Health Insurance

Quickly and sufficiently absorbed from the gastrointestinal tract, but the bioavailability is not more than 50-55% (the effect of the first passage through the liver). Maximum plasma concentration is achieved through 0,5-3,5 hours. Protein binding 95%. The half-life is 0,5-1 hours (with normal liver function) or 3 hours (with chronic liver diseases). Biotransformation in the liver. Metabolites are not active. Excreted by the kidneys as metabolites (72-80%) and through the intestine (18-23%). After a single dose of 20 mg of inhibition of gastric secretion occurs during the first hour, reaching a maximum after 2 hours and lasts about 24 hours. Severity of effect depends on the dose. The ability of parietal cells produce hydrochloric acid is restored within 3-5 days after treatment.

The peculiarity of omeprazole is that after repeated application of increasing absorption of the generic, thus increasing its antisecretory effect.

The injectable form of the drug (the only representative in the pharmaceutical market Loseke Swedish firm Online Pharmacy Without Prescription) is used for quick relief of (in the first 1-2 days) of clinical symptoms of exacerbation kislotozavisimyh diseases of the upper digestive tract, especially those with complicated course.

Especially important is the intravenous Loseke with gastroduodenal hemorrhage occurring as a complication of peptic ulcer, portal hypertension, as well as in stress, steroids, indometatsinovyh (or the use of other ulcerogenic indian drugs) and other acute ulcers. Conducted numerous clinical studies have shown the possibility of such a conservative stop bleeding without surgical intervention. Intravenous form Loseke is also convenient when it is impossible oral dose.

Overdosage
Total for the group, as well as:
” fever
” photosensitization,
” paresthesia,
” interstetsialny nephritis
” alopecia,
” gynecomastia
” impotence,
” breach of taste
” stomatitis,
” candidiasis,

On the part of hematopoiesis: thrombocytopenia, leukopenia, agranulocytosis, pancytopenia.

Interaction
Total for the group, as well as:
” Enhances the effect of coumarins and difenina.
” Slows eliminitsiyu generics metabolized in the liver by microsomal oxidation (warfarin, diazepam, phenytoin).
” Increases (mutually) concentration in the blood of clarithromycin.

Dosage and application

Inside:
In gastric ulcer, duodenal ulcer and reflux esophagitis - 20 mg 1 time a day (if necessary - 40 mg). In duodenal ulcer treatment 2-4 weeks, with a stomach ulcer and reflux esophagitis - 4-8 weeks.
For the prevention of peptic ulcer disease - 20 mg 1 time per day.

In Zollinger-Ellison syndrome: initial dose - 20-60 mg per day, if necessary, up to 120 mg / day (daily dose above 80 mg should be divided into two sessions) for 2-8 weeks. The level of secretion in the stomach must be at nerezetsirovannyh patients up to 10 mM HCl / h, the resected - up to 5 mmol HCl / h

In peptic ulcer caused by Helicobacter pylori, in combination: omeprazole 20 mg, amoxicillin 1 g, clarithromycin 500 mg or omeprazole 20 mg, metronidazole 400 mg, clarithromycin 250 mg 2 times a day for 7 days.

Intravenous:
1 times per day. The substance (40 mg) was dissolved in 100 ml of saline or 5% dextrose solution and injected within 20-30 minutes after dilution. Infusion should be completed in 12 hours, if the solvent - saline solution, and within 6 hours, when dissolved in dextrose. Usually it is sufficient to conduct infusion over 2-5 days, after which the patient can be transferred to oral medication.

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Side effects
On the part of the digestive tract: indigestion, nausea, diarrhea, constipation, abdominal pain, flatulence, dry mouth, lack of appetite;
From the nervous system: headache, dizziness, fatigue (including muscle), sleep disturbance, drowsiness, depression, anxiety, restlessness, excitation, hallucinations;

From other organs and systems: an allergic reaction (bronchospasm, pharyngitis, rhinitis, skin rashes, itching), myalgia, arthralgia.
In short (up to 3 months) of therapy, proton pump inhibitors side effects occur rarely. With long-term (especially in a few years) is continuously receiving these indian drugs in patients gipergastrinemiya occurs, the phenomenon of progressive atrophic gastritis may develop Uzelkov hyperplasia of endocrine cells (ECL-cells) of gastric mucosa, producing histamine.

Gipergastrinemiya most pronounced when using rabeprazole. 2-3 weeks after cessation of treatment in serum gastrin level returned to the original. If necessary, prolonged or continuous maintenance treatment to reduce the severity gipergastrinemii proton pump inhibitors is recommended to take along with the synthetic prostaglandin analog (misoprostol) or Pirenzepine, which significantly reduces the level of gastrin.

Application of proton pump inhibitors also leads to increased levels of pepsinogen I in serum. Gipergastrinemiya and raising pepsinogen I in the treatment of these drugs is much more pronounced in patients infected with Helicobacter pylori, compared to patients who have been held its eradication.

Admission omeprazole 40 mg daily led to a decrease in motor-evacuation function of the stomach. After a 10-day course of treatment there were differences in the concentrations motilina, gastrin and cholecystokinin in the blood serum in the groups who received omeprazole and placebo. Reducing motor-evacuation function of the stomach due gipomotilinemii during treatment with proton pump inhibitors, is probably one of the causes of gastroesophageal reflux disease after eradication therapy.
Interactions with other pharmacological agents:

Pharmacokinetic
You can change the pH-dependent absorption of generics belonging to the groups of weak acids (slowdown) and bases (acceleration).

Dosage regimen
Inside: the morning, before eating.No chewing. Squeezed a small amount of water.
Intravenous: once a day.

Application of proton pump inhibitors in elderly patients do not require dose adjustment.Since proton pump inhibitors are characterized by slow onset of action (not earlier than 1 h), they are not suitable for treatment on demand (at the time of pain, heartburn). For such therapy appropriate to apply modern Antacids drugs, or soluble tablet H-2 blockers (the effect appears within 1.6 minutes).

Product
The product is available in dosage form having acid-shell, which dissolves in the intestines.

Precautions
Be used with caution in children and elderly patients. Treatment of patients with reduced liver function should begin with half-doses, gradually increasing them to the recommended. Should regularly check the activity of liver enzymes, if they increase the generic should be discontinued. Before and after therapy is required endoscopic control to exclude malignancies, as lanzoprazol may mask symptoms and delay the establishment of an accurate diagnosis. Should abandon breast-feeding during treatment. The following article was published by a Online Pharmacy Without Prescription.

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