Candles omeprazole. What is Omeprazole used 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 agents / gastrointestinal agents / 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 stomach cavity and blocks the main stage of hydrochloric acid formation. 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 during 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 form hydrochloric acid again is restored.

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

With peptic ulcer in the acute stage (2 times a day, 20 mg) increases the frequency of eradication of Helicobacter pylori 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 decreases. Normalization of acid exposure in the esophagus and maintenance of intragastric pH>4.0 during the day with a decrease in the damaging properties of the contents of the stomach 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-histamine receptor blockers. Long-term maintenance treatment prevents relapse of reflux esophagitis and reduces the possibility of complications. Omeprazole in 85% of patients with gastroesophageal reflux disease provides remission within 1 year. Omeprazole has been shown to be effective in portal hypertension, chronic pancreatitis (pain relief), for the prevention of erosive and ulcerative lesions of the gastric and esophageal mucosa and associated bleeding in patients with stage 2-3 esophageal varices and aspiration pneumonia in surgical patients. In the first 1-2 weeks of therapy, there is an increase in the content of gastrin in the blood serum (it normalizes after discontinuation of the drug). At a dose of 40 mg daily, it reduces the motor-evacuation capacity of the stomach. With a 10-day course of therapy, it changes the content of gastrin, motilin and cholecystokinin in the blood serum. The study of biopsies did not reveal an increase in the number of ECL cells.

Omeprazole is almost completely and rapidly absorbed in the gastrointestinal tract, its bioavailability is no more than 65% (due to the effects of the "first pass" through the liver). The maximum concentration of omeprazole is reached after 3-4 hours. With repeated administration, the absorption of omeprazole increases (the maximum concentration and bioavailability increase) and the antisecretory effects increase. The distribution of omeprazole is 0.2-0.5 l / kg. Omeprazole is 95% bound 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 the normal functional state of the liver is 0.5-1 hour, in chronic liver diseases is 3 hours. It is excreted mainly in the form of metabolites by the kidneys 72-80% and the intestines 18-23%. In elderly patients, there may be some increase in bioavailability and a decrease in the rate of excretion of omeprazole.

Indications

Exacerbation of peptic ulcer of the duodenum and stomach; reflux esophagitis (including both ulcerative and erosive); gastroesophageal reflux disease (including 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.

Dosing and Administration of Omeprazole

Omeprazole is taken orally, intravenously. Inside, before meals in the morning, without crushing, chewing or damaging the capsule, drinking a small amount of liquid (reception 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: gastric ulcer and esophageal reflux - 4-8 weeks, reflux esophagitis - 4 weeks, duodenal ulcer - 2-4 weeks. For the prevention of relapse of reflux esophagitis and duodenal ulcers, a long-term dose of 10 mg is possible. If it is impossible to prescribe omeprazole orally and / or severe peptic ulcer - intravenously 1 time per 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. Perhaps the introduction in an encapsulated form intragastrically through a tube to patients in critical condition.

Zollinger-Ellison syndrome: the dose is set individually, according to 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 doses (daily doses greater than 80 mg should be given 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 the use of non-steroidal 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).

Before starting therapy with omeprazole, it is necessary to exclude the presence of a malignant neoplasm in the gastrointestinal tract, especially with a stomach ulcer. In severe liver failure, omeprazole therapy is possible only under the close supervision of a physician (in this case, the dose should not exceed 20 mg / day). For patients from Asia, the need for dose adjustment is likely, especially with prolonged anti-relapse therapy. When sharing omeprazole with warfarin, it is recommended to regularly determine the prothrombin time or monitor the content of warfarin in the blood serum with further dose adjustment. It should be borne in mind that the following groups of patients need continuous anti-relapse treatment with omeprazole: with frequent and severe symptoms and/or endoscopically proven stage 3-4 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 lower esophageal sphincter. With stage 2 esophagitis, maintenance treatment is recommended after two relapses. The effectiveness of permanent treatment in gastroesophageal reflux disease increases the 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.

Application restrictions

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

Use during pregnancy and lactation

During pregnancy, only for health reasons, the use of omeprazole is possible. During therapy with omeprazole, it is necessary to stop breastfeeding.

Side effects of omeprazole

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

sense organs and nervous system: headache, malaise, dizziness, asthenia, sleep disturbance, paresthesia, drowsiness, in some cases - agitation, anxiety, 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 covers: 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, as well as 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 ostelasts. In order to evaluate these conflicting data in the aspect of osteoporosis, a case-control study was undertaken, which used the UK General Practice Research Database, which included 9.4 million people. Cohorts were identified - people over 50 years of age who took PPIs in a standard dose and did not take PPIs. As a case, the outcome was chosen - a fracture of the femoral neck. The database analysis revealed 13,556 cases of hip fractures (10,834 in non-PPI users and 2,722 in PPI users), 135,386 people were included in the control group. The OR for hip fracture with more than 1 year of PPI use was 1.44 (95% CI 1.30–1.59); OR for high-dose PPI 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 males was 1.78 and for females was below 1.36, although female sex 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 could not find any relationship with either dose or duration of PPI use. L.E. Targownik et al. revealed an increased risk of hip fracture only after 5 years of continuous PPI use, and any other fracture due to osteoporosis only after 7 years (!) of continuous PPI use. According to this group of authors, 4-year (or shorter) PPI use was not associated with osteoporosis and fractures, and their calculated fracture risk with PPI use is comparable to the effect of smoking, low body mass index, or excessive alcohol intake on this indicator. Thus, different studies that have shown an association of PPIs with osteoporosis and bone fractures are in conflict in assessing 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 action of diphenin and coumarins, does not change - 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. The substance of omeprazole for intravenous infusion is compatible only with dextrose solution and physiological saline (when using other solvents, the stability of omeprazole may decrease due to changes in the pH of the infusion medium). Serum ciclosporin levels are not usually affected by omeprazole, but two separate reports described a more than 2-fold decrease in ciclosporin concentration in one patient and a 2-fold increase in another.

Overdose

With an overdose of omeprazole, there are: nausea, dry mouth, blurred vision, increased sweating, headache, flushing of the face, drowsiness, tachycardia, confusion. It is necessary: symptomatic treatment; hemodialysis is ineffective.

The cause of ulcerative lesions of the stomach 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 the so-called proton pump or proton pump inhibitors occupy a prominent place. The proton pump (alternative name - H + / K + -ATPase) is an enzyme that plays the most important 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 are subsequently happily combined into hydrochloric acid. If this process takes on a pathological character, then it's time to slow down the functioning of the proton pump, with which such a drug as omeprazole successfully copes, 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 an irritant) secretion of hydrochloric acid are reduced.

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

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

Omeprazole is available in enteric capsules that 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. So, an acute duodenal ulcer requires taking 20 mg (1 capsule) of omeprazole per day for 2-4 weeks, in especially severe cases, you can increase the daily dose to 2 capsules. In acute gastric ulcer and erosive and ulcerative inflammation of the esophagus, 1-2 capsules of the drug per day are taken for 4-8 weeks. The duration of taking omeprazole for erosive and ulcerative lesions of the digestive tract, caused by the use of non-steroidal anti-inflammatory drugs, is similar, however, the daily dose should not exceed 1 capsule in this case. With helicobacteriosis, the drug is taken 1 capsule 2 times a day for 1 week in combination with antibiotics. Omerpazole can also 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 with gastric ulcer) to undergo an oncological examination before starting treatment in order to exclude the presence of malignant neoplasms. Otherwise, you can hide the symptoms of oncopathology, which can lead to an untimely start of its 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, it is also a "proton pump" or "proton pump") in the parietal cells of the stomach, thereby blocking the transfer of ions hydrogen and the final stage of the synthesis of hydrochloric acid in the stomach.Omeprazole is a prodrug.In the acidic environment of the tubules of parietal cells, omeprazole turns into an active metabolite sulfenamide, which inhibits the membrane H + / K + - adenosine triphosphate (ATP) -phase, connecting to it due to the disulfide bridge This explains the high selectivity of the action of omeprazole specifically on parietal cells, where there is a medium for the formation of sulfenamide.Biotransformation of omeprazole into sulfenamide occurs quickly (after 2-4 minutes).Sulfenamide is a cation and is not absorbed.

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

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

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

Pharmacokinetics

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

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

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

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

Release form

Capsules are gelatinous, 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. - cellular contour packings (3) - packs of cardboard.

Dosage

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

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

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

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

With Zollinger-Elisson syndrome, usually 60 mg 1 time per day; if necessary, the dose is increased to 80-120 mg / day (the dose is divided into 2 doses).

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

For the eradication of Helicobacter pylori, "triple" therapy is used (for 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 1 time per 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 per day and clarithromycin 500 mg - 3 times a day or amoxicillin 0.75-1.5 g -2 times a day).

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

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 the pH of the stomach).

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

At the same time, long-term use of omeprazole at a dose of 20 mg once a day in combination with caffeine, theophylline, piroxicam, diclofenac, naproxen, metoprolol, propranolol, ethanol, cyclosporine, lidocaine, quinidine and estradiol did not lead to a change in their plasma concentration.

Enhances 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 gravis, myalgia.

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

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

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

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

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 lactation

Application for violations of liver function

Application for violations of kidney function

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 the symptoms, may delay the correct diagnosis.

Taking it with food does not affect its effectiveness.

The composition of the medicinal product Omeprazole

omeprazole (in 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 peptic ulcers of the stomach and duodenum H2-histamine receptor blockers

Pharmacological properties

It suppresses the secretion of hydrochloric acid in the stomach, being an inhibitor (suppresses the function) of the “proton pump” (the process of exchanging hydrogen ions). The mechanism of antisecretory action is associated with inhibition (suppression of activity) of the H-K-ATPase enzyme (an enzyme that accelerates the exchange of hydrogen ions) in the membranes of the 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 (own) and stimulated secretion (secretion of digestive juices) decreases, regardless of the nature of the stimulus. The action 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, intestines or esophagus, developed as a result of the destructive action of gastric juice on the mucous membrane), caused by Helicobacter pylori (microorganisms that, under certain conditions, can cause gastritis or recurrent / periodically recurring / gastric ulcer), reflux esophagitis (inflammation of the esophagus due to the throwing of gastric contents into the esophagus), Zollinger-Ellison syndrome (a combination of stomach ulcers and a benign tumor of the pancreas).

Contraindications

Pregnancy, breastfeeding.

Usage Precautions

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

Reception along with food does not affect the effectiveness.

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

In patients with severe hepatic insufficiency, the daily dose should not exceed 20 mg.

Interaction 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 a change in their plasma concentration.

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

With exacerbation of peptic ulcer and reflux esophagitis, the drug is prescribed at 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. In those patients who have not completely healed after a 2-week course, healing usually occurs during the next 2-week treatment period.

Patients with poor healing of duodenal ulcers are recommended to prescribe omeprazole at a dose of 0.04 g 1 time per day, which allows healing to be achieved within 4 weeks.

For the prevention of recurrence (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.

For the prevention of recurrence of gastric ulcer in patients with poor healing, it is recommended to prescribe 0.02 g of the drug 1 time per day.

The duration of treatment for gastric ulcer is usually 4 weeks. With incomplete scarring, an additional 4-week therapy is carried out. Patients with poor healing of gastric ulcers are recommended to prescribe omeprazole at a dose of 0.04 g per day, which will provide scarring for 8 weeks.

With peptic ulcer 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 for 2 weeks. If after a 2-week course no complete scarring of the ulcer is noted, then the course of treatment is extended for another 2 weeks.

With reflux esophagitis, omeprazole is prescribed in a daily dose of 0.02 g. The course of treatment is 4-5 weeks. In severe cases of 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 1 time per day. If necessary, the dose can be increased to 0.02-0.04 g 1 time per day.

With 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 set 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 may mask the symptoms and delay the correct diagnosis.

Side effects

Rarely - dizziness, headache, agitation, drowsiness, sleep disorders, paresthesia (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 previous 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 reddening of symmetrical skin areas and fever), increased sweating, alopecia (complete or partial hair loss); blurred vision, peripheral edema, fever (a sharp rise in body temperature). In some cases - interstitial nephritis (inflammation of the kidney with a primary lesion of the 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 (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 vials).

Capsules Omeprazole is an effective modern drug used to treat gastric erosions, certain types of gastritis and peptic ulcer with high acidity. The active substance of the drug successfully fights against various inflammatory processes in the gastrointestinal tract by reducing the production of hydrochloric acid (decrease in acidity).

What helps Omeprazole?

The use of omeprazole capsules is possible not only for gastritis and gastric ulcer, but also for prevention, in the presence of risk factors. In particular, it is possible to use omeprazole for short-term attacks of heartburn, the therapeutic effect is manifested already 10-20 minutes after ingestion. The effect of prolonged exposure prevents repeated unpleasant sensations of heartburn for 12 - 18 hours.

The use of omeprazole with long-term use of non-steroidal anti-inflammatory drugs (for example, in arthrosis and arthritis) is shown to prevent the development of the so-called "aspirin" gastric and duodenal ulcer.

In addition, the tool helps to 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 - its 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;
with some tumors of the pancreas.

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 course of the disease. In the acute form of ulcers and reflux - esophagitis, the medication is prescribed once a day in the morning on an empty stomach 20 mg 1 time per 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 the course 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, in severe cases of the 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 set individually.
for the prevention of recurrence of peptic ulcer - 10 mg 1 time per day.

Resistant to other antiulcer drugs, patients are shown taking omeprazole at a dose of 40 mg / day.

Especially severe patients who are 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.

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

Elderly people require an individual dosage calculation, due to the increase in the bioavailability of omeprazole.

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

Can I take omeprazole continuously? Treatment is carried out until the symptoms disappear or recovery, if no improvement is observed within the specified period, a second examination and consultation with a doctor (at least) is necessary.

Does omeprazole help with pancreatitis? It is possible to use omeprazole capsules to relieve pain, treat pancreatitis more effectively 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 during breastfeeding, the issue of stopping breastfeeding should be resolved.

Contraindications Omeprazole

Hypersensitivity to the active substance and / or other components of the drug;
Simultaneous use with atazanavir, erlotinib, posaconazole;
Children under 5 years old;
breastfeeding period.
With caution in osteoporosis and the presence of oncological tumors.

Treatment with omeprazole does not affect driving.

Clinical experience indicates good tolerability of the drug by most patients.

Side effects of the drug Omeprazole

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

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

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

Enhances the effect of some drugs, when used together, consult a doctor.

Omeprazole analogues, 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,
Ortanol,
Ultop,
chelicide,
Helol,
ranitidine,
Nexium,
famotidine,
Pariet

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

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

The composition of the drug

The main active component of this domestic remedy is omeprazole. Also, the composition of this medicine includes such additional substances as:

sodium lauryl sulfate;

titanium dioxide;

purified water;

dye E 129.

The drug "Omeprazole" is supplied to pharmacies in the form of capsules packed in a blister pack in most cases, 10 pcs. 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. The active substance they include 10, 20 or 40 mg.

There is also an 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.

You can buy in pharmacies and tablets "Omeprazole". Instructions for use are almost the same as for capsules. The active substance in the composition of the drug in this form also includes 10, 20 or 40 milligrams.

"Omeprazole": pharmacological group

This drug is classified by doctors as a proton pump inhibitor. Drugs of this group are able to suppress H + -K + -ATPase on the membrane of cells of the gastric mucosa. The main purpose of the proton pump in the human body is the transfer of 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 has taken food.

Medicines of the pharmacological group "Omeprazole" in case of prolonged 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 microflora of the colon.

The funds of this group begin to act on the patient's body rather quickly. Patients usually feel the effect of taking Omeprazole within the first hour. At the same time, the medicines of this group are able to maintain their beneficial effect on the body of patients for a long time - about a day.

In pharmacology, "omeprazole" refers to proton inhibitors. And like many other drugs of this group, in the human body it is rapidly 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 by us above. This drug, in addition to gastric and duodenal ulcers, can be prescribed for such, for example, diseases as:

ulcerogenic adenoma of the pancreas;

Zollinger-Ellison syndrome;

reflux esophagitis;

heaviness in the abdomen;
bloating;

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

Contraindications

This medicine is prescribed for the treatment of various diseases of the gastrointestinal tract quite often. However, of course, he also has contraindications. First of all, Omeprazole should not be prescribed to those patients who have shown hypersensitivity 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, according to health indications, this remedy can still be prescribed to pregnant women. But treatment in this case is carried out under the strict supervision of a doctor. If the drug is necessary for a woman during lactation, the child is transferred to artificial feeding.

What you need to know

Pharmacological group of the drug "Omeprazole" - proton inhibitors. Only benign gastric and intestinal ulcers are treated with this remedy. Before using this medicine, the doctor must make sure that there are no malignant tumors. In the presence of such a problem, the drug cannot cause special harm. However, it very easily hides the symptoms of oncology. And this, in turn, can lead to 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 this particular disease. Also, a treatment regimen using this remedy can be developed taking into account the characteristics of the patient's body, his age, etc. Therefore, you should not prescribe this medicine on your own in any case. It is allowed to take it only as directed by a doctor.

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

With an exacerbation of a stomach ulcer, as well as with an erosive form of esophagitis, doctors prescribe to patients 1-2 capsules of the drug per day. The course of treatment in this case usually lasts for 1-2 months.

With a duodenal ulcer, the drug is prescribed at 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 NVPS, the patient is prescribed 1 capsule or tablet per day for a course of 1-2 months.

If you wish to prevent an exacerbation of an ulcer of the intestine or stomach, it is most often prescribed to take 1 capsule per day.

When eradicating Helicobacter pylori, it is supposed to 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 may be taken 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.

With 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 parameters of the gastric secretion of the patient.

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

Those patients who have been diagnosed with severe liver failure, the drug is allowed to prescribe in a daily dose of not more than 20 mg.

How to drink

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

According to the instructions, you need to swallow Omeprazole capsules whole with a small amount of water. It is not necessary to grind or chew the drug. It is desirable that the capsule shell remains intact when taken. But the condition is still not strict. If the patient suddenly has difficulty swallowing the capsule, it can be opened and the contents drunk with water. It will not cause any harm to the stomach.

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

Omeprazole tablets are also best swallowed whole with water.

Instructions for use for children

It is allowed to prescribe this medicine for the treatment of gastric diseases in pediatrics to patients over the age of 5 years. In this case, 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 the Omeprazole tablets say that the amount of the drug taken per day can be increased if necessary, but not more than twice.

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

What side effects can the drug give?

The medicine "Omeprazole" has any negative effect on the patient's body quite rarely. However, like any other medical drug, this remedy 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, bronchospasm.

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

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 value of 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 medicines, Omeprazole does not affect the concentration of ethanol and caffeine in the blood. However, alcohol should not be taken simultaneously with this remedy, of course. Moreover, this drug is usually prescribed in the treatment of those diseases in which alcohol is categorically contraindicated. Also, this medicine in no way affects the concentration in the blood of substances such as diclofenac, lidocaine, quinidine, cyclosporine and some others.

The action of difenin and coumarins "Omeprazole" is able to enhance. When using it, of course, it is worth considering.

Sometimes, on the basis of the active substance of this drug, as already mentioned, a substance is prepared for intravenous administration. It is considered compatible only with saline. You can also use intravenous drugs and dextrose. 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 overdose

Of course, it is impossible to violate the instructions for use for Omeprazole in tablets and capsules. The drug should be taken strictly according to the scheme recommended by the doctor. With an overdose of 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 prescribed only symptomatic. Dialysis is considered to be ineffective.

How to properly store medicine

The shelf life of "Omeprazole" in capsules is not too long. It is allowed to take this medicine for the treatment of diseases of the digestive system within a year from the date of issue. The expired product is disposed of. Store this medication 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 with its use should keep in mind, among other things, that at room temperatures above 25 ° C, the drug may lose its qualities. Therefore, in the summer, in the heat, it is advisable to transfer capsules or tablets to the refrigerator.

Drug analogues

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. A therapeutic effect similar to "Omeprazole" is different, for example, such drugs as:

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

"Losek". The composition of the drug includes the same active substance as in "Omeprazole". Instructions for use analogue "Losek", respectively, has almost the same.

"Pantoprazole". The advantages 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 reviews of the analogues of this drug, described above, have earned good ones from patients. Acidity, as noted by patients, they lower well with various diseases of the gastrointestinal tract. But to take them, like Omeprazole, is only as directed by a doctor.