Peptic ulcer disease is a pathology that is extremely difficult to treat. The most common method of getting rid of the disease is to lower the acidity of the gastric environment. The drug that was effective for this effect is Omeprazole tablets.
Material Content:
Description of the dosage form, composition
The drug exists in various forms: tablets, powder, from which a solution for infusion is prepared, lyophilisate, intended for the same, capsules. It is the latter species that is most common in the CIS countries.
The shell has a light pink color, the lid that closes the gelatinous body - a brighter shade. Inside there are white pellets of the substance - small spherical particles, which include 10 to 20 mg of the substance, which is most active, omeprazole.
Among the auxiliary components: diethyl phthalate, sucrose, lactose, sodium lauryl sulfate, hypromellose, starch, sodium phosphate, hydroxypropylcellulose, hypromellose phthalate, dodecahydrate. The shell is made of gelatin with the addition of azorubine and food additives E122 and E171.
Pharmacological properties
The principle of operation of omeprazole is based on the inhibition of hydrogen-potassium adenosine triphosphatase, an enzyme that is an essential component of proteins of parietal cells (the substance easily penetrates them, due to its high lipophilicity).The latter produce hydrochloric acid - a substance that forms the acidic environment in the stomach and is responsible for the digestion of food. Inhibition of the production of these enzymes interrupts the secretion of acid at one of the last stages, thereby reducing the acidity in the body.
After taking a therapeutic dose of the drug, the effect of it is noticeable in an hour or two. The secretion of the stomach is reduced by half, this action lasts up to a day.
- The absorption rate (absorption in body tissue) is high.
- The maximum amount of substance accumulates over a period of 30 minutes to 3.5 hours.
- Bioavailability is up to 40%.
- Binding to blood proteins is also high - from 90% to 95%.
- The elimination half-life makes 30 minutes or 1 hour.
- It is processed in the liver by the enzyme CYP2C19 to form six completely inactive metabolites.
- About 80% of the active component is excreted in urine, and approximately 20% in bile.
- The metabolic rate of the substance in patients after 55 years is significantly lower than in young people.
Why is omeprazole prescribed
Despite the fact that Omeprazole is considered an exclusively antiulcer drug, the list of its indications includes not only this pathology:
- gastroesophageal reflux disease (gastric juice entering the esophagus);
- systemic mastocytosis (symptom relief);
- Vermeer syndrome or independent polyendocrine adenomatosis;
- stress ulcers;
- Zolinger-Ellison syndrome;
- extermination of Helicobacter pylori in people who have ulcers of bacterial origin;
- treatment of gastrointestinal relapse ulcers;
- expressions after taking NSAIDs (non-steroidal anti-inflammatory drugs).
"Omeprazole" is also prescribed for children over 1 year old with such violations:
- reflux esophagitis;
- bacterial ulcers;
- heartburn (symptomatic treatment);
- acid regurgitation in reflux disease (symptomatic treatment).
Method of application, dosage
For most diseases described in the paragraph “Indications”, the dosage is almost the same, although there are exceptions.
Capsules must be swallowed with a small amount of water (about half a glass). Patients who cannot swallow the medicine freely should open the capsule and add pellets to a small volume (tablespoon) of the product with low acidity levels - applesauce or diluted juice, you can use distilled water for the same purpose.
Another option is to hold the capsule in your mouth for a while until the gelatin shell dissolves, quickly wash down with the indicated amount of water.
Do not chew capsules or dissolve granules after dissolving the shell.
It is important to follow a diet during therapy.
The optimal time for admission is breakfast, immediately at the time of eating or before. As a rule, a one-time appointment is prescribed.
- "Omeprazole" is prescribed for adults with heterogeneous ulcerative formations in the duodenum at a dosage of 20 mg of the drug. Usually, treatment lasts no more than 2 weeks. In cases of complications or relapses, the dose is increased to 40 mg.
- Gastric ulcers are treated in a similar way. Such ulcerations disappear after 3 to 4 weeks. In severe cases, it is possible to increase the dose in the same amount that is indicated for the treatment of such a bowel disease.
- The eradication (destruction) of a specific bacterium Helicobacter pylori, which is a common cause of ulcers in the gastrointestinal mucosa, requires complex therapy in combination with antibiotics.
Three possible treatment options are indicated in the table.
| Methodology | Preparations | Dosage (mg) | The number of receptions per day | Course duration |
|---|---|---|---|---|
| 1 | Clarithromycin | 500 | 2 | 7 days |
| Amoxicillin | 1000 | |||
| Omeprazole | 20 | |||
| 2 | Tinidazole / Metronidazole | 400/500 | 2 | 7 days |
| Clarithromycin | 250 | |||
| Omeprazole | 20 | |||
| 3 | Amoxicillin | 500 | 3 | 7 days |
| Tinidazole / Metronidazole | 400/500 | |||
| Omeprazole | 40 | 1 |
Only the attending physician can choose one of the methods, taking into account the stage of the course of the disease, its neglect, as well as additional factors affecting recovery.
- Therapy of reflux esophagitis includes the use of 20 mg of the drug with an interval of 24 hours. In the absence of the desired effect, the dose is increased to 40 mg.
- Zollinger-Ellis syndrome requires individual norms, which depend on how the disease progresses. Usually prescribed to start with 60 mg of omeprazole. But the dose can reach 120 mg per day. If you need to take more than 80 mg, it is recommended to divide the daily norm into two doses.
For the treatment of children from one year old, it is recommended to precisely select the dose depending on the weight of the child. Patients with a weight of 10 to 20 kg are prescribed 10 mg Omeprazole capsules with a time interval between doses of 24 hours. For children weighing more than 20 kg, doses similar to adult standards are recommended.
The duration of therapy depends on the type of disease. For example, getting rid of heartburn occurs within 2 to 3 weeks, and reflux disease is treated for up to 8 weeks.
Treatment of bacterial intestinal ulcers is carried out in the following order, adjusted for the weight of the patient.
| Weight | Preparations | Dosage (mg) | The number of receptions per day | Course duration |
|---|---|---|---|---|
| 15 to 30 kg | Clarithromycin | 7.5 per 1 kg of weight | 2 | 7 days |
| Amoxicillin | 25 per 1 kg of weight | |||
| Omeprazole | 10 | |||
| 30-40 kg | Clarithromycin | 7.5 per 1 kg of weight | 2 | 7 days |
| Omeprazole | 20 | |||
| Amoxicillin | 750 | |||
| More than 40 kg | Omeprazole | 20 | 2 | 7 days |
| Clarithromycin | 500 | |||
| Amoxicillin | 1000 |
Dose adjustment is not required for patients over the age of 65, and for people who have impaired renal function.
During pregnancy and lactation
As a result of the experiments, it turned out that Omeprazole does not have a negative effect on the health of the fetus during pregnancy and does not affect the well-being of the mother.
According to the instructions for use, drug therapy during this period is allowed, but if the doctor believes that there are certain risks, it is better to choose another remedy.
It is also known that Omeprazole is able to penetrate the mother’s milk when breastfeeding, but whether it harms the baby is not yet clear. Because of this, it is not recommended to use the drug during lactation.
Can I take omeprazole constantly
It was previously believed that prolonged use of Omeprazole increases the risk of developing stomach or intestinal cancer in a patient, but as a result of a large-scale study, this information was disproved.
The study involved 230 patients who had been using an antisecretory drug for 7 years. None of them were malignant neoplasms. This led to the conclusion that oncological diseases appear only with a predisposition to them.
Omeprazole helps people with reflux diseases, in which a certain amount of gastric juice is constantly thrown into the esophagus. The lower part of the body becomes inflamed, accompanied by severe pain.
Despite the results of the experiment, it is important to monitor the patient’s condition for other side effects with prolonged use of Omeprazole.
Drug interaction
It should be noted that due to the reduced secretion of gastric juice, the absorption rate of many drugs, especially those that directly depend on the acidity of the gastric environment, can change.
Other options for the interaction of Omeprazole with certain drugs are presented below.
| A drug | Effect of combining |
|---|---|
| Clopidogrel | Decreased platelet aggregation ability by 47% |
| Vitamin K Antagonists | Strengthening their action, but only with doses above 20 mg |
| "Digoxin" | 10% increase in bioavailability of the drug, intoxication with Digoxin is possible |
| Ketoconazole, Erlotinib, Itraconazole, Proconaconazole | Reducing their effect due to low acidity in the stomach |
Contraindications, side effects and overdose
Omeprazole has a small number of contraindications, among which only the presence of an allergy to the active component or other components and treatment with Atazonavir and Nelfinavir.
Of the side effects distinguish:
- dyspeptic disorders, dry mouth, gastrointestinal candidiasis, mild forms of colitis, jaundice, encephalopathy (if the patient had impaired liver activity at the beginning of therapy);
- changes in the blood test: a decrease in the level of Ca, K, Mg, Na ions, a lack of platelets, white blood cells, pancytopenia (platelet deficiency, red blood cells, white blood cells), agranulocytosis;
- the development of allergies, anaphylactic shock (rarely), hypersensitivity to ultraviolet radiation, Stevens-Johnson syndrome, TEN (toxic epidermal necrolysis), bronchospasm;
- insomnia, aggressive behavior, agitation, hallucinations;
- hearing and vision impairment;
- immuno-inflammatory damage to the kidneys, increased swelling;
- pathological enlargement of the mammary glands;
- paresthesia (the appearance of tingling, burning, numbness), changes in taste perception, headaches, asthenia (chronic fatigue syndrome).
Additional hypersensitivity may develop in relation to karmoizin - a dye in the capsule shell.
An overdose manifests itself in the form of apathy, pain in the skull and abdomen, confusion, tachycardia and other symptoms. In medical practice, there have been no fatalities.
An antidote for the treatment of overdose "Omeprazole" does not exist, only symptomatic therapy helps.
Analogs of antiulcer drug
Structural analogues of Omeprazole are drugs that contain the same active substance. They may differ in the form of release and the manufacturer, but the articles "Indications" and "Contraindications" will be the same.
Among the direct substitutes can be identified:
- "Gasek" (dosage of 10, 20 silt 40 mg);
- "Losid";
- Omezin;
- "Omep";
- Lorsek
- "Osid";
- "Ultop";
- "Diaprazole";
- "Omelik";
- Omez
- "Proton".
There are similar actions, but the main activity in them is shown by another substance.
These are non-structural analogues of Omeprazole, which include:
- "Gerardin";
- Zulbeks;
- "Barol";
- "Velos";
- "Zovanta";
- "Lancerol";
- Nexium
- "Panzol";
- "Panocar";
- Penta;
- "Rabizol";
- "Topraz";
- "Ultra";
- Esomaps;
- Esozol
- Pantralis
- Pantonex
- "Nolpaza."
It is worth remembering that other drugs may have other side effects and some differences in the indications. Therefore, you should not prescribe yourself a cheaper or more expensive drug - it can not only be pointless, but also harm your health, exacerbating existing problems or developing new ones.
Mandatory medical advice regarding the selection and use of structural and non-structural analogues of Omeprazole.
Anti-ulcer drugs are mandatory for use in the presence of expressions on the surface of the mucous membranes of the stomach and intestines, but you always need to be careful - strictly observe the dosage and follow all the instructions of the treating gastroenterologist.
