intestinal colic, headache, photosensitivity, alopecia, Quincke's edema, dizziness, parasthesia, drowsiness, insomnia, blurred vision , disturbance of taste, agitation, depression, leukopenia, thrombocytopenia, pancytopenia, agranulocytosis, myalgia, arthralgia, bronchospasm, interstitial nephritis, very rarely - galactorrhea, gynecomastia. Domperidone may cause the development of extrapyramidal reactions, especially in young and elderly patients.

Omeprazole analogues

The high effectiveness and positive recommendations of Omeprazole naturally pushed the pharmaceutical market to offer analogues and generic drugs that contain the same main active ingredient, but differ in price, contraindications and side effects. So, in the pharmacy you can find:

Synonyms (based on the same active ingredient as Omeprazole): Omeprazole-Acri, Omeprazole-Teva, Gastrozole, Omeprazole-STADA, Zerocid, Omez, Omipix, Omitox, Omizak, Omeprazole-Richter, Promez, Ultop, Helitsid.

Omeprazole analogues

Analogs (drugs with a similar therapeutic effect): Helicol, Crosacid, Lansofed, Lancid, Pariet, Parkour, Ontime, Nolpaza, Nexium, Ulthera, Epicurus, Neo-Zext, Razo, Peptazol, Pantoprazole, Rabeprazole, De-Nol, Esomeprazole.

Omez or Omeprazole?

Often, to treat certain problems with the gastrointestinal tract, the attending physician can prescribe medications or replace drugs that seem to be similar in composition and therapeutic effect with one another. A reasonable question arises: which is better - Omez or Omeprazole? Both drugs are based on the same active ingredient - omeprazole - which enters the acidic environment of the stomach and affects its mucous membranes. This determines the similarity of the therapeutic effect.

Therefore, the treatment regimen according to which Omez or Omeprazole should be taken for gastritis or ulcers is identical.

The difference between the drugs is the presence of auxiliary components. This should not be underestimated, because the patient may be allergic to some of them, or this will provoke an adverse reaction.

Also, Omeprazole represents the active substance in the maximum volume, and Omez is a drug that contains omeprazole and excipients that mitigate side effects and help the perception of the medicine.

As a result, the choice between these two drugs must be made by the doctor, based on the course of the disease, the severity of its symptoms and the individual indications of the patient.

Special instructions for the use of the drug Omez d

Before starting and after completing therapy with Omez D, it is necessary to conduct an endoscopic examination to exclude a malignant process, since treatment with omeprazole can mask its symptoms and delay correct diagnosis. During pregnancy, the drug is used if the expected benefit to the mother outweighs the potential risk to the fetus. If it is necessary to prescribe the drug during breastfeeding, it is advisable to stop breastfeeding. During treatment with the drug, special care should be taken when driving vehicles or working with potentially dangerous mechanisms.

How to take Omeprazole

Omeprazole is recommended to be taken in the morning, immediately before meals. Capsules are taken orally with a small amount of liquid (can be with food), without crushing, chewing, or damaging the integrity of the shell. If it is necessary to take the drug again during the day, it is usually prescribed in the evening.

Omeprazole can be dissolved in yogurt or juice

For patients with swallowing disorders or children, Omeprazole can be dissolved in acidified water, yogurt or juice (15-20 ml). The diluted drug is prepared immediately before use or no more than 30 minutes before use. In severe cases, especially if the patient is in the intensive care unit, Omeprazole can be administered through a catheter directly into the stomach, or sterile solutions can be used for intravenous infusion. The standard dose for intravenous administration is 40 mg 1 time/day as an infusion lasting 20-30 minutes.

Before administration, the contents of the bottle are dissolved in a volume of 5 ml, and then the volume is immediately adjusted to 100 ml. A 5% glucose solution or a 0.9% NaCl solution is used as a solvent.

A single dose of Omeprazole (tablets/capsules) is 20 mg, but it can be adjusted by the doctor depending on the severity of the disease and the general condition of the patient.

Omeprazole is prescribed in courses of no more than 2 months, after which a break is necessary.

For ulcerogenic adenoma of the pancreas, the course of treatment can last up to 5 years.

Omeprazole during pregnancy and lactation

It has been clinically proven that taking Omeprazole in the first trimester of pregnancy provokes the risk of developing pathology of the cardiovascular system in the fetus. In the second and third trimester, Omeprazole is prescribed with great caution and only when the benefits of the drug outweigh the possible risks. The drug penetrates into the bloodstream and breast milk, so it is not prescribed during lactation.

The therapeutic course of Omeprazole is not intended for children under 5 years of age. However, for Zollinger-Ellison syndrome and some other acute diseases of the upper digestive tract, the doctor may prescribe treatment with the drug. In this case, the dose of the drug is calculated based on the child’s body weight:

• with body weight up to 10 kg: 5 mg/day;
• with body weight from 10 to 20 kg: 10 mg/day;
• with a body weight of 20 kg or more: 20 mg/day.

Omeprazole for gastritis

Omeprazole is prescribed only in cases where gastritis with high acidity is diagnosed. For normo- and hypoacid gastritis, Omeprazole is contraindicated and can provoke thinning of the mucous membrane, a decrease in the number of glands and secretory insufficiency of the stomach and the development of atrophic gastritis with zero acidity of gastric juice.

Omeprazole is prescribed for gastritis with high acidity

The maximum effect from a single dose of Omeprazole at an average therapeutic dose of 20 mg (1 capsule) occurs after 1.5-2 hours. The therapeutic effect of the drug lasts from 18 to 24 hours. The duration of the course is usually 2–3 weeks. During this time, the acidity of the stomach is normalized and the main symptoms of gastritis are eliminated. If the disease is associated with H. pylori infection, then complex therapy is used, supplemented with antibacterial drugs according to one of the generally accepted regimens.

Interactions of the drug Omez d

Antacids slow down and reduce the absorption of the drug, so they should be taken no earlier than 2 hours after taking Omez D. Since omeprazole is metabolized in the liver through the cytochrome P450 system, it should be prescribed with caution simultaneously with diazepam, phenytoin, warfarin, propranolol, prednisolone , theophylline (while omeprazole may reduce their elimination, which requires a reduction in the doses of these drugs). With simultaneous use of omeprazole and clarithromycin, their concentration in the blood plasma increases. Cimetidine and sodium bicarbonate reduce the bioavailability of domperidone. Anticholinergic drugs counteract the effects of domperidone.

Contraindications

Omeprazole should not be taken in the following cases:

• individual intolerance to the components of the drug;
• pregnancy and lactation;
• age up to 5 years;
• severe forms of liver and kidney failure (with caution);
• malignant tumors of the digestive tract;
• gastrointestinal infections (Omeprazole may increase their reproduction);
• osteoporosis (Omeprazole leaches calcium from bones).

As for osteoporosis, in extreme cases, the attending physician may prescribe complex therapy, including calcium supplements and vitamin D.

The drug should not be taken during pregnancy

Omeprazole also helps reduce the acidity of gastric juice. In this regard, it is not prescribed for gastritis with low acidity and atrophic gastritis.

Efficacy of the drug

A noticeable result from taking the medicine occurs after one hour and lasts about a day. When the acute stage of inflammation passes, omeprozole is discontinued, and the secretory activity of the exocrine glands is restored within three to five days.

The intestines are cleared of this drug very quickly.

For patients with duodenal ulcer, maintaining intragastric pH is 3 units and lasts for seventeen hours.

Omez D