Effect of omeprazole on the last stage of the formation of hydrochloric acid is dose-dependent and provides effective inhibition of basal and stimulated secretion, irrespective of the nature of the stimulating factor.
When taken daily deca durabolin price omeprazole provides rapid and effective inhibition of daytime and nighttime gastric acid secretion. The maximum effect is reached within 4 days. In patients with duodenal ulcer receiving 20 mg of omeprazole supports intragastric acidity to a pH level greater than 3 for 17 hours.
The action of omeprazole together with antibacterial drugs leads to the eradication of Helicobacter pylori, which allows you to quickly arrest the symptoms of the disease, a high degree of healing of damaged mucosa and persistent long-term remission and reduce the likelihood of bleeding from the gastrointestinal tract (GIT), and eliminates the need of long-term anti-ulcer therapy.
After oral administration of omeprazole is rapidly absorbed from the small intestine, the maximum plasma concentration (C max ), is achieved through 0.5-3.5 h. The bioavailability is 30-40%, with liver failure – 100%. The binding to plasma proteins (albumin and sour aα1-glycoprotein) – about 90%. Metabolism and excretion . (omeprazole is almost completely metabolized in the liver with the participation of the enzyme CYP2C19 system to form a six pharmacologically inactive metabolites (gidroksiomeprazol, sulfide and sulfone derivatives, etc.) is an inhibitor of the isozyme CYP2C19… The half-life (the T 1/2 ) – 0,5-1 hours , hepatic insufficiency -3 hours. The clearance of 300-600 ml / min. excreted by the kidneys (70-80%) and in the intestine (20-30%) in the form of metabolites. Pharmacokinetics in specific clinical situations . chronic renal failure excretion decreases proportionally decrease in creatinine clearance. In the elderly elimination of omeprazole is reduced, increasing bioavailability.
- gastric ulcer and duodenal ulcers, including relapse prevention;
- gastroesophageal reflux disease (GERD), reflux esophagitis, including relapse prevention;
- erosive and ulcerative lesions of gastric and duodenal ulcers associated with nonsteroidal anti-inflammatory drugs (NSAIDs);
- erosive and ulcerative lesions of gastric and duodenal ulcers associated with Helicobacter pylori (in a combination therapy);
- Zollinger-Ellison syndrome, and other pathological conditions associated with poreshennoy gastric secretion.Contraindications
: Hypersensitivity to omeprazole or to any component of the drug; fructose intolerance; saccharose / isomaltose deficiency; glucose-galactose malabsorption; joint application with clarithromycin in patients with hepatic insufficiency patients, atazanavir, St. John’s wort; pregnancy, breast-feeding; age 18 years.
Lack of liver function; deca durabolin price failure of kidney function; simultaneous use with clarithromycin.
Pregnancy and lactation
Use of omeprazole during pregnancy and breastfeeding is contraindicated due to insufficient efficacy and safety data in this group of patients.
Dosing and Administration
Inside, in the morning before eating mud during a meal with a small amount of water; the contents of the capsules can not chew. Adults In acute gastric ulcer, duodenal ulcer and reflux esophagitis 20 mg 1 time per day. Course of treatment 4-8 weeks. In some cases, may increase the dose to 40 mg per day. In supporting suffers GERD to prevent a recurrence of 10-20 mg for 26-52 weeks depending on the clinical effect, with severe ezofagite- life.
<brIn the treatment of erosive and ulcerative lesions of the stomach and duodenal ulcers associated with NSAID (including for the prevention of recurrences)
of 10-20 mg per day. In the Zollinger-Ellison syndrome The dosage is determined individually. The recommended starting dose – 60 mg once per day. If necessary to increase the dose of 80-120 mg per day e, m which case it should be divided into two steps. Erosive lesions of gastric ulcer and duodenal ulcer associated with Helicobacter pylori At 20 mg 2 times a day in combination with antibacterial agents for 7 days. In patients with gastric ulcer and / or duodenal ulcer in the acute stage may be extended monotherapy omeprazole. Elderly patients No dose adjustment is required. Patients with renal insufficiency dose adjustment is required. Patients with impairment of liver function, the maximum daily dose of 20 mg . If you have trouble swallowing whole capsule can be swallowed its contents after opening resorption or capsules and can mix the contents of the capsule with slightly acidified liquid (juice, yogurt), and use the resulting suspension for 30 min.
The frequency of side effects is classified in accordance with the recommendations of the World Health Organization: very often – at least 10%; often – at least 1% but less than 10%; infrequently – at least 0.1% but less than 1%; rare – less than 0.01% but less than 0.1%; very rare (including isolated cases) – less than 0.01%. On the part of the blood and lymphatic system: rarely -gipohromnaya microcytic anemia in children; very rare invertible thrombocytopenia, leukopenia, pancytopenia, agranulocytosis. Immune system: very rarely – nutsedge, increased body temperature, angioedema, bronchoconstriction, allergic vasculitis, fever, anaphylactic shock. From deca durabolin price the nervous system: often – headache, dizziness, insomnia, somnolence, lethargy (listed side effects tend to exacerbate the long-term therapy), rarely – paresthesia, confusion, hallucinations, especially in elderly patients or in severe disease; . very rare anxiety, depression, especially in elderly patients or in severe disease part of the vision: rarely – visual impairment, including reduction of the visual field, reduced visual clarity and visual perception (usually disappear after discontinuation of therapy). On the part of the organ of hearing and labyrinth disorders:rarely -Violation auditory perception, including “Tinnitus” (usually disappear after discontinuation of therapy). On the part of the gastrointestinal tract: often – nausea, vomiting, bloating, constipation, diarrhea, abdominal pain (in most cases, the severity of these effects increases with the continuation of treatment); infrequently – dysgeusia (usually resolves after discontinuation of therapy); rarely – to change the language of color to brown-black appearance and benign cysts of the salivary glands with the simultaneous use with clarithromycin (effects are reversible after discontinuation of therapy); very rarely – dry mucous membranes of the mouth, stomatitis, candidiasis, pancreatitis. Liver and biliary tract: rare • Changes rates of “liver” enzymes (reversible); very rare Hepatitis, jaundice, hepatic failure, encephalopathy, especially in patients with liver disease. With the skin side and subcutaneous tissue disorders: nechasto- rash, pruritus, alopecia, erythema multiforme, photosensitivity, increased sweating; . very rare Stevens-Johnson syndrome, toxic epidermal necrolysis the part of the musculoskeletal and connective tissue disorders: uncommon – fractures of the vertebrae, the bones of the wrist, the femoral head (see “Cautions.”); rarely -mialgiya, arthralgia; rarely – muscle weakness. On the part of the kidney and urinary tract: rarely -interstitsialny nephritis. General disorders and administration site at:infrequently -perifericheskie edema (usually disappear after discontinuation of therapy); rarely – hyponatremia; very rare hypomagnesemia (see. section “Special instructions”), gynecomastia.
Overdose symptoms: blurred vision, drowsiness, agitation, confusion, headache, increased sweating, dry mouth, nausea, arrhythmias. Treatment: symptomatic therapy, hemodialysis is not effective enough.A specific antidote is not known.
Interaction with other drugs
When applied simultaneously with omeprazole may decrease the absorption of ketoconazole.
While the use of omeprazole for 10% increases the bioavailability of digoxin as a result of increasing the pH.
Omeprazole may reduce the absorption of vitamin B12 for prolonged use.
Omeprazole should not be used simultaneously with drugs St. John’s wort due to pronounced clinically significant interaction.
with the simultaneous use of omeprazole and clarithromycin concentration in blood plasma increases.
at the same time prpminenii with omeprazole 75% reduced area fashion curve “concentration-time” atazanavir, therefore concurrent use is contraindicated.
in an application with omeprazole may slow excretion warfarin, diazepam and phenytoin, as well as imipramine, clomipramine, citalopram, geksabarbitala, disulfiram as omeprazole biotransformed in the liver with the participation of isoenzyme CYP2C19. You may need to decrease doses of these drugs. In the application of omeprazole with caffeine, propranolol, theophylline, metoprolol, lidocaine, quinidine, erythromycin, phenacetin, estradiol, amoxicillin, naproxen, piroxicam, and antacids clinically significant interactions have not been established.
Before starting treatment to rule out malignancy in the upper gastrointestinal tract, as receiving omeprazole-Teva drug may mask the symptoms and delay the correct diagnosis.
Reduced gastric acidity, including those using proton pump blockers increases the number of bacteria in the digestive tract, which increases the risk of gastro-intestinal infections.
In patients with severe impairment of liver function is necessary regularly monitor the performance of “liver” enzymes during therapy with Omeprazol- Teva.
The drug omeprazole-Teva contains sucrose, and therefore is contraindicated in patients with congenital disorders of carbohydrate metabolism (fructose intolerance, sucrase insufficiency / isomalt, glucose-galactose malabsorption).
in the treatment of erosive and ulcerative lesions associated with taking NSAIDs should carefully consider the possibility of limiting or stopping NSAIDs for efficiency anti-ulcer therapy.
The drug contains sodium, which should be taken into account in patients on a controlled sodium diet.
it is necessary to regularly assess the balance between risks and benefits of long-term (more than 1 year) maintenance therapy with omeprazole-Teva. There is evidence of an increased risk of fractures of the vertebrae, wrist bones, femoral head mostly in elderly patients, as well as in the presence of predisposing factors. Patients at risk of developing osteoporosis should ensure adequate intake of vitamin D and calcium.
There are reports of occurrence of severe hypomagnesemia in patients receiving therapy with proton pump inhibitors, including omeprazole, more than 1 year.
Patients receiving omeprazole therapy for a long time, especially in combined with digoxin or other drugs that reduce the content of magnesium in the blood plasma (diuretics), require regular monitoring of the magnesium content.
Effects on ability to transport management and work with the technique
Given the possibility of adverse effects on the central nervous system and organ of vision during treatment with omeprazole must be careful when driving and other deca durabolin price activities potentially hazardous activities that require high concentration and speed of psychomotor reactions .