Omeprazole suppositories. What is the drug "Omeprazole" prescribed for? How to treat gastritis or heartburn with Omeprazole? Comparison of omeprazole with other proton pump blockers

Formula: C17H19N3O3S, chemical name: 5-Methoxy-2-[[(4-methoxy-3,5-dimethyl-2-pyridinyl)methyl]sulfinyl]-1H-benzimidazole.
Pharmacological group: organotropic drugs / gastrointestinal drugs / proton pump inhibitors.
Pharmachologic effect: antiulcer.

Pharmacological properties

Omeprazole enters the parietal cells of the gastric mucosa, where it accumulates and is activated at acidic pH values. Sulfenamide (active metabolite) inhibits the H+-K+-ATPase of the proton pump (secretory membrane of parietal cells), stops the release of hydrogen ions into the gastric cavity and blocks the main stage of the formation of hydrochloric acid. Omeprazole dose-dependently reduces the content of stimulated and basal secretion, the release of pepsin and the total volume of gastric secretion. Omeprazole effectively inhibits both daytime and nighttime production of hydrochloric acid. With a single dose of 20 mg of omeprazole, suppression of gastric secretion occurs within the first hour and becomes maximum after 2 hours. The effect of omeprazole lasts about a day. Within 3–5 days after the end of treatment, the ability of parietal cells to again form hydrochloric acid is restored.

Omeprazole has a bactericidal effect on Helicobacter pylori. The MIC of omeprazole is 25–50 mg/l. When taking 20 mg of omeprazole daily, the average healing rate of duodenal ulcers in the first 2 weeks of treatment is 68%, after 4 weeks of treatment - 93%. After 4 weeks of daily intake of 20 mg of omeprazole, complete healing of the gastric ulcer is observed in 77% of patients, after 8 weeks of therapy - in 96%. After omeprazole therapy, the recurrence rate of peptic ulcers is 41%. Anti-Helicobacter combinations, which include omeprazole, provide eradication of H. pylori in more than 85% of cases.

For peptic ulcers in the acute stage (2 times a day, 20 mg) increases the frequency of eradication of Helicobacter infection by 20%. Therapy of peptic ulcers, which are complicated by gastrointestinal bleeding, is accompanied by a significant reduction in the intensity and duration of bleeding. Therefore, the frequency of blood transfusions, additional endoscopic manipulations and surgical interventions is reduced. Normalization of acid exposure in the esophagus and maintaining intragastric pH>4.0 during the day with a decrease in the damaging properties of gastric contents in reflux ulcerative esophagitis helps to alleviate symptoms and complete healing of esophageal injuries.

Omeprazole is highly effective in the treatment of complicated and severe forms of ulcerative and erosive esophagitis, which is resistant to treatment with H2-blockers of histamine receptors. Long-term maintenance treatment prevents relapses of reflux esophagitis and reduces the possibility of complications. Omeprazole provides remission within 1 year in 85% of patients with gastroesophageal reflux disease. The effectiveness of omeprazole has been shown for portal hypertension, chronic pancreatitis (pain relief), for the prevention of erosive and ulcerative lesions of the mucous membrane of the stomach and esophagus and associated bleeding in patients with esophageal varicose veins of stages 2–3 and aspiration pneumonia in surgical patients. In the first 1–2 weeks of therapy, the gastrin content in the blood serum increases (after discontinuation of the drug it returns to normal). At a dose of 40 mg daily, it reduces the motor-evacuation capacity of the stomach. With a 10-day course of therapy, the content of gastrin, motilin and cholecystokinin in the blood serum changes. Biopsy examination did not reveal an increase in the number of ECL cells.

Omeprazole is almost completely and quickly absorbed from the gastrointestinal tract, its bioavailability is no more than 65% (due to the effects of “first pass” through the liver). The maximum concentration of omeprazole is reached after 3–4 hours. With repeated doses, the absorption of omeprazole increases (the maximum concentration and bioavailability increases) and the antisecretory effects increase. The distribution of omeprazole is 0.2–0.5 l/kg. Omeprazole binds 95% to plasma proteins (acid alpha1-glycoprotein and albumin). In the liver, omeprazole undergoes biotransformation with the formation of at least 6 inactive metabolites (sulfonic and sulfide derivatives, hydroxyomeprazole and others). The half-life of omeprazole in normal liver function is 0.5–1 hour, and in chronic liver diseases it is 3 hours. Excreted mainly in the form of metabolites by the kidneys 72–80% and intestines 18–23%. In elderly patients, there may be a slight increase in bioavailability and a decrease in the rate of elimination of omeprazole.

Indications

Exacerbation of peptic ulcer of the duodenum and stomach; reflux esophagitis (including both ulcerative and erosive); gastroesophageal reflux disease (including those refractory to treatment with H2-antihistamines); pathological hypersecretory conditions (systemic mastocytosis, polyendocrine adenomatosis, Zollinger-Ellison syndrome, stress ulcer, including prevention); NSAID gastroenteropathy; peptic ulcer of the gastrointestinal tract, which is caused by Helicobacter pylori; non-ulcer dyspepsia; ulcerative and erosive lesions of the duodenum and stomach in HIV-infected patients.

Method of administration of omeprazole and dose

Omeprazole is taken orally, intravenously. Orally, before meals in the morning, without crushing, chewing or damaging the capsule, with a small amount of liquid (take with food is possible). Peptic ulcer, esophageal reflux - 1 time per day 20 mg, reflux esophagitis - 1 time per day 20–40 mg. Duration of therapy: stomach ulcer and esophageal reflux - 4–8 weeks, reflux esophagitis - 4 weeks, duodenal ulcer - 2–4 weeks. To prevent relapses of reflux esophagitis and duodenal ulcers, long-term administration at a dose of 10 mg is possible. If it is impossible to prescribe omeprazole orally and/or severe peptic ulcer disease, intravenously once a day at a dose of 40 mg for 20–30 minutes. The solution for intravenous administration is prepared ex tempore by dissolving 40 mg of the substance for intravenous infusion in 100 ml of a 5% dextrose solution or saline solution. It is possible to administer it in encapsulated form intragastrically through a tube to patients in critical condition.

Zollinger-Ellison syndrome: the dose is set individually, based on the results of determining the level of gastric secretion (should not be higher than 10 mmol HCl/h or 5 mmol HCl/h after resection), the initial dose is 20–60 mg/day, if necessary, increase the dose to 120 mg/day in 3 divided doses (a daily dose of more than 80 mg must be administered in divided doses) for 2–8 weeks (long-term use up to 5 years is possible). Peptic ulcer caused by Helicobacter pylori, in combinations: omeprazole 20 mg, clarithromycin 250–500 mg, metronidazole 400 mg or omeprazole 20 mg, clarithromycin 250–500 mg, amoxicillin 1 g 2 times a day for 1 week. Gastroenteropathy associated with taking nonsteroidal anti-inflammatory drugs - 20 mg once a day for 4–8 weeks. Ulcerative and erosive lesions of the duodenum and stomach in HIV-infected patients - 20 mg once a day for 4 weeks.

The prepared infusion solution must be used no later than 6 hours (when dissolved in dextrose) or 12 hours (when dissolved in saline solution).

Before starting therapy with omeprazole, it is necessary to exclude the presence of a malignant neoplasm in the gastrointestinal tract, especially with a gastric ulcer. In case of severe liver failure, therapy with omeprazole is possible only under the close supervision of a physician (the dose should not exceed 20 mg/day). For Asian patients, dosage adjustments may be necessary, especially during long-term anti-relapse therapy. When using omeprazole with warfarin, it is recommended to regularly determine the prothrombin time or monitor the level of warfarin in the blood serum with further dose adjustment. It is necessary to take into account that the following groups of patients require continuous anti-relapse treatment with omeprazole: with frequent and severe symptoms and/or endoscopically proven stages 3–4 of gastroesophageal reflux disease, in the presence of complications (Barrett’s esophagus, ulcer or stricture), prolonged use of drugs that contribute to development of gastroesophageal reflux disease; long duration of symptoms before the start of therapy, persistence of symptoms after healing, very low basal pressure in the area of the lower esophageal sphincter. For stage 2 esophagitis, maintenance treatment is recommended after two relapses. The effectiveness of permanent treatment for gastroesophageal reflux disease is increased by joint therapy with prokinetic drugs. When conducting maintenance treatment in patients with gastroesophageal reflux disease associated with H. pylori, eradication of the pathogen is recommended to prevent mucosal atrophy.

Contraindications for use

Hypersensitivity, breastfeeding, pregnancy.

Restrictions on use

Children's age (except Zollinger-Ellison syndrome), chronic liver diseases.

Use during pregnancy and breastfeeding

During pregnancy, omeprazole can be used only for health reasons. During therapy with omeprazole, breastfeeding must be stopped.

Side effects of omeprazole

Digestive system: lack of appetite, dry mouth, nausea, flatulence, vomiting, abdominal pain, constipation, diarrhea, changes in taste sensitivity, candidiasis of the gastrointestinal tract, stomatitis, atrophic gastritis, polyposis of the fundus of the stomach, increased activity of liver enzymes;

sense organs and nervous system: headache, malaise, dizziness, asthenia, sleep disturbance, paresthesia, drowsiness, in some cases - agitation, restlessness, anxiety, hallucinations, reversible mental disorders, depression, visual impairment, including irreversible ones; support system and movement: muscle weakness, arthralgia;

blood: thrombocytopenia, neutropenia, leukopenia, eosinopenia, leukocytosis, pancytopenia, anemia; genitourinary system: proteinuria, hematuria, urinary tract infection, peripheral edema, gynecomastia;

skin: erythema multiforme, photosensitivity, alopecia; allergic reactions: urticaria, skin rash, itching, in some cases - angioedema, bronchospasm, anaphylactic shock, interstitial nephritis;

others: chest pain.

When using omeprazole, like other proton pump inhibitors (PPIs), a decrease in calcium absorption and, consequently, bone mineral density is suspected. However, there are isolated reports that omeprazole reduces bone resorption by inhibiting the H+-,K+-ATPase of osteclasts. To evaluate these conflicting findings in relation to osteoporosis, a case-control study was undertaken using the UK General Practice Research Database of 9.4 million people. Cohorts were identified - people over 50 years of age who took PPIs at a standard dose and those who did not take PPIs. The outcome chosen was femoral neck fracture. When analyzing the database, 13,556 cases of hip fractures were identified (10,834 in people who did not take PPIs and 2,722 in people who took PPIs), 135,386 people were included in the control group. The OR for hip fracture with PPI use for more than 1 year was 1.44 (95% CI 1.30–1.59); OR for high-dose PPIs 2.65 (95% CI 1.80–3.90). The risk varied depending on the duration of PPI use: OR for PPI use for 1 year – 1.22; 2 years – 1.41; 3 years – 1.54; 4 years – 1.59. Interestingly, the OR for men was 1.78, but for women it was lower than 1.36, although female gender is a risk factor for osteoporosis. Despite the fact that in the study by P. Vestergaard et al. also found an increase in the risk of hip fractures; this group of authors was unable to identify an association with either the dose or duration of PPI administration. L.E. Targownik et al. revealed an increase in the risk of hip fracture only after 5 years of continuous use of PPIs, and of any other fracture due to osteoporosis - only after 7 years (!) of continuous use of PPIs. According to this group of authors, 4 years (or less) of PPI use was not associated with osteoporosis and fractures, and their calculated risk of fractures with PPI use was comparable to the effects of tobacco smoking, low body mass index, or excess alcohol intake. Thus, different studies that have shown an association of PPIs with osteoporosis and bone fractures are conflicting in their assessment of this risk.

Interaction of omeprazole with other substances

Omeprazole changes the bioavailability of any drug whose absorption depends on pH (iron salts, ketoconazole and others). Omeprazole slows down the elimination of drugs that are metabolized in the liver by microsomal oxidation (diazepam, warfarin, phenytoin and others). Omeprazole enhances the effect of diphenin and coumarins, but does not change the effect of non-steroidal anti-inflammatory drugs. When omeprazole is taken together with clarithromycin, the concentration of these drugs in the blood mutually increases. Omeprazole may increase the thrombocytopenic and leukopenic effects of drugs that inhibit hematopoiesis. Omeprazole substance for intravenous infusion is compatible only with dextrose solution and saline (when using other solvents, the stability of omeprazole may decrease due to changes in the pH of the infusion medium). Serum cyclosporine levels are usually not affected by omeprazole, but two separate reports described a more than 2-fold decrease in cyclosporine concentrations in one patient and a 2-fold increase in another.

Overdose

An overdose of omeprazole causes: nausea, dry mouth, blurred vision, increased sweating, headache, flushing, drowsiness, tachycardia, confusion. Required: symptomatic treatment; hemodialysis is ineffective.

The cause of gastric ulcers is its excessive acidity, an overly aggressive environment that provokes damage to the mucous membrane. To combat this phenomenon, drugs of various pharmacological groups are used, among which a prominent place is occupied by the so-called proton pump inhibitors or proton pump inhibitors. The proton pump (alternatively called H+/K+-ATPase) is an enzyme that plays a major role in the secretion of hydrochloric acid by parietal (parietal) cells of the gastric mucosa. Thanks to his tireless work, H+ and Cl ions are released into the lumen of the stomach, which subsequently happily combine into hydrochloric acid. If this process takes on a pathological character, then it’s time to slow down the functioning of the proton pump, which is successfully accomplished by a drug such as omeprazole, with the direct participation of which the final stage of hydrochloric acid synthesis is blocked. Under such conditions, both stimulated and basal (without the presence of a stimulus) secretion of hydrochloric acid decreases.

The effect of omeprazole develops within 1 hour after administration, reaches its peak in the second hour and lasts for almost the whole day. In order to evaluate the full power of omeprazole, you should pay attention to specific figures: 20 mg of the drug is enough to maintain the intragastric pH in a patient suffering from duodenal ulcer at level 3 for 17 hours.

After discontinuation of omeprazole, secretion returns to normal within 3-5 days.

Omeprazole is available in enteric capsules, which should be swallowed without chewing, along with a small amount of liquid. The dose, frequency and duration of administration is determined by the specific disease. Thus, an acute duodenal ulcer requires taking 20 mg (1 capsule) of omeprazole per day for 2-4 weeks; in especially severe cases, the daily dose can be increased to 2 capsules. For acute gastric ulcers and erosive-ulcerative inflammation of the esophagus, 1-2 capsules of the drug per day are taken for 4-8 weeks. The duration of taking omeprazole is similar for erosive and ulcerative lesions of the digestive tract caused by taking non-steroidal anti-inflammatory drugs, however, the daily dose should not exceed 1 capsule in this case. For helicobacteriosis, the drug is taken 1 capsule 2 times a day for 1 week in combination with antibiotics. Omerpazole can be taken after the active phase of the disease has ceased in order to prevent relapses. In such cases, the drug is taken 1 capsule once a day for a long (up to six months) period of time.

It is very important (especially for gastric ulcers) to undergo an oncological examination before starting treatment in order to exclude the presence of malignant neoplasms. Otherwise, you can hide the symptoms of cancer, which can lead to untimely initiation of treatment.

Pharmacology

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, also known as the “proton pump” or “proton pump”) in the parietal cells of the stomach, thereby blocking the transport 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 into an active metabolite sulfenamide, which inhibits the membrane H + /K + - adenosine triphosphate (ATP) phase, connecting with it through a 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. The biotransformation of omeprazole into sulfenamide occurs quickly (within 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 gastroprotective activity, the mechanism of which is not clear. Does not affect the production of intrinsic factor of Castle and the rate of transition of food mass from the stomach to the duodenum. Omeprazole does not act on acetylcholine and histamine receptors.

Omeprazole capsules contain film-coated microgranules, the gradual release and onset of action of omeprazole begins 1 hour after administration, reaches a maximum after 2 hours, and 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 rapid and effective suppression of daytime and nighttime gastric secretion, reaching its maximum after 4 days of treatment. In patients with duodenal ulcers, 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 is 30-40% (in case of liver failure it increases to almost 100%), increases in elderly people and in patients with impaired liver function; insufficiency of renal function has no effect. TC max - 0.5-3.5 hours.

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

T1/2 - 0.5-1 hour (for liver failure - 3 hours), 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 sulfone derivatives, etc.). It is an inhibitor of the CYP2C19 isoenzyme. Excretion by the kidneys (70-80%) and bile (20-30%) in the form of metabolites.

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

Release form

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

10 pieces. - contour cell packaging (3) - cardboard packs.

Dosage

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

For 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 once a day. The course of treatment for duodenal ulcer is 2-4 weeks, if necessary - 4-5 weeks; for gastric ulcers, for reflux esophagitis, for erosive and ulcerative lesions of the gastrointestinal tract caused by taking NSAIDs - for 4-8 weeks.

Reduction of symptoms of the disease and scarring of the ulcer in most cases occurs within 2 weeks. For patients who do not experience complete scarring of the ulcer after a two-week course, treatment should be continued 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 is 4 weeks, for gastric ulcer and reflux esophagitis - 8 weeks.

For 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).

To prevent relapses of peptic ulcer - 10 mg 1 time per day.

To eradicate Helicobacter pylori, “triple” therapy is used (within 1 week: omeprazole 20 mg, amoxicillin 1 g, clarithromycin 500 mg - 2 times a day; or omeprazole 20 mg, clarithromycin 250 mg, metronidazole 400 mg - 2 times a day). day; or omeprazole 40 mg once a day, amoxicillin 500 mg and metronidazole 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 a day and clarithromycin 500 mg - 3 times a day or amoxicillin 0.75-1.5 g -2 times a day).

For liver failure, 10-20 mg is prescribed once a day (for severe liver failure, the daily dose should not exceed 20 mg); in case of impaired renal function and in elderly patients, no dosage adjustment is required.

Overdose

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

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

Interaction

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

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 via cytochrome CYP2C19), which in some cases may require a reduction in the doses of these drugs. May increase plasma concentrations of clarithromycin.

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 concentrations.

Strengthens the inhibitory effect on the hematopoietic system and other drugs.

There was no interaction with concomitantly taken antacids.

Side effects

From 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, myalgia.

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

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

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

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

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);

Use during pregnancy and breastfeeding

Use for liver dysfunction

Use for renal impairment

Use in children

special instructions

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

Taking it with food does not affect its effectiveness.

Composition of the medicinal product Omeprazole

omeprazole (pellets) 20 mg
excipients: gelatin; glycerol; nipagin; nipazole; sodium lauryl sulfate; titanium dioxide; purified water; dye E 129

Dosage form

Capsules

Pharmacotherapeutic group

Medicines used to treat gastric and duodenal ulcers H2-histamine receptor blockers

Pharmacological properties

Suppresses the secretion of hydrochloric acid in the stomach, being an inhibitor (suppresses the function) of the “proton pump” (the process of exchange of hydrogen ions). The mechanism of antisecretory action is associated with inhibition (suppression of activity) of the enzyme H-K-ATPase (an enzyme that accelerates the exchange of hydrogen ions) in the membranes of cells of the gastric mucosa, which leads to blocking the final stage of the formation of hydrochloric acid. As a result, the level of basal (intrinsic) and stimulated secretion (excretion of digestive juices) decreases, regardless of the nature of the stimulus. The effect of the drug occurs quickly and depends on the dose. After a single dose of 0.02 g of omeprazole, the effect lasts for 24 hours.

Omeprazole - indications for use

Peptic ulcer of the stomach and duodenum, peptic ulcer (ulcer of the stomach, intestine or esophagus, developed as a result of the destructive effect of gastric juice on the mucous membrane), caused by Helicobacter pylori (microorganisms that, under certain conditions, can cause gastritis or recurrent / periodically recurring / stomach ulcer), reflux esophagitis (inflammation of the esophagus caused by the reflux of gastric contents into the esophagus), Zollinger-Ellison syndrome (a combination of a stomach ulcer and a benign tumor of the pancreas).

Contraindications

Pregnancy, breastfeeding.

Cautions for use

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

Taking with food does not affect effectiveness.

If you have difficulty swallowing a whole capsule, you can swallow its contents after opening or dissolving the capsule, or you can mix the contents of the capsule with a slightly acidified liquid (juice, yogurt) and use the resulting suspension for 30 minutes.

In patients with severe liver failure, the daily dose should not exceed 20 mg.

Interactions with drugs

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 changes in their plasma concentrations.

There was no interaction with concomitantly taken antacids.

Changes the bioavailability of any drug whose absorption depends on the pH value (for example, iron salts).

Omeprazole - method of administration and dosage

In case of exacerbation of peptic ulcer disease and reflux esophagitis, the drug is prescribed in a dose of 0.02 g once in the morning (before breakfast). Capsules should be swallowed whole with a small amount of liquid.

The duration of treatment for duodenal ulcer is usually 2 weeks. For those patients who do not experience complete healing after a 2-week course, healing usually occurs over the next 2-week treatment period.

For patients with poor healing of duodenal ulcers, it is recommended to prescribe omeprazole at a dose of 0.04 g once a day, which allows healing to be achieved within 4 weeks.

To prevent relapses (reappearance of signs of the disease) of duodenal ulcer, 0.01 g of the drug is prescribed once a day. If necessary, the dose can be increased to 0.02-0.04 g 1 time per day.

To prevent relapses of gastric ulcer in patients with poor healing, it is recommended to prescribe 0.02 g of the drug once a day.

The duration of treatment for gastric ulcer is usually 4 weeks. In case of incomplete scarring, an additional 4-week therapy is carried out. For patients with poor healing of gastric ulcers, it is recommended to prescribe omeprazole 0.04 g per day, which will ensure scarring within 8 weeks.

For peptic ulcers associated with Helicobacter pylori, omeprazole is prescribed in a daily dose of 0.04-0.08 g in combination with amoxicillin - 1.5-3 g in several doses over 2 weeks. If after a 2-week course there is no complete scarring of the ulcer, then the course of treatment is extended for another 2 weeks.

For reflux esophagitis, omeprazole is prescribed in a daily dose of 0.02 g. The course of treatment is 4-5 weeks. In case of severe reflux esophagitis, the daily dose of the drug can be increased to 0.04 g, and the course of treatment extended to 8 weeks. For long-term treatment of patients with reflux esophagitis, it is recommended to use a dose of 0.01 g once a day. If necessary, the dose can be increased to 0.02-0.04 g 1 time per day.

For Zollinger-Ellison syndrome, the recommended initial dose is 0.06 g per day in 1 dose. If necessary, the dose is increased to 0.08-0.12 g per day, in which case it is divided into 2 doses. The duration of treatment is determined individually.

Before starting treatment with the drug, it is necessary to exclude the presence of a malignant process, especially in patients with gastric ulcers, since treatment with omeprazole can mask symptoms and delay correct diagnosis.

Side effects

Rarely - dizziness, headache, agitation, drowsiness, sleep disorders, paresthesia (a feeling of numbness in the limbs), in some cases - depression (a state of depression) and hallucinations (delusions, visions that acquire the character of reality). Rarely - dry mouth, taste disturbances, diarrhea (diarrhea) or constipation, gastrointestinal candidiasis (a disease of the stomach and small intestine caused by yeast-like fungi such as Candida), stomatitis (inflammation of the oral mucosa), abdominal pain. Increased activity of liver enzymes, liver failure, hepatitis with or without jaundice, encephalopathy in patients with pre-existing severe liver disease. Rarely - bronchospasm (sharp narrowing of the lumen of the bronchi), leukopenia (decrease in the level of leukocytes in the blood), thrombocytopenia (decrease in the number of platelets in the blood). Arthralgia (joint pain), muscle weakness, myalgia (muscle pain), skin rash, urticaria and/or itching, erythema multiforme (an infectious-allergic disease characterized by redness of symmetrical areas of the skin and a rise in temperature), increased sweating, alopecia (complete or partial hair loss); blurred vision, peripheral edema, fever (sharp rise in body temperature). In some cases - interstitial nephritis (inflammation of the kidney with primary damage to connective tissue).

Overdose

Symptoms: blurred vision, drowsiness, agitation, confusion, headache, increased sweating, dry mouth, nausea, arrhythmia.

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

Active ingredient: Omeprazole is an antiulcer drug, a proton pump inhibitor.

Release form: Omeprazole 20 mg capsules and lyophilisate for the preparation of a solution for intravenous administration and infusion therapy (40 mg bottles).

Omeprazole capsules are an effective modern drug used to treat gastric erosions, some types of gastritis and peptic ulcers with high acidity. The active ingredient of the drug successfully fights various inflammatory processes in the gastrointestinal tract by reducing the production of hydrochloric acid (decreased acidity).

What does Omeprazole help with?

The use of omeprazole capsules is possible not only for gastritis and gastric ulcers, but also for preventive purposes, in the presence of risk factors. In particular, it is possible to use omeprazole for short-term attacks of heartburn; the therapeutic effect appears within 10 to 20 minutes after administration. The effect of long-term exposure prevents repeated unpleasant sensations of heartburn for 12 to 18 hours.

The use of Omeprazole is indicated for long-term use of non-steroidal anti-inflammatory drugs (for example, for arthrosis and arthritis) to prevent the development of so-called “aspirin” ulcers of the stomach and duodenum.

In addition, the drug helps prevent bleeding from the upper gastrointestinal tract in critically ill patients.

Omeprazole 20 capsules are prescribed for the treatment of:

ulcerative pathology of the intestine (12 duodenal component);
stomach ulcers;
polyendocrine adenomatosis;
induced gastropathy;
systemic mastocytosis;
reflux esophagitis;
Zollinger-Ellison syndrome;
prevention and disposal of Helicobacter pylori;
diaphragmatic hernia of the esophagus;
acute and chronic duodenitis;
for some pancreatic tumors.

I hope I answered the question of what omeprazole treats, now how to take it.

Omeprazole - instructions for use, dosage

The daily dose of the drug depends on the severity of the disease. In acute forms of ulcers and reflux-esophagitis, the medication is prescribed once a day in the morning on an empty stomach, 20 mg once a day. After a single dose of 20 mg of omeprazole, inhibition of gastric secretion occurs within the first hour, reaches a maximum after 2 hours and lasts about 24 hours, the severity of the effect depends on the dose.

The duration of treatment is approximately two weeks. If the patient's condition does not improve, the course of therapy is extended until the ulcer is completely healed.

The daily dose of the drug depends on the indications:

peptic ulcer, esophageal reflux - 20 mg (1 capsule);
reflux esophagitis - Omeprazole 20, for severe disease - 2x20 mg;
prevention of relapse of reflux esophagitis and peptic ulcer - 10 mg (in small doses the drug can be taken for a long time);
prevention of acid aspiration pneumonitis - 40 mg once an hour before surgery;
acid-dependent dyspepsia - 10-20 mg for 2-4 weeks;
ulcerogenic adenoma of the pancreas - 20-120 mg (if the dose exceeds 80 mg/day, it should be divided into 2-3 doses).
Zollinger-Ellison syndrome – 60 mg, but if necessary, the dose is increased to 80-120 mg/day in 2-3 doses. The duration of therapy is determined individually.
for the prevention of relapses of peptic ulcer – 10 mg 1 time per day.

Patients resistant to other antiulcer drugs are advised to take Omeprazole at a dose of 40 mg/day.

For particularly severe patients in intensive care, Omeprazole is administered through a catheter directly into the stomach. To do this, the contents of the capsule must be dissolved in a small amount of water.

In the presence of liver failure - no more than 10-20 mg of the drug once a day.

If renal function is impaired, no dosage adjustment is required.

Elderly people require individual dosage calculations due to the increased bioavailability of omeprazole.

Use for children - Omeprazole capsules are used for children over 5 years old with a body weight of at least 20 kg.

Is it possible to take omeprazole constantly? Treatment is carried out until the symptoms disappear or recovery; if no improvement is observed within the specified period, a re-examination and consultation with a doctor is necessary (at a minimum).

Does omeprazole help with pancreatitis? It is possible to use omeprazole capsules to relieve pain; it is more effective to treat pancreatitis with other drugs.

Omeprazole during pregnancy and lactation

Due to the lack of clinical experience, omeprazole is not recommended for use during pregnancy and lactation. If it is necessary to use it during breastfeeding, the issue of stopping breastfeeding should be decided.

Contraindications Omeprazole

Hypersensitivity to the active substance and/or other components of the drug;
Concomitant use with atazanavir, erlotinib, posaconazole;
Children under 5 years old;
Breastfeeding period.
Use caution in case of osteoporosis and the presence of cancer.

Treatment with omeprazole has no effect on driving.

Experience in clinical use indicates that the drug is well tolerated by most patients.

Side effects of the drug Omeprazole

The most common gastrointestinal disorders that are observed after taking the drug Omeprazole include the following:

constipation or diarrhea;
gases;
dryness of the oral mucosa;
flatulence;
taste disturbance;
liver dysfunction;
stomatitis;
vomiting, nausea and abdominal pain;

Allergic reactions are rarely observed - skin rash, urticaria, itching, and in some cases - bronchospasm, angioedema, anaphylactic shock.

Strengthens the effect of some medications; if used together, consult a doctor.

Analogues of Omeprazole, list of drugs

Currently, there are a sufficient number of Omeprazole analogues produced by foreign or Russian manufacturers, but they should not be used according to the instructions for Omeprazole, since the content of the active substance (omeprazole) in 1 tablet or capsule may be changed.

List of similar analogues of Omeprazole by active substance and effect:

Gastrozol,
Losek,
Omez,
Omitox,
Orthanol,
Ultop,
Helicid,
Helol,
Ranitidine,
Nexium,
Famotidine,
Pariet

Instructions for use of Omeprazole, price and reviews do not apply to analogues! Be careful. When changing the drug, you should consult a doctor.

As you know, various kinds of pathologies of the digestive system, accompanied by ulceration of their walls, are dangerous not only to a person’s physical health, but also to his life. Such diseases need to be treated on time and using the most effective drugs. One of the modern medicines that helps well with ulcers of the duodenum and stomach is Omeprazole. In the pharmacological group, this drug belongs to proton inhibitors.

Composition of the drug

The main active component of this domestic product is omeprazole. This medicine also contains additional substances such as:

sodium lauryl sulfate;

titanium dioxide;

purified water;

dye E 129.

The medicine “Omeprazole” is supplied to pharmacies in the form of capsules, packed in blister packs, in most cases, 10 pieces each. Actually, the drug itself is a spherical pellet of white or light yellow color. The cap of the medicine capsules is red, the body is white. They contain 10, 20 or 40 mg of active substance.

There is also Omeprazole powder on the market, intended for the preparation of solutions for intravenous administration. But the medicine is used in this form somewhat less often than capsules and, of course, usually only in a hospital setting.

Omeprazole tablets can also be purchased at pharmacies. Their instructions for use are almost the same as those for capsules. The drug in this form also contains 10, 20 or 40 milligrams of the active substance.

"Omeprazole": pharmacological group

This drug is classified by doctors as a proton pump inhibitor. Medicines in this group are capable of suppressing H+-K+-ATPase on the cell membrane of the gastric mucosa. The main purpose of the proton pump in the human body is to transfer hydrogen ions from cells into the lumen of the stomach. Acting at the molecular level, such drugs suppress and prevent increased secretion after the patient eats food.

Medications of the pharmacological group "Omeprazole" in case of long-term use can cause atrophy of the gastric mucosa in patients, as well as Campylobacter gastroenteritis. In addition, such drugs often disrupt the dynamic balance of the colon microflora.

The drugs of this group begin to act on the patient’s body quite quickly. Patients usually feel the effect of taking Omeprazole within the first hour. At the same time, medications in this group can retain their beneficial effects on the patient’s body for a long time—about a day.

In pharmacology, Omeprazole is a proton inhibitor. And like many other drugs in this group, in the human body it is quickly absorbed inside the digestive canal. Omeprazole is 90% bound to plasma proteins. At the same time, it is almost completely metabolized in the liver and then excreted by the kidneys.

Indications for use

The pharmacological action of Omeprazole was discussed above. This drug, in addition to stomach and duodenal ulcers, can be prescribed for diseases such as:

ulcerogenic adenoma of the pancreas;

Zollinger-Ellison syndrome;

reflux esophagitis;

heaviness in the stomach;
bloating;

Omeprazole belongs to the pharmacological group of proton inhibitors and in the human body provokes a persistent decrease in acidity. Accordingly, this drug can be prescribed only when the pH in the stomach is elevated.

Contraindications

This medicine is prescribed quite often for the treatment of various gastrointestinal diseases. However, of course, it also has contraindications. First of all, Omeprazole should not be prescribed to those patients who are hypersensitive to any of its components. According to the instructions for use, Omeprazole capsules are also contraindicated:

children under 5 years old;

pregnant women;

lactating women.

Sometimes, for health reasons, this drug can still be prescribed to pregnant women. But treatment in this case is carried out under the strict supervision of a doctor. If a woman needs to take the drug during lactation, the child is transferred to artificial feeding.

What you need to know

The pharmacological group of the drug "Omeprazole" is proton inhibitors. Only benign gastric and intestinal ulcers are treated with this remedy. Before starting to use this medicine, the doctor must make sure that there are no malignant tumors. The drug cannot cause any particular harm in the presence of such a problem. However, it very easily hides the symptoms of oncology. And this, in turn, can cause untimely and, as a result, ineffective treatment.

Instructions for use of capsules and tablets: dosages

Of course, the doctor determines the amount and frequency of taking Omeprazole primarily depending on the specific disease. Also, a treatment regimen using this drug can be developed taking into account the characteristics of the patient’s body, his age, etc. Therefore, under no circumstances should you self-prescribe this medicine. It can only be taken as prescribed by a doctor.

In most cases, depending on the type of disease, patients take Omeprazole according to the following scheme:

In cases of exacerbation of stomach ulcers, as well as in the erosive form of esophagitis, doctors prescribe 1-2 capsules of the drug per day to patients. The course of treatment in this case usually lasts 1-2 months.

For duodenal ulcers, the medicine is prescribed in a dosage of 1 capsule per day. In resistant cases, the amount of the drug taken can be increased to 2 capsules. The course of treatment for this disease lasts in most cases 2-4 weeks.

In the presence of ulcerative disorders in the gastrointestinal tract, the cause of which was the use of NSAIDs, the patient is prescribed 1 capsule or tablet per day for a course of 1-2 months.

If you want to prevent exacerbation of an intestinal or stomach ulcer, you most often take 1 capsule per day.

When eradicating Helicobacter pylori, you should take 1 caps/day. Treatment in this case is carried out in combination with antibiotics. The course lasts a week.

In order to prevent relapse of reflux esophagitis, this drug can be prescribed for a long time. In this case, prevention often lasts up to six months. The medicine is prescribed to the patient in a dosage of 1 pc. in a day.

For Zollinger-Ellison syndrome, according to the instructions for use, Omeprazole capsules are used strictly in dosages selected on an individual basis. The amount of the drug taken in this case depends on the patient’s gastric secretion.

Most often, the doctor prescribes at least 60 mg of Omeprazole per day to patients with this pathology. That is 3 tab. 20 mg. In this case, you should take the medicine once a day. Sometimes experts prescribe higher doses of the drug to patients with Zollinger-Ellison syndrome - 80-120 mg/day. The patient should take the drug 2 times a day.

For those patients who have been diagnosed with severe liver failure, the drug is allowed to be prescribed in a daily dose of no more than 20 mg.

How to drink correctly

It is believed that the effectiveness of this medicine, despite the fact that it is intended for the treatment of the gastrointestinal tract, does not depend on food. Therefore, drinking Omeprazole is allowed both before, after, or during meals. However, it is believed that it is best to take this medicine in the morning before breakfast.

According to the instructions, you need to swallow Omeprazole capsules whole with a small amount of water. There is no need to crush or chew the drug. It is desirable that the capsule shell remains intact when taken. But this condition is still not strict. If the patient suddenly has difficulty swallowing the capsule, it can be opened and the contents drunk with water. This will not cause any harm to the stomach.

Omeprazole capsules can also be dissolved. Some patients drink this drug by pouring the contents into an acidified liquid - kefir, juice or yogurt. This method of administration is also allowed. In this case, the resulting suspension can be drunk not in one dose, but gradually, over half an hour.

Omeprazole tablets are also best swallowed whole with water.

Instructions for use for children

This medicine can be prescribed for the treatment of gastric diseases in pediatrics for patients over the age of 5 years. At the same time, the drug can be prescribed only to those children whose weight exceeds 20 kg. The standard dose for a child is 20 mg per day. The instructions for Omeprazole tablets say that the amount of the drug taken per day can be increased if necessary, but not more than doubled.

The course of treatment for children using this remedy usually lasts 2-8 weeks. During therapy with Omeprazole, the child must be constantly under the supervision of a doctor.

What side effects can the drug have?

The drug Omeprazole rarely has any negative effect on the patient’s body. However, like any other medication, this drug can still cause side effects. Most often, patients taking this medicine experience:

diarrhea, constipation, nausea;

muscle weakness;

dizziness, headache, drowsiness or insomnia, depression, in severe cases - hallucinations;

leukopenia or thrombocytopenia;

itching, urticaria, bronchospasms.

Also, peripheral edema, visual disturbances, and fever were recorded in patients undergoing treatment using this drug. With long-term treatment with this drug, the patient may develop, among other things, gastric glandular cysts. They are caused by inhibition of hydrochloric acid secretion and are benign in nature.

Interaction

Like many other drugs of the same pharmacological group, Omeprazole is usually not prescribed to patients simultaneously with those drugs whose absorption depends on the acidity in the stomach. The drug can significantly change the degree of bioavailability of such drugs. This applies, for example, to iron salts.

Unlike many other medications, Omeprazole does not affect the concentration of ethanol and caffeine in the blood. However, of course, you should not take alcohol at the same time as this drug. Moreover, this drug is usually prescribed for the treatment of diseases for which alcohol is strictly contraindicated. Also, this medicine does not in any way affect the concentration in the blood of substances such as diclofenac, lidocaine, quinidine, cyclosporine and some others.

Omeprazole can enhance the effect of diphenin and coumarins. This is of course worth taking into account when using it.

Sometimes, based on the active substance of this medicine, as already mentioned, a substance is prepared for intravenous administration. It is considered compatible only with saline solution. Dextrose can also be used for intravenous medications. All other solvents reduce the effectiveness of this drug due to changes in acidity. This drug is almost never administered intravenously to children.

What happens in case of an overdose

Of course, you cannot violate the instructions for use of Omeprazole tablets and capsules. The drug must be taken strictly according to the regimen recommended by the doctor. When overdosing on Omeprazole, patients experience the following problems:

visual impairment;

increased sweating;

flushed face;

tachycardia;

confusion;

vomiting, nausea;

Strong headache.

Treatment for patients who have drunk too much of this drug is usually only symptomatic. Dialysis is considered ineffective.

How to properly store medicine

The shelf life of Omeprazole capsules is not too long. This medicine can be taken for the treatment of diseases of the digestive system within a year from the date of release. The expired product is disposed of. This drug should be stored in a dark, dry place, where pets or children cannot reach it.

In most cases, this medicine is kept at home simply in the medicine cabinet. However, people undergoing treatment courses using it should keep in mind, among other things, that when the air temperature in the room is above 25 ° C, the drug may lose its qualities. Therefore, in the summer, when it’s hot, it is advisable to transfer capsules or tablets to the refrigerator.

Analogues of the drug

Omeprazole is inexpensive and rarely causes side effects. However, sometimes, for example, if you are allergic to any of its components, this remedy has to be changed to a similar one. For example, medications such as:

"Ranitidine". This drug belongs to the group of histamine receptor blockers. When it enters the body, the formation of hydrochloric acid in the stomach is reduced. The active ingredient is ranitidine. The advantages of this medicine include, first of all, that it rarely causes any side effects.

"Losek". The drug contains the same active substance as Omeprazole. The instructions for use of the Losek analogue, accordingly, have almost the same.

"Pantoprazole." The advantage of this remedy, in comparison with Omeprazole, is, first of all, that it can be taken by both lactating and pregnant women.

Also, instead of Omeprazole, doctors can prescribe a drug such as Omez to patients. The mechanism of action of this Indian medicine is the same. However, it works somewhat slower than Omeprazole. The analogues of this drug described above received good reviews from patients. As patients note, they reduce acidity well in various types of gastrointestinal diseases. But you should take them, like Omeprazole, only as prescribed by a doctor.