Last Updated on February 19, 2017 by Dr.Derek Fhisher
Most popular brand: Prilosec
Active ingredient: Omeprazole
Available dosage forms: 10, 20, 40 mg
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Omeprazole general information
Pick out the medication at around exactly the same time each day. Continue to spend the medication even should you feel well. In addition they could induce constipation. In a few countries this medication can be found over the counter. They are normally common in elderly patients. Moreover, Peritol shouldn’t be used in mothers that are breast-feeding.
All people today have coping skills. Usually their family members and friends see the change in their own behaviour and mood but the individual may deny any change. You should possess the attribute of endless patience. I wish you very good luck and superior health.
While there aren’t any evidence of fetal harm, the company’s advice to stop from using Hitop during pregnancy. Peritol should be shunned in pregnancy. Don’t eat food full of fat in the time of the drug. Practice the directions on your own prescription label cautiously and ask your personal doctor or pharmacist to clearly explain any part you really do not understand.
Anti psychotic medication might be administered orally in addition to in a similarity to injections. At the similar time, only a qualified psychiatrist will have the ability to determine the best medication and the correct dosage to be able to deal with all of the emotional and behavioral disorders that exist with the ailment of schizophrenia. Despite the customary achievement of the mixture of medication and counseling, at times the symptoms of the ailment may well not come under control. It’s not to be properly used for treatment purposes, but instead for discussion with all the patient’s own physician. The information presented here isn’t meant to diagnose health issues or to select the place of professional medical care.
Elderly individuals will get nearly all of the side outcomes. The possibility for dementia increases as the individual gets older. Its symptoms could be managed, and you may live the usual daily life. Particular medicines might be used to lower the speed at which problems worsen. Peritol shouldn’t be taken in case you have liver diseases. Peritol can result in weight gain because of its ability to improve appetite.
You and also your doctor will decide what sort of treatment is best for you. This medication can help control your symptoms, although it will not cure your situation. Whatever be the instance, you should speak about your symptoms with an experienced psychiatrist and just then follow the method of cure prescribed by them. The drug really should not be administered on a bare stomach. Don’t stop taking it without speaking to your doctor. This medication ought to be taken with a complete glass of plain water.
Many people with bipolar disorder can receive the majority of their treatment without needing to remain in hospital. Anti anxiety medication is, in addition, frequently used within this ailment among the key symptoms of an individual experiencing schizophrenia is anxiety. A lot of people with bipolar disorder could be treated employing a mix of different treatments. The benefit coming from these types of drugs is normally small, and patients and their families might not always notice a good deal of change. Children, teenagers, and young adults who take antidepressants to take care of depression or another mental illnesses might be more probable to turn into suicidal than children, teenagers, and young adults who r take antidepressants to take care of these conditions. To discover more about bipolar disorder.
The term psychosis describes a condition which impacts the mind. Anticonvulsant medicines are regularly used as a treatment for epilepsy, but they’re also effectual in treating bipolar disorder. Antipsychotic medicines are from time to time prescribed to take care of episodes of mania or hypomania.
Omeprazole (Omeprazole): instruction, and the use of a formula
The nosological classification (ICD – 10)
Feature substance omeprazole
White or off-white crystalline powder, readily soluble in ethanol and methanol, slightly ; in acetone and isopropanol, it is very small ; in water. It is a weak base resistance depends on the pH. undergoes rapid degradation in the acidic environment is relatively stable in alkaline.
Mode of action -. Protivoyazvennoe
penetrates in the parietal cells of the gastric mucosa, and builds up therein is activated at an acidic pH. The active metabolite ; sulfenamide inhibits the H + – K + – ATPase secretory membrane of the parietal cell (proton pump), stops the output of hydrogen ions in the gastric cavity, and blocks the final phase of acid secretion. Dozozawisimo reduces basal and stimulated secretion, the total amount of gastric secretion and excretion of pepsin. Effectively inhibits both night and daytime acid production. After a single dose (20 mg) suppression of gastric acid secretion occurs during the first hours and reaches a maximum after 2 hours effect lasts about 24 hours, ability of the parietal cells to produce hydrochloric acid is recovered for 3 –.. 5 days after the end of therapy. Bactericidal effect on the Helicobacter pylori MIC of 25 –. 50 mg / l. With daily omeprazole 20mg average frequency healing duodenal ulcers in the first 2 weeks was 68%, and after 4 weeks ; 93%. After 4 weeks of treatment at a dose of 20 mg complete healing of gastric ulcers is observed in 77% of patients after 8 weeks of treatment ; 96%. The recurrence rate of peptic ulcers after treatment with omeprazole is 41%. Helicobacter combinations comprising omeprazole, ensure eradication of H. pylori in more than 85% of cases. In gastric ulcer and duodenal ulcer in the acute stage (20 mg 2 times a day) increases the rate of eradication of H. pylori infection by 20%. Treatment of peptic ulcer complicated by gastro – intestinal bleeding (intravenous injection at a dose of 80 mg (8 mg / h) and the subsequent ingestion of 20 mg of 3 – to 21 – day) is accompanied by a significant reduction in the duration and intensity of bleeding. Consequently, the frequency of transfusions is decreased, additional surgical operations and endoscopic procedures. When reflux ulcerative esophagitis normalization acid exposure in the esophagus and maintaining intragastric pH> 4,0 for 24 hours with a decrease in damaging the properties of the gastric contents (braking transition pepsinogen to pepsin) helps to reduce symptoms and complete healing lesions of the esophagus (healing exceeds 90%). It is highly effective in the treatment of severe and complicated forms of erosive and ulcerative esophagitis resistant to H 2 – histamine receptor blockers. Long-term maintenance therapy to prevent relapse of reflux esophagitis and reduces the risk of complications. In gastroesophageal reflux disease provides remission in 85% of patients within 1 year. The effectiveness in chronic pancreatitis (pain relief), portal hypertension, for the prevention of erosive – ulcerative lesions of the mucous membrane of the esophagus and stomach and associated bleeding in patients with esophageal varices II – III Art. and aspiration pneumonia in surgical patients.
In the first 1 – 2 weeks of treatment there is an increase in serum gastrin (normalized after discontinuation of the drug). The study biopsies showed no increase in the number of ECL – cells. At a dose of 40 mg daily lowers the motor – evacuation function of the stomach. After a 10 – day course of treatment changes the concentration of motilin, cholecystokinin and gastrin in serum.
Quickly and almost completely absorbed from the gastrointestinal tract. bioavailability is no more than 65% (the effect of “first pass” through the liver). C max is achieved through 3 –. 4 hours at reappointments absorption increases (increases bioavailability, C max ) and antisecretory effect is enhanced. After receiving a dose of 20 mg AUC in 0,5 – 3,5% of patients from Asia to 4 times greater than that of the Caucasian race. Distribution 0,2 – 0,5 l / kg. The binding proteins (albumin and acid alpha 1 – glycoprotein) amounts to 95%. Treated biotransformation in the liver with the formation of at least 6 inactive metabolites (gidroksiomeprazol, sulfide and sulfone derivatives, etc.), T 1/2 ; 0,5 – 1 h (with normal liver function) or 3 hours (with chronic liver diseases). Excreted mainly kidneys as metabolites (72 – 80%) and through the intestine (18 – 23%). Elderly patients may be some increase bioavailability and decrease the clearance rate.
Application of the substance omeprazole
Gastric ulcer and duodenal ulcer in the acute phase, gastroesophageal reflux disease, including refractory to therapy H 2 – antihistamines, reflux – esophagitis, including erosive and ulcerative, pathological hypersecretory conditions (syndrome Zollinger – Ellison syndrome, multiple endocrine adenomatosis, systemic mastocytosis, stress ulcers, including prevention), peptic ulcer gastrointestinal tract. caused by Helicobacter pylori, NSAIDs – gastroenteropathy, erosive and ulcerative lesions of the stomach and duodenum in HIV – infected patients with non-ulcer dyspepsia.
Hypersensitivity, pregnancy, breast-feeding.
Restrictions on the use
Chronic liver disease, children’s age (except for ; syndrome Zollinger ; Ellison).
Application of pregnancy and breastfeeding
Category effects on the fetus by FDA ; C.
During pregnancy is possible only for health reasons.
breast-feeding should be discontinued at the time of treatment.
Side effects of substance omeprazole
From the digestive tract: dry mouth, loss of appetite, nausea, vomiting, flatulence, abdominal pain, diarrhea, constipation, in some cases ; changes in taste sensitivity, stomatitis and gastrointestinal candidiasis. polyposis fundus, atrophic gastritis, elevated liver enzymes.
From the nervous system and sensory organs: headache, rare ; malaise, asthenia, dizziness, insomnia, somnolence, paresthesia, and in some cases ; anxiety, agitation, anxiety, depression, reversible mental disorders, hallucinations, visual disturbances, including irreversible.
From the musculo – skeletal system: in some cases ; arthralgia, muscle weakness.
From the cardio – vascular system and blood: in some cases ; thrombocytopenia, leukopenia, neutropenia, hypoeosinophilia, pancytopenia, leukocytosis, anemia.
With the genitourinary system: rare ; hematuria, proteinuria, peripheral edema, urinary tract infection.
For the skin: in some cases ; photosensitivity, erythema multiforme, alopecia.
Allergic reactions: rare ; skin rash, hives, itching, in some cases ; bronchospasm, angioedema, interstitial nephritis, anaphylactic shock.
Other: in some cases ; chest pain, gynecomastia.
Changes the bioavailability of any drug, the absorption of which depends on pH (ketoconazole, iron salts, and others.). Slows elimination of drugs metabolized in the liver by microsomal oxidation (warfarin, diazepam, phenytoin, etc.).
Enhances the effect of coumarin and difenina does not change ; NSAIDs. Increases (mutually) concentration in the blood of clarithromycin. May increase leykopenicheskoe and thrombocytopenic effects of drugs which depress hematopoiesis. The substance for the intravenouslyfusion is compatible only with saline and dextrose solution (when using other solvents may decrease stability of omeprazole – a change in the pH of fluid medium).
The combined use of omeprazole and cyclosporine
Omeprazole is usually no effect on cyclosporine levels in the serum, but in two separate statements described 2 – fold increase in the concentration of cyclosporine in one patient, and a decrease of more than 2 times – from another
in a study of 10 patients with kidney transplant is not revealed significant changes in the level of cyclosporin in the appointment of omeprazole 20 mg / day for 2 weeks. In another study 7 patients with renal transplants, similar results were obtained: after application of 20 mg of omeprazole for 6 days significant changes cyclosporine levels were absent. There were no significant changes in serum cyclosporine levels in patients with kidney transplants after administration of 20 mg / day omeprazole for 8 weeks
In contrast, a patient with liver transplant cyclosporine levels increased approximately 2-fold (from 187 -. 261 to 510 ng / ml) after approximately 2 weeks after initiation of therapy with omeprazole (40 mg / day). It was able to restore levels of cyclosporine after reducing the dose of cyclosporin from 130 to 80 mg 2 times a day. Then a stabilization (approximately 171 ng / ml) for a further four months. The other patient with bone marrow transplantation shown inverse interaction: cyclosporine levels in serum during treatment with omeprazole (40 mg / day), she fell from 254 to about 100 ng / ml for 14 days and then rapidly increased after cancellation
value and a warning
the information is limited, but what we know, suggests that the interaction does not occur normally. However, since it is not clear what will be the result of the appointment of omeprazole patients receiving cyclosporine for patients taking the two drugs. It needs to be closely monitored and, if necessary, dose otkorregirovat. Noteworthy is that in studies in which interaction does not occur, the dose of omeprazole was 20 mg / day. while in two cases of interaction – 40 mg / day.
Stockley’s drug interactions / Ed. by I.H. Stockley. – 6th ed. – London – Chicago, Pharmaceutical Press. – 2002. – P.622
interaction with clopidogrel
Co-administration of omeprazole (inhibitor of CYP2C19) and clopidogrel, is metabolized to its active metabolite, with the participation of CYP2C19. is not recommended.
In a crossover clinical study, 72 healthy volunteers were used for only 5 days clopidogrel (300 mg loading dose, followed by 75 mg per day) or clopidogrel with omeprazole (80 mg, while that and clopidogrel). The conversion of clopidogrel into an active metabolite was reduced by 46% (1 – day) and 42% (5 – day), clopidogrel and omeprazole if taken simultaneously. Clopidogrel active metabolite selectively and irreversibly inhibits the binding of ADP to platelet P2Y12 receptor, thereby inhibiting platelet aggregation. The average value of inhibition of platelet aggregation at 5 uM ADP had decreased by 39% (1 – day) and 21% (5 – day), clopidogrel and when taken together omeprazole
In another study, 72 healthy subjects who. received the same dose of clopidogrel and 80 mg of omeprazole, but with intervals of 12 hours, the results were similar, indicating that the use of clopidogrel and omeprazole does not prevent their interaction at different times.
interaction with antiretroviral drugs
It has been shown that while the use of omeprazole reduced serum levels of certain antiretroviral drugs. such as atazanavir and nelfinavir. After repeated use of nelfinavir (1250 mg twice daily) and omeprazole (40 mg daily) AUC nelfinavir and M8 was reduced by 36 and 92%, C max – by 37 and 89%, C min – 39 and 75%, respectively. Repeated atazanavir (400 mg daily) and omeprazole (40 mg daily, 2 hours prior to atazanavir) AUC was reduced with 94, C max – 96 and C min -. 95%
Concomitant use of proton pump inhibitors (such as omeprazole) and atazanavir or nelfinavir is not recommended.
Symptoms: dry mouth, nausea, blurred vision, headache, increased sweating, flushing, tachycardia, drowsiness, confusion.
Treatment: is symptomatic; Dialysis is ineffective.
Dosing and Administration
Inside, intravenously . Inside, preferably in the morning before a meal without chewing, without crushing or damaging the capsule, squeezed small amounts of liquid (can be received from the food). When gastric ulcer, duodenal ulcer, oesophageal reflux ; 20 mg 1 time a day, with reflux – esophagitis ; 20 – 40 mg 1 time per day. Duration: duodenal ulcer ; 2 – 4 weeks. reflux – esophagitis ; 4 weeks. gastric and oesophageal reflux ; 4 – 8 weeks. To prevent recurrence of duodenal ulcers and reflux – esophagitis possible long-term use at a dose of 10 mg.
In severe peptic ulcer and / or inability to destination inside ; / in a dose of 40 mg for 20 – 1 30 minutes once a day. P – p preparing infusion ex tempore by dissolving 40 mg of a substance / infusion in 100 ml saline or 5% dextrose solution. Patients in critical condition possible intragastric gavage encapsulated. With Zollinger ; Ellison dose is adjusted individually, as measured by the level of gastric secretion (should not exceed 10 mmol HCl / h or 5 mmol HCl / h after resection), the initial dose of ; 20 – 60 mg / day. if necessary to 120 mg / day in 3 divided doses (daily dose above 80 mg should be administered in divided doses) for 2 – 8 weeks (possible prolonged use ; up to 5 years). Peptic ulcer induced by Helicobacter pylori, in combination: omeprazole 20 mg, amoxicillin 1 g Clarithromycin 250 – 500 mg or omeprazole 20 mg metronidazole 400 mg clarithromycin 250 – 500 mg 2 times a day for 7 days. When gastroenteropathy associated with NSAID ; 1 20 mg once a day for 4 – 8 weeks. When erosive and ulcerative lesions of the stomach and duodenum in HIV – infected patients ; 20 mg daily for 4 weeks.
Precautions substance omeprazole
Before the start of treatment should be to exclude the presence of cancer in the digestive tract. particularly gastric ulcer (from – to the possibility of smoothing the symptoms and increase the time before diagnosis). Against the backdrop of severe hepatic insufficiency treatment is possible only under close medical supervision (the dose should not exceed 20 mg / day). For patients from Asia likely need to adjust the dose, especially with long-term anti-treatment. When concomitant administration of warfarin is recommended that monitoring of the concentration of an anticoagulant in blood serum or regular determination of prothrombin time with subsequent dose adjustments. Please note that the following groups of patients in need of continuous preventive treatment with omeprazole: a severe and frequent symptoms and / or endoscopically proven stage III – IV gastroesophageal reflux disease (GERD) by Savary ; Miller, in the presence of complications (Barrett’s esophagus, stricture or ulcers), chronic administration of drugs that contribute to the emergence of GERD. symptoms persist after healing, the long duration of symptoms before treatment, very low basal pressure in the lower esophageal sphincter. In stage II esophagitis (on Savary ; Miller) maintenance therapy is recommended after two relapses. The effectiveness of permanent therapy for GERD increases combined treatment prokinetic drugs. In the case of maintenance treatment in patients with GERD. associated with H. pylori, for the prevention of mucosal atrophy suitable eradication of the pathogen.
The prepared infusion solution can be used within 12 hours (dissolution at a physiological solution) or 6 hours (solvent ; dextrose).