Omeprazole - antiulcer medicinal product, which suppresses the process of hydrochloric acid release in the stomach, inhibiting the process of hydrogen ion exchange.

Modern effective drug to reduce acid production in the stomach. 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 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 omeprazole 20 mg, the effect lasts for 24 hours.

Does not affect the formation of the internal factor of Castle and the speed of passage of the food mass through the stomach into the duodenum; does not act on histamine and acetylcholine receptors.

Has high absorption. Bioavailability reaches 30-40%, increases in the elderly, and with insufficient liver function reaches 100%. The drug has a high lipophilicity, as a result of which it easily enters the parietal cells. It enters into contact with plasma proteins (albumin and acid alpha1-glycoprotein) up to 90-95%.

Indications for use

What helps Omeprazole? According to the instructions, the drug is prescribed in the following cases:

• benign stomach / duodenal ulcer (including if the disease is associated with taking NSAIDs);
• eradication therapy for H. pylori (in combination with antibacterial drugs);
• GERD;
• prevention of aspiration of acidic gastric contents;
• ulcerogenic adenoma of the pancreas;
• weakening the symptoms of acid-dependent dyspeptic disorders (the drug helps with heartburn, eliminates heaviness in the abdomen, belching, flatulence, bloating, unpleasant aftertaste and nausea).

Instructions for use Omeprazole, dosage

It is taken orally with a small amount of water. The capsule cannot be chewed. Simultaneous intake with food does not affect the effectiveness of the drug.

With an exacerbation peptic ulcer stomach and 12 p. intestines, NSAID-gastropathy and erosive and ulcerative esophagitis recommended daily dose is 1 caps. Omeprazole (20 mg). At severe course reflux esophagitis, the dosage is increased to 2 capsules (40 mg). They should be taken once a day. The duration of the course of treatment for peptic ulcer 12 p. Intestine - 2-3 (if necessary - 4-5 weeks), for reflux exophagitis and gastric ulcer - 8 weeks.

Patients suffering from Zolinger-Ellison syndrome are prescribed 60 mg of the drug, divided into 2-3 doses. According to medical indications, the dose can be increased to 80-120 mg per day.

In order to prevent recurrence of peptic ulcer - 1 capsule 1 time per day.

To prevent the development of Mendelssohn's syndrome (acid-aspiration pneumonitis), an hour before surgery, the patient is recommended to take 40 mg of omeprazole. With a long course of surgical intervention (more than two hours), a similar dose is administered repeatedly.

Destruction of Helicobacter pylori (eradication of Helicobacter pylori): daily dose - 40 mg (in 2 divided doses), course duration - 7 days in combination with antibacterial drugs.

Patients with liver failure are prescribed 20 mg of the drug per day.

Side effects

The instruction warns of the possibility of developing the following side effects when prescribing Omeprazole:

• On the part of the digestive system: diarrhea or constipation, nausea, vomiting, flatulence, abdominal pain, dry mouth, taste disturbances, stomatitis, transient increase in plasma levels of liver enzymes; in patients with previous severe liver disease - hepatitis (including with jaundice), impaired liver function.
• From the side nervous system: headache, dizziness, agitation, drowsiness, insomnia, paresthesia, depression, hallucinations; in patients with severe concomitant somatic diseases, in patients with previous severe liver disease - encephalopathy.
• From the musculoskeletal system: muscle weakness, myalgia, arthralgia.
• From the hemopoietic system: leukopenia, thrombocytopenia; in some cases - agranulocytosis, pancytopenia.
• From the side skin: itching; rarely (in some cases) - photosensitivity, erythema multiforme, alopecia.
• Allergic reactions: urticaria, angioedema, bronchospasm, interstitial nephritis and anaphylactic shock.
• Other: blurred vision, peripheral edema, increased sweating, fever, gynecomastia; rarely - the formation of gastric glandular cysts during long-term treatment (a consequence of inhibition of the secretion of hydrochloric acid, is benign reversible).

Contraindications

Omeprazole is contraindicated in the following cases:

• during pregnancy and lactation - since there are no studies confirming or denying penetration into breast milk and through the placenta, you should refrain from taking the drug;
• with individual intolerance to the drug;
• in children under 12 years of age;
• with severe renal or hepatic insufficiency.

Overdose

Symptoms of an overdose are confusion, drowsiness, decreased clarity in the perception of visual images, headache, dry mucous membranes. oral cavity, nausea, arrhythmia, tachycardia.

Therapy is symptomatic. Hemodialysis is considered insufficiently effective.

Omeprazole analogues, price in pharmacies

If necessary, you can replace Omeprazole with an analogue of the active substance - these are drugs:

1. Gastrozol,
2. Zerocide,
3. Omipix,
4. Omitox,
5. omizak,
6. Ortanol,
7. Promez,
8. Ultop,
9. chelicide,
10. Helicol.

When choosing analogues, it is important to understand that the instructions for use of Omeprazole, the price and reviews of drugs of similar action do not apply. It is important to consult a doctor and not to make an independent replacement of the drug.

Price in Russian pharmacies: capsules Omeprazole 20 mg 30 pcs. - from 25 to 34 rubles, according to 746 pharmacies.

Problems with the digestive organs are frequent companions modern man. Due to malnutrition, abundance bad habits and excess chemical elements in food, the stomach most often suffers. Gastritis and peptic ulcer disease are very common, fortunately, they are treated quite successfully, provided that they are diagnosed in a timely manner and treated correctly.

"Omeprazole" is one of the most popular among both doctors and ordinary people, medicines. It is quite well tolerated by a large percentage of patients, however, like all drugs, Omeprazole has a number side effects. In what cases, taking the drug will be an effective help, and when it is better to refuse it, let's try to figure it out below.

This antiulcer drug is successfully used in the treatment of any inflammatory processes in the stomach. Its mechanism of action is that "Omeprazole" neutralizes excess acid in gastric juice, bringing it back to normal, and also reduces the production of new hydrochloric acid. This creates pleasant conditions for the healing of ulcerative foci and erosions on the gastric mucosa.

Take the drug once a day, preferably before breakfast. The effect of one tablet or capsule lasts a whole day. After stopping the medication, the drug continues to act for several more days.

Indications for the use of "omeprazole" are:

1. stomach ulcer and duodenum, including those caused by medication, Helicobacter pylori bacteria and stress;
2. Reflux esophagitis;
3. Gastrinoma;
4. Gastroesophageal reflux

Side effects when taking omeprazole

The drug rarely causes side effects. As a rule, they can occur when the rules of admission are violated, when the patient prescribes an appointment on his own and exceeds the allowable duration of the course. The most commonly observed side effects are:

• Headache;
• Violation of the stool;
• Nausea, vomiting;
• Stomach ache;

Such symptoms, as a rule, disappear quite quickly after the end of taking Omeprazole, and does not require any additional therapy. In rare cases, symptoms may occur up to two weeks after discontinuation.

Much less often, but still there have been cases of the following side effects from taking Omeprazole:

1. The digestive system. There may be symptoms such as dry mouth, malfunction of taste buds, an increase in the level of enzymes produced by the liver, against the background of previous liver diseases, hepatitis, liver dysfunction may occur;
2. Nervous system. As a rule, against the background of other serious diseases (including the liver), dizziness, hyperexcitability, sleep disorder, depression, hallucinations;
3. The musculoskeletal system. Pain in the muscles, muscle hypertonicity, or vice versa, weakness;
4. Blood supply system. Violation of the composition of the blood, including a decrease in the level of platelets and leukocytes.
5. Skin covers. Itching, redness may be observed. Isolated cases of skin hypersensitivity to ultraviolet radiation, erythema multiforme exudative ( inflammatory disease skin), uncontrolled hair loss;
6. Allergic reactions. More often than others, there may be various manifestations of allergy to one of the components of the drug, such as urticaria, Quincke's edema, bronchospastic syndrome, interstitial nephritis and anaphylactic shock.
7. other reactions. In addition to the possible side effects listed above, there were also isolated cases of visual impairment while taking Omeprazole, a drop in the level of magnesium in the body, peripheral edema of the extremities, malfunctions of the sweat glands, fever, breast enlargement in men, against the background of a long course of administration, to form benign formations - stomach cysts.

Taking medication during pregnancy

According to the classification of the danger of exposure to the unborn baby, "Omeprazole" belongs to category "C" (animal tests have shown an effect on the fetus, but no human studies have been conducted), conditionally dangerous drugs that can be prescribed to the expectant mother if the benefits of taking drugs will outweigh the risk to the baby.

In the event that there is no emergency, "Omeprazole" is not prescribed to pregnant women, trying to get by with other means, such as a therapeutic diet and category "A" drugs. In any case, even if Omeprazole is required, it is postponed until the beginning of the 2nd trimester, since the ingestion of the drug in the body in the first weeks of pregnancy can cause congenital heart disease in the baby.

When taking the drug, expectant mothers may experience side effects such as diarrhea, chest pain, and a disorder of the nervous system.

Children taking medicine

In the instructions for the drug, children's age is indicated as a contraindication to admission. However, in rare cases, the attending physician may prescribe Omeprazole to a small patient. As a rule, it is prescribed to children older than two years (some doctors - not earlier than four or five years), calculating the dose depending on the weight of the child.

You can give medicine to a child by opening the capsule and mixing its contents with applesauce. There is also a suspension form of release, which can be fed to a child quite easily.

It is worth recalling once again that the indications for taking Omeprazole for children are very serious illness, and the decision on this should be made by a competent doctor.

"Omeprazole" is a drug tested by millions of patients, which, subject to all medical prescriptions, rarely causes negative reactions from the body. However, side effects occur in a few percent of people taking the drug.

As a rule, all symptoms are reversible and disappear a few days after the end of the drug. If you suspect that a reaction to the drug has occurred, you should immediately consult a doctor who will choose an analogue for the treatment of the disease.

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INN: Omeprazole

Manufacturer: open joint-stock company"Borisov plant medical preparations"(JSC "BZMP")

Anatomical-therapeutic-chemical classification: Omeprazole

Registration number in the Republic of Kazakhstan: No. RK-LS-5 No. 121776

Registration period: 30.10.2015 - 30.10.2020

ALO (Included in the Free Outpatient Drug Supply List)

ED (Included in the List of drugs in the framework of the guaranteed volume of medical care, subject to purchase from a single distributor)

Instruction

Tradename

Omeprazole

International non-proprietary name

Omeprazole

Dosage form

Capsules 20 mg

Compound

Each capsule contains:

active substance - omeprazole (in the form of 8.5% omeprazole pellets) - 20 mg;

Excipients - mannitol, sucrose, calcium carbonate, lactose, disodium hydrogen orthophosphate, sodium lauryl sulfate, hydroxypropyl methylcellulose, methacrylic acid L30D, propylene glycol, cetyl alcohol, sodium hydroxide, polysorbate 80, povidone S-630, titanium dioxide (E 171).

Capsule composition: titanium dioxide (E 171), methyl parahydroxybenzoate, propyl parahydroxybenzoate, gelatin.

Description

Capsules hard gelatin No. 0 cylindrical shape with hemispherical ends, white.

The contents of the capsules are white or almost white pellets.

Farmacotherapeutic group

Preparations for the treatment of diseases associated with impaired acidity. Antiulcer drugs and drugs for the treatment of gastroesophageal reflux (GORD). proton pump inhibitors. Omeprazole.

ATH code: A02BC01.

Pharmacological properties

Pharmacokinetics

After oral administration, it is rapidly and almost completely absorbed in the gastrointestinal tract (GIT). Bioavailability is 30 - 40% due to the effect of "first pass" through the liver. After administration at a dose of 40 mg, the maximum plasma concentration is 1.26 ± 0.41 μg / ml and is reached after 1.38 ± 0.32 hours. With repeated injections, bioavailability increases to 60%.

In the blood, it is 95% bound to plasma proteins (albumin, acid α1-glycoprotein). The volume of distribution is 0.2 - 0.5 l / kg.

It is metabolized in the liver with the participation of cytochrome P450 CYP2C19 with the formation of 6 inactive metabolites: hydroxyomeprazole, sulfide and sulfonic derivatives of omeprazole. The R-enantiomer of omeprazole acts as an inhibitor of its own metabolism, reducing the activity of CYP2C19. In the European population, 3-5% of people have defective CYP2C19 genes (slowly metabolize omeprazole). In the Asian population, the proportion of slow metabolizers is 4 times higher.

It is excreted mainly by the kidneys in the form of metabolites (72-80%) and through the intestines (18-23%). The total clearance is 7.14 - 8.57 ml / min / kg. The elimination half-life in people with normal liver function is 0.5 - 1 hour; in chronic liver failure, it can increase up to 3 hours. In chronic kidney failure the elimination of omeprazole decreases in proportion to the decrease in creatinine clearance.

Elderly patients may slow down the metabolism of omeprazole and increase its bioavailability.

Pharmacodynamics

Omeprazole has an antisecretory effect.

The mechanism of action is associated with the ability of omeprazole to block the work of the "proton" pump H + / K + -ATPase. After oral administration, the omeprazole capsule dissolves in the acidic contents of the stomach and releases pellets (microgranules). Pellets enter the duodenum, where omeprazole is isolated in an alkaline environment. After absorption with blood flow, omeprazole enters the gastric mucosa and the lumen of the tubules of parietal cells, where there is acidic environment(pH<3,0), окисляется в активную форму - сульфенамид-омепразола (SA-O). SA-O связывает SH-группы Н+/K+-АТФазы в канальцах париетальных клеток и необратимо блокирует работу фермента. Это приводит к нарушению последней стадии процесса образования соляной кислоты желудочного сока.

Omeprazole dose-dependently reduces the level of basal and stimulated (postprandial) secretion of gastric juice, reduces the total volume of gastric secretion, the release of pepsin, and effectively inhibits both nocturnal and daytime secretion of gastric juice.

After a single dose of 20 mg, the maximum plasma concentration is reached after 1-3 hours. Inhibition of stimulated secretion by 50% persists for 24 hours, while the level of intragastric pH> 3.0 persists for 17 hours. A stable decrease in secretion develops by the 4th day of therapy. The ability of parietal cells to produce hydrochloric acid is restored 2 to 3 days after stopping omeprazole.

Omeprazole is concentrated in the parietal cells of the gastric glands and has a cytoprotective effect (stimulates the secretion of mucus and bicarbonates, the reproduction of epithelial cells, prevents the back diffusion of protons from the lumen of the stomach into its mucosa).

eradication Helicobacter pylori when prescribing omeprazole and antibacterial agents, it is associated with a high frequency of ulcer healing and long-term remission of peptic ulcer. In the treatment of duodenal ulcers for 4 weeks, scarring of the ulcer occurs in 93% of patients, in the treatment of gastric ulcers for 8 weeks, this figure is 96%, scarring of peptic ulcers of the esophagus is achieved in 90% of patients.

Indications for use

Treatment of peptic ulcer of the stomach and duodenum

prevention of recurrence of duodenal ulcers

gastric ulcer treatment

prevention of recurrence of gastric ulcer

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

treatment of erosive and ulcerative lesions of the stomach and duodenum caused by the use of non-steroidal anti-inflammatory drugs (NSAIDs)

prevention of peptic ulcer of the stomach and duodenum, due to the use of NSAIDs, in patients at risk

reflux esophagitis treatment

long-term maintenance therapy to prevent recurrence of erosive esophagitis

treatment of symptomatic gastroesophageal reflux disease

treatment of Zollinger-Ellison syndrome

Children over the age of 12:

reflux esophagitis treatment

treatment of duodenal ulcer caused by Helicobacter pylori(as part of complex therapy).

Dosage and administration

It is recommended to take the capsules in the morning, preferably before meals, swallowing whole and drinking half a glass of water, without chewing or crushing the capsule. For patients with swallowing disorders or children, you can open the capsule and take the contents, after mixing it with a small amount of non-carbonated water or a slightly acidic liquid (fruit juice, applesauce), washed down with a small amount of water. The contents of the capsule are mixed with liquid immediately before use or no more than 30 minutes before taking the drug.

Dosage in adults

Treatment of duodenal ulcer

Patients with an active duodenal ulcer are recommended to take omeprazole at a dose of 20 mg once a day. In most patients, ulcer healing occurs within 2 weeks. In cases where complete healing of the ulcer does not occur within 2 weeks, healing is achieved with a subsequent 2-week intake of the drug. Patients with unresponsive duodenal ulcers are usually treated with omeprazole 40 mg once daily; Ulcer healing usually occurs within 4 weeks.

Prevention of exacerbations of peptic ulcer of the stomach and duodenum

For the prevention of recurrence of duodenal ulcer in patients with a negative test for Helicobacter pylori or in cases where eradication H. pylori not possible, the recommended dose is omeprazole 20 mg once daily. For some patients, a daily dose of 10 mg may be sufficient. In case of unsuccessful therapy, the dose may be increased to 40 mg.

Treatment of gastric ulcer

The recommended dose is omeprazole 20 mg once daily. In most patients, recovery occurs within 4 weeks. In cases where complete healing does not occur after the first course of taking the drug, a repeated 4-week course of treatment is usually prescribed, during which healing is achieved. Patients with gastric ulcers that are not very responsive to treatment are usually prescribed 40 mg of omeprazole once a day; healing is usually achieved within 8 weeks.

Prevention of recurrence of gastric ulcer

To prevent recurrence in patients with gastric ulcers that are not very susceptible to treatment, omeprazole 20 mg once a day is recommended. If necessary, the dose can be increased to 40 mg once a day.

Elimination of Helicobacter pylori in gastric ulcer

Possible use various schemes treatment with the choice of antibiotics for a particular patient. Selection should be made in accordance with national, regional and local resistance data and treatment guidelines.

When conducting "triple therapy":

omeprazole 20 mg + clarithromycin 500 mg + amoxicillin 1000 mg each taken twice a day for one week, or

omeprazole 20 mg + clarithromycin 250 mg or 500 mg + metronidazole 400 mg (or 500 mg or tinidazole 500 mg) each taken twice daily for one week, or

omeprazole 40 mg + amoxicillin 500 mg + metronidazole 400 mg (or 500 mg or tinidazole 500 mg), each taken 3 times a day for one week.

After the liquidation Helicobacter pylori further treatment of gastric ulcer should be carried out according to the standard treatment regimen.

In cases where, after therapy, a test for Helicobacter pylori remains positive, the course of treatment can be repeated.

Treatment of NSAID-associated stomach and duodenal ulcers

The recommended dose of the drug is 20 mg once a day. Most patients heal within 4 weeks. In those patients who did not experience a cure during the period of initial therapy, healing is usually achieved with a repeated 4-week dose of the drug.

To prevent NSAID-associatedgastric and duodenal ulcers in patients at risk(age over 60 years, history of gastric and duodenal ulcer, history of gastrointestinal bleeding) The recommended dose is 20 mg of omeprazole once a day.

Treatment of reflux esophagitis

The recommended dose is omeprazole 20 mg once daily. Most patients heal within 4 weeks. In cases where complete healing does not occur after the first course of taking the drug, a repeated 4-week course of treatment is usually prescribed. For patients with severe reflux esophagitis, omeprazole 40 mg once daily is recommended; healing usually occurs within 8 weeks.

For long-term treatment of patients with healed reflux esophagitis(in remission phase) appoint 10 mg of omeprazole per day in the form of long courses of maintenance therapy. If necessary, the dose can be increased to 20-40 mg once a day.

Treatment of symptomatic gastroesophageal reflux disease

If after 4 weeks of daily use of omeprazole 20 mg the symptoms do not disappear, an additional examination of the patient is recommended.

Treatment of Zollinger-Ellison Syndrome

For patients with Zollinger-Ellison syndrome, the drug is prescribed in an individual dosage and treatment is continued according to clinical indications for as long as necessary. The recommended starting dose is 60 mg of omeprazole daily. In all patients with severe disease, as well as in cases where other therapeutic methods have not led to the desired result, the use of the drug was effective in more than 90% of patients when taking 20 mg -120 mg of omeprazole daily. In cases where the daily dose of the drug exceeds 80 mg, the dose should be divided into two parts and taken 2 times a day.

Special populations

For the sick with impaired renal function

For the sick with impaired liver function it is enough to take 10-20 mg of omeprazole per day

For the elderly (over 65 years old) there is no need to adjust the dose.

Dosage for children over 12 years of age

In case of severe reflux esophagitis resistant to other therapies, children weighing more than 20 kg are prescribed 20 mg / day (equivalent to about 1 mg / kg / day). The duration of treatment is 4 - 8 weeks.

For the treatment of duodenal ulcer caused byHelicobacter pylori, children and teenagers the choice of treatment regimen should be made in accordance with national, regional and local guidelines regarding bacterial resistance, duration of treatment (usually 7 days, but sometimes up to 14 days) and appropriate use of antibacterial agents.

Children weighing 15-30 kg: omeprazole 10 mg + amoxicillin 25 mg / kg body weight + clarithromycin 7.5 mg / kg body weight, each drug 2 times / day for one week.

Children weighing 31-40 kg: omeprazole 20 mg + amoxicillin 750 mg + clarithromycin 7.5 mg / kg body weight, each drug 2 times / day for one week.

Children weighing over 40 kg: omeprazole 20 mg + amoxicillin 1000 mg + clarithromycin 500 mg, each drug 2 times / day for one week.

Side effects

Often (≥ 1/100, up to<1/10)

headache

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

Uncommon (≥ 1/1000, up to<1/100)

insomnia

dizziness, paresthesia, drowsiness

• increased levels of enzymes in the liver

  dermatitis, itching, rash, urticaria

  malaise, peripheral edema

Rare (≥ 1/10,000, up to<1/1 000)

leukopenia, thrombocytopenia

allergic reactions, eg fever, angioedema

and anaphylactic reaction/shock

hyponatremia

agitation, confusion, depression

taste disturbances

blurred vision

bronchospasm

dry mouth, stomatitis, candidiasis

gastrointestinal tract

hepatitis with or without jaundice

alopecia, photosensitivity

arthralgia, myalgia

interstitial nephritis

excessive sweating

Rarely (<1/10 000)

agranulocytosis, pancytopenia

hypomagnesemia

aggression, hallucinations

liver failure, encephalopathy in patients with already

existing liver disease

erythema multiforme, Stevens-Johnson syndrome, toxic

epidermal necrolysis (TEN)

muscle weakness

gynecomastia.

The adverse event profile in children aged 0-16 years is generally the same as in adults, both in short-term and long-term treatment.

Contraindications

hypersensitivity to omeprazole, substituted benzimidazoles

or to any of the excipients

children's age up to 12 years

simultaneous use with nelfinavir and / or atazanavir.

Drug Interactions

With simultaneous use with antacids, no clinically significant interactions were noted.

Slows down the absorption of drugs, due to a decrease in absorption - ampicillin, itraconazole, ketoconazole, iron preparations.

Slows down the elimination and enhances the effect of drugs metabolized by cytochrome CYP2C19 - warfarin, diazepam, phenytoin.

Since omeprazole is metabolized by the CYP2C19 and CYP3A4 cytochrome system, the use of drugs that inhibit CYP2C19 and CYP3A4 (for example, clarithromycin and voriconazole) may lead to an increase in the concentration of omeprazole in the blood serum due to a decrease in its metabolism.

Enhances the hematotoxic effect of chloramphenicol, thiamazole (mercasolil), lithium preparations.

Co-administration of omeprazole and clopidogrel leads to a decrease in the therapeutic effect of clopidogrel.

The combined use of omeprazole and digoxin can lead to an increase in the bioavailability of digoxin by 10%. Cases of digitalis intoxication have been described. Caution should be exercised when co-prescribing drugs, especially in elderly patients.

Plasma levels of nelfinavir and atazanavir decrease when co-administered with omeprazole. Simultaneous reception of omeprazole and nelfinavir is contraindicated (see section "Contraindications"). Due to the significant reduction in absorption of posaconazole and erlotinib, this combination should be avoided when co-administered with omeprazole. With simultaneous use with omeprazole, plasma concentrations of saquinavir / ritonavir increase. With the simultaneous administration of omeprazole and tacrolimus, the concentration of tacrolimus in the blood serum increases. It is necessary to monitor the concentration of tacrolimus in the blood serum and kidney function (creatinine clearance). Inducers of microsomal liver enzymes CYP2C19 and / or CYP3A4 (for example, rifampicin and St. John's wort) can reduce the concentration of omeprazole in the blood serum due to an increase in its metabolic rate.

special instructions

If any worrisome symptoms are present (eg, significant unintentional weight loss, repeated vomiting, dysphagia, hematemesis, anemia, or melena), or if a stomach ulcer is present or suspected, malignancy should be ruled out, as treatment may relieve symptoms and delay diagnosis.

The drug contains lactose, therefore patients with congenital galactose intolerance, lactase deficiency or malabsorption of glucose-galactose should not use this drug.

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

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

Co-administration of atazanavir with proton pump inhibitors is not recommended; if such combination therapy is necessary, careful clinical monitoring (for example, viral load) is recommended with an increase in the dose of atazanavir to 400 mg with 100 mg of ritonavir; Do not exceed the daily dose of omeprazole 20 mg.

Omeprazole, like all drugs that block the secretion of hydrochloric acid, can reduce the absorption of vitamin B12 (cyanocobalamin) due to hypo- and achlorhydria. This should be taken into account during long-term therapy in patients with low body weight or with an increased risk of reduced absorption of vitamin B12, or if relevant clinical symptoms are observed.

Omeprazole is an inhibitor of CYP2C19. At the beginning or end of treatment with omeprazole, attention should be paid to the potential for interactions with drugs that are metabolized by CYP2C19. An interaction has been observed between clopidogrel and omeprazole. The clinical significance of this interaction is unclear. As a precautionary measure, the simultaneous administration of omeprazole and clopidogrel should not be prescribed.

Treatment with proton pump inhibitors may lead to a slightly increased risk of gastrointestinal infections caused by bacteria such as Salmonella and campylobacter.

In long-term treatment, especially when treated for more than 1 year, patients should be monitored regularly.

Pregnancy and lactation. The results of a number of studies have shown that omeprazole does not adversely affect pregnancy or the health of the fetus / newborn, so omeprazole can be used during pregnancy after a careful analysis of the risk-benefit ratio of the drug.

Omeprazole is excreted in breast milk, however, when using the recommended therapeutic dosages, it does not adversely affect the child.

Influence on the ability to drive vehicles and control mechanisms.

Given the possibility of developing such side effects as dizziness, care must be taken when driving vehicles and working with driving mechanisms.

Overdose

Omeprazole has low toxicity. When used in doses up to 270 mg / day, omeprazole did not cause the development of intoxication. In patients with severe hepatic insufficiency, when administered at extremely high doses, confusion, blurred vision, drowsiness, dry mouth, headache, nausea, tachycardia, and arrhythmias may develop.

The medicine Omeprazole is one of the latest and most effective drugs that are taken to treat gastric erosions, gastritis and peptic ulcers. Also, the drug effectively fights various inflammatory processes in the gastrointestinal tract.

Omeprazole reduces the production of hydrochloric acid, lowers acidity, which is essential in acute and chronic forms of gastritis. It is used for peptic ulcer with high acidity, since its action is activated only when it enters an acidic environment.

After the patient takes the medicine, Omeprazole begins to actively penetrate into the gastric cells, which are responsible for the secretory function of hydrochloric acid production. Accumulating, the drug regulates the production of pepsin (as experts call the enzyme that is responsible for the breakdown of proteins), and also controls the secretion of gastric juice.

Omeprazole tablets act directly on the microorganism, which is called pylori, it is he who contributes to the development of gastritis and stomach ulcers.

Ulcerative reflux and erosive esophagitis is a disease in which there is a pathological reflux of stomach contents into the esophagus. This disease is characterized by damage to the mucosa, since food enters the esophagus already with gastric juice, which has a corrosive effect on the mucosa. To avoid the appearance of erosions and ulcerative formations, experts prescribe Omeprazole.

The medicine reduces the negative effects of hydrochloric acid, normalizes the pH of the juice secreted by the stomach, thereby significantly reducing all the symptoms and consequences that high acidity can cause. The main feature of Omeprazole is that the positive effect lasts even after the patient has completed the course of taking the drug. Once in the body, the drug begins to act after an hour, the effect lasts for 24 hours. That is, we can say with confidence that after 120 minutes the patient will already be able to feel significant relief. The higher the dose, the more pronounced the therapeutic effect is.

The drug is excreted mainly by the kidneys - up to 80%, and also by the intestines - about 20%. It should be borne in mind that the drug must be prescribed with caution to the elderly, as well as to patients who have impaired renal function - the withdrawal of the drug may slow down.

In pharmacies you can find:

1. Omeprazole capsules - contain either 10 or 20 mg of the active ingredient.
2. Tablets (pellets) - contain 10, 20, 40 mg of the active substance, which is Omeprazole.
3. Powder for solution - contains 40 mg of active ingredient.

Released upon presentation of the prescription form.

Instructions for use

The medicine is prescribed for children from 5 years old, as well as adults. The drug is recommended for use in diseases of the gastrointestinal tract and duodenum.

Indications for use:

If you are concerned about the question - what does Omeprazole help with, and whether it will cope specifically with your disease - it is better to consult a doctor on these issues. Self-medication without diagnostics is not welcome - stomach pain can be caused by a number of reasons that cannot be determined independently.

Contraindications

The very first and most important thing is the individual intolerance of the components of the drug.

It has been clinically proven that omeprazole is prohibited for use by pregnant women - it can cause a malformation in the fetus. Since the drug is well absorbed, and a small part of it is absorbed and passed through breast milk, therefore, Omeprazole is also not prescribed for nursing mothers.

Due to the fact that the action of Omeprazole is active only in an acidic environment, and he himself is prescribed exclusively for people with high acidity, the drug is not prescribed for patients who have a peptic ulcer with low acidity.

The drug should not be taken with the following diseases:

1. atrophic gastritis.
2. Cancer of the stomach or duodenum. This is especially true in cases where the diagnosis has not yet been confirmed: Omeprazole can stop the syndromes of the disease, and in this case it will not be easy to diagnose the disease.
3. In diseases of the bones - the drug contributes to the leaching of calcium, therefore, it can aggravate the course of the disease. If there is an urgent need - in this case, the patient is prescribed Omeprazole in combination with vitamin D and calcium.

The medicine is not prescribed to people who have the following diseases:

1. Malignant neoplasms of the gastrointestinal tract and duodenum;
2. Infections of the gastrointestinal tract - compylobacter or salmonella. The drug can promote the reproduction of these microbes.
3. Allergic reactions.
4. Renal and liver failure.

Also, contraindications include age up to 5 years.

Before you start using Omeprazole, you should always consult with your doctor.

Side effects

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

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

• nausea, vomiting;
• weakness;
• pain in the stomach;
• constipation;
• dizziness;
• diarrhea.

If the above symptoms occur, the drug should be discontinued and consult a doctor.

In very rare cases, the use of omeprazole can also cause:

• flatulence;
• loss of smell;
• headaches;
• irritability, depression;
• encephalopathy.

All of the above symptoms can occur in people who have disorders of the nervous system.

On the part of the skin - taking omeprazole can provoke the appearance of skin rashes, peeling and itching. People who are prone to allergic reactions may notice the appearance of hives or an increase in overall body temperature.

Omeprazole promotes leaching of calcium from the bones, so in some cases, older people, as well as patients who have diseases of the skeletal system, may experience severe weakness and joint pain.

That is why the patient must necessarily get a specialist consultation before taking Omeprazole.

Instructions for use

Omeprazole is prescribed to be taken once a day - just before breakfast. In some cases, doctors suggest dividing the reception into two times - in the morning and in the evening. In any case, the maximum effect will be achieved only if the medicine is taken on an empty stomach.

Capsules should not be chewed - if necessary, dilute the contents of the capsule in acidified water. Tablets should be washed down with a small amount of purified water without gases.

Adults are prescribed the use of omeprazole in the amount of 20 mg. In some cases, the doctor adjusts the dosage - it all depends on the general well-being of the patient. The course of treatment, as a rule, lasts no more than a month, after which it is necessary to stop taking the drug for two months. If necessary, Omeprazole is resumed. If it is necessary to take the medicine as a prophylaxis, in this case 20 mg per day will be enough, no more.

How to take Omeprazole for the following disorders

1. Gastric ulcer - up to 40 mg per day, the course of treatment - up to 2 months.
2. Erosive esophagitis involves taking the drug in a similar way to the scheme for peptic ulcer.
3. Duodenal ulcer - 20 mg per day, for a period of two to four weeks.
4. With Zollinger-Ellison syndrome, the doctor must designate the dose on his own, but it should be borne in mind that it should not exceed 60 mg per day.
5. With Helicobacter pylori infection, Omeprazole is prescribed one 10 mg tablet before meals in the morning, and also before going to bed. The course of treatment is 7 days.
6. For reflux, the drug should be taken in an amount of 40 mg per day, the dose should be divided into two doses.

It is possible to use a medication even if the patient is in intensive care. In this case, doctors put a catheter into the stomach. To do this, dilute 20 mg of the active ingredient in powder form with 30 ml of water. Within three minutes, the components completely dissolve, after which the drug can be administered through a gastric tube.

If the patient is in a very serious condition, Omeprazole is administered intravenously, diluting the active ingredient with sodium chloride.

Overdose

An overdose of the drug is extremely rare. It is known that by increasing the dose, it is possible to alleviate the patient's condition, however, it should not exceed 60 mg per day. Otherwise, the following complications are possible:

• tachycardia;
• confusion;
• Strong headache;
• dryness of the mucous membranes of the mouth and nose;
• difficulty breathing;
• loss of clarity of vision;
• drowsiness;
• increased sweating;
• heat all over the body.

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

How to take Omeprazole for pregnant women?

In the first trimester of pregnancy, the drug is categorically not prescribed, as it can cause severe pathologies in the development of the fetus. In other terms, the medicine is prescribed only in cases where there is a vital need.

Generics of Omeprazole (analogues)

Due to the fact that the drug is very effective and in demand, every year you can find more and more different analogues. All of them have a different cost - if you want to buy a drug cheaper, consult a pharmacist.

The most famous synonyms of Omeprazole:

• Gastrozole;
• Omezol;
• Bioprazol;
• Omephez;
• Omeprazole-Acre;
• Omez;
• Losek.

There are other generics of Omeprazole that are not registered in Russia, but are used in Evprop:

• Prilosec;
• Antra Maps;
• Romesek;
• Lokit;
• Proseptin.

Comparison of two generics: which is better Omez or Omeprazole?

Omez is a synonym for Omeprazole. In Omez, the active ingredient is Omeprazole, but the fact is that the content of the active ingredient in these two drugs may vary.

The synonym includes a lot more various excipients, so experts recommend taking it with caution to people prone to allergies. Due to the fact that additional ingredients - sucrose, titanium dioxide, sodium lauryl sulfate, etc. Because of them, the active substance reaches its maximum concentration in the body more slowly, but is also excreted from it faster. As a rule, analogues have a lower cost, which is why they are more popular.

Omez is an effective medical remedy that is widely used to treat ailments of the gastrointestinal tract. Experts say that the drug is in no way inferior to Omeprazole in its effectiveness.

Let's highlight the main criteria for the differences between Omez and Omeprazole:

1. Omeprazole is the active ingredient. In turn, Omez is a medicine that contains Omeprazole in combination with excipients.
2. The price for Omez is lower than for Omeprazole due to the fact that it contains a smaller amount of active ingredient. That is, more Omez tablets may be required for effective treatment.
3. Despite the fact that Omez starts its action more slowly, nevertheless, it is considered effective in the fight against ulcers of the gastrointestinal tract and duodenum, with gastritis and heartburn.

Price

The price of the drug is relatively low and affordable for every average resident of Russia. It may vary depending on what form of the drug you want to purchase, in what dosage. For example:

• Omeprazole 20 mg capsules has an average cost of 30-50 rubles for 30 pieces.
• A 40 mg drug can cost from 170 to 200 rubles for 28 pieces.

In general, Omeprazole tablets cost no more than 200 rubles in any pharmacy.

If you want to achieve the maximum therapeutic effect, you must consult a doctor. Only he will be able to correctly and competently choose a drug that will affect exactly those parts of the body that need it. The same applies to generics - do not be self-willed, ask your doctor for help. He literally knows your entire medical history, as well as possible allergic reactions to the components of the drug.

The medical drug omeprazole is prescribed for the treatment and prevention of diseases of the internal organs in the digestive tract system.

It purposefully suppresses the process of secretion of hydrochloric acid in the stomach, reduces its activity. The medicinal qualities of the drug are able to manifest only in an acidic environment, which is characteristic of the stomach. Once in it, it begins to regulate the process of secretion of gastric juice. That is why omeprazole is used to treat and prevent diseases associated with high acidity.

Omeprazole appointment

Omeprazole: what does it treat and what is it prescribed for? The tool is indicated for the treatment and prevention of pathologies of the digestive tract. The list includes the following indications:

• gastric and duodenal ulcers, as well as lesions caused by long-term use of non-steroidal anti-inflammatory drugs;
• reflux esophagitis (a disease of the esophagus when the acidic contents of the stomach enter it);
• the development of tumors in the pancreas, stomach, duodenum (called the Zollinger-Ellison syndrome);
• stress ulcers of the digestive system (acute lesions resulting from critical situations: injuries, injuries, operations);
• systemic mastocytosis - an excess of mast cells is observed in the gastrointestinal tract, which leads to ulcerative lesions of the digestive tract;
• polyendocrine adenomatosis - the development of tumors of the endocrine glands, usually pancreas and parathyroid;

The remedy can be taken to destroy Helicobacter pylori, the causative agent of infection in patients with ulcers of the digestive system. The bacterium multiplies in an acidic environment, the use of the drug can reduce acidity, thereby stopping its activity.

Indications for treatment with this medicine are:

• heartburn;
• belching;
• bloating;
• gastritis;

It can be taken as an adjuvant for pancreatitis, prevention of recurrence of peptic ulcer.

It is effectively used to prevent bleeding from the stomach in critically ill patients.

Drug therapy includes such indications as dyspepsia - discomfort and pain in the upper abdomen, a feeling of overcrowding, heaviness, indigestion.

heartburn therapy

Why is the drug prescribed for heartburn? The medicine helps with heartburn, it can be taken only to get rid of heartburn, which is of a periodic nature, which does not occur constantly.

You should know that the drug as an independent method can be used as an emergency. The dosage should not be more than 10 mg per day, the course of treatment should be limited to 2 weeks. You can repeat the therapy after 4 months.

Consultation should be sought if recurrence of heartburn is observed more often, also in case of appearance and action of other symptoms - pain in the upper abdomen, behind the sternum, weight loss.

Therapy of gastritis

Why is this remedy prescribed for gastritis? The medicine helps in the treatment of patients with gastritis, accompanied by increased acidity at times. With other types of gastritis, it is contraindicated, since it leads to minimization of the acidic environment of the stomach.

This situation can lead to the development of atrophic gastritis. The disease threatens with thinning of the mucous membrane of the walls of the organ. The production of gastric juice is significantly reduced.

Treatment of gastritis lasts no more than 3 weeks, the patient is prescribed 20 mg per day. The therapy leads to the normalization of the acid balance of the stomach. If gastritis is accompanied by Helicobacter pylori, antibiotics may be additionally prescribed.

Contraindications

Before the patient starts taking the medication, the doctor must make sure that the patient has no contraindications, after which he can write a prescription.

This is first of all:

• tumor of the digestive tract of a malignant nature;
• the presence of infections in the intestines and stomach;
• liver disease in a chronic form;
• violations in the functioning of the kidneys (renal failure), as the removal of the substance from the body will slow down;
• intolerance to components;

The drug is not prescribed to patients with osteoporosis, because it promotes the leaching of calcium from bone tissue, which can worsen the course of the disease. If there are proven necessary indications for therapy with this agent, the doctor will additionally prescribe calcium-containing medicines in combination with a group of vitamins D.

Pregnancy

There are contraindications for taking the drug for pregnant women. It is strictly forbidden to take omeprazole during pregnancy.

This is especially true of the first trimester, when the laying and formation of the child's organs takes place. From taking the drug in the fetus, abnormalities in the cardiovascular system may develop. Only in extreme situations, if there are serious indications, the benefits of which are undeniably proven, omeprazole during pregnancy can be allowed.

The drug is not used and has contraindications for women during breastfeeding, as it quickly enters the baby's body with mother's milk.

Childhood

In what cases and for what purpose can the remedy be used in childhood? The drug is contraindicated in children under five years of age. Very rarely, if there are special indications, the medicine is used.

These may be diseases associated with the development of tumors in the digestive tract (Zollinger-Ellison syndrome). The dose for children depends on body weight, calculated accordingly with it. If the weight of the child does not exceed 10 kg, he is prescribed 5 mg of the drug per day. With a weight of 10 to 20 kg, the dose is increased to 10 mg. A child weighing more than 20 kg is allowed to take 20 mg of the substance per day.

How to use omeprazole

The medicine is available in the following forms:

• capsules with prolonged action (10 mg or 20 mg each);
• tablets with prolonged action (10 mg, 20 mg or 40 mg each);
• powder (40 mg vials);

Dosing

The required dose for admission is determined by the doctor, it varies depending on the severity of the disease. Taking the drug for more than 2 months is not recommended, after which a break of several months always follows.

Usually the standard reception scheme looks like this:

• treatment of stomach ulcers - appoint 20-40 mg per day, the course of treatment lasts at least 1 month;
• duodenal ulcer therapy - take 20 mg per day, the course of treatment is usually from 2 to 4 weeks;
• prevention of recurrence of diseases - maintenance doses can be prescribed for 4 weeks at 10 mg per day;
• therapy for Zollinger-Ellison syndrome - a personal approach is practiced (the daily dose should be at least 60 mg);
• heartburn treatment - 20 mg per day is prescribed for 2 weeks (tablets or capsules);
• Helicobacter pylori infection - appoint 20 mg twice a day, the course of therapy is at least a week;

When taking capsules, it is forbidden to chew, it is impossible to divide them into parts. Tablets can be pre-dissolved in slightly acidic water, yogurt, juice are suitable for this purpose.

Overdose

The patient must strictly adhere to the prescribed regimen of taking the drug in order to avoid the risk of overdose.

Overdose can be expressed as follows:

• visual impairment;
• drowsiness;
• confusion of consciousness;
• increased sweating;
• headache;
• feeling of dryness in the mouth;
• feeling of nausea;
• signs of arrhythmia;
• symptoms of tachycardia;

Side effects

The use of the drug is not characterized by the frequency of side effects. Usually they occur when the reception scheme is violated. They can be provoked by long-term treatment with a remedy for more than 2 months in a row.

Side effects associated with the functioning of the digestive system are accompanied by:

• nausea;
• bloating and flatulence;
• diarrhea or constipation;
• feeling of dryness in the mouth;
• violation of taste buds;
• stomatitis;
• impaired liver function;

Side effects associated with the functioning of the central nervous system can manifest themselves:

• depression
• increased irritability;
• headache;
• lethargy and weakness;
• hallucinations;

Side effects related to the functioning of the epidermis:

• itching of the skin;
• redness and peeling of the skin;
• skin rashes;

Side effects associated with the work of the musculoskeletal system:

• muscle weakness;
• swelling of the lower extremities;
• arthralgia;
• myalgia;

Very rarely, when using the product, the mammary glands can swell, allergic reactions occur, and changes in the hematopoietic system occur.

In general, treatment with omeprazole is characterized by a very low development of serious side effects in patients taking it. If you follow the doctor's recommendations and the prescribed regimen, adverse events will be minimized.