Alternative treatment in relation to the oral form, when significant (in the case of injections also fast) inhibition of hydrochloric acid secretion is required in the following cases: duodenal ulcer, mild gastric ulcer, reflux oesophagitis, Zollinger-Ellison syndrome.
Composition:
1 vial contains 40 mg of Omeprazole in the form of a sodium salt.
Action:
Proton pump inhibitor (H+/ K+ATP-ases) in the parietal cells of the stomach. It inhibits the secretion of hydrochloric acid, both basic and stimulated (regardless of the type of stimulus). Increases pH and reduces the volume of secreted hydrochloric acid. At pH <4, omeprazole is converted into an active form - omeprazole sulfenamide. About 95% is bound to plasma proteins. It is completely metabolised, mainly in the liver by the CYP2C19 enzyme. Almost 80% of the dose is excreted in the form of metabolites in the urine, the remaining 20% - with faeces. T0,5 is about 40 minutes. In patients with hepatic impairment the elimination is reduced, the half-life can be up to about 3 hours.
Contraindications:
Hypersensitivity to the components of the preparation. Simultaneous treatment with atazanavir. In patients with hepatic impairment, combination therapy with clarithromycin.
Precautions:
Caution should be exercised in combination therapy in patients with impaired hepatic and renal function. Diagnosis of reflux oesophagitis should be confirmed endoscopically. The use of drugs that reduce the secretion of hydrochloric acid leads to a slight increase in the risk of gastrointestinal infections of the genus typeSalmonella andCampylobacter. Due to the lack of data on the use of omeprazole intravenously in children, the preparations should not be administered to patients in this group.
Pregnancy and lactation:
The preparation can be used during pregnancy only in cases of absolute necessity. Omeprazole passes into breast milk. During breastfeeding, use only if the expected benefit to the mother outweighs the potential risk to the fetus or breast-fed child.
Side effects:
Common: drowsiness, insomnia, pain and dizziness, diarrhea, constipation, bloating, nausea, vomiting. Uncommon: urticaria, paresthesia, blurred vision (blurred vision, decreased visual acuity or reduced visual field), hearing disorders (including tinnitus), taste disturbances, increased liver enzymes, pruritus, skin eruptions, alopecia, erythema multiforme , hypersensitivity to light, increased sweating, malaise, peripheral edema. Rarely: hypersensitivity reactions (including fever, angioneurotic edema, bronchospasm, anaphylactic shock, allergic vasculitis), transient confusion, agitation, aggression, depression, hallucinations, brown-black language during the simultaneous use of Clarithromycin, mild glandular cysts, dryness or inflammation of the oral mucosa, candidiasis, pancreatitis, hepatitis (including jaundice), hepatic failure and encephalopathy (in patients with severe liver disease), Stevens-Johnson syndrome, toxic epidermal necrolysis, muscle weakness, myalgia and arthritis, interstitial nephritis, hyponatremia, gynecomastia, leukopenia, thrombocytopenia, agranulocytosis, pancytopenia. Very rare: changes in peripheral blood morphology. Occasionally, irreversible visual disturbances have been reported in very seriously ill patients treated with omeprazole in the form of intravenous infusions, especially at high doses, however no causal relationship has been established with the use of the drug. In addition, hearing loss was observed.
Dosage:
Intravenously. Adults: 40 mg once a day. Intravenous use is recommended only in special cases when oral treatment is inadvisable and a significant inhibition of hydrochloric acid secretion is necessary. The average reduction in the production of hydrochloric acid in the stomach during the day is 90%. In the Zollinger-Ellison syndrome, the starting dose is 60 mg a day. Higher doses may be necessary and the dosage should be adjusted individually. If the daily dose is> 60 mg, it should be given in several doses.The duration of treatment is usually 1 week. In patients with impaired liver function a daily dose of 10-20 mg may be sufficient. The infusion rate is 3-5 ml / min, infusion time of at least 20-30 min and at least 10-15 min if half of the volume is administered. The solution should be used within 12 hours if the solvent was 0.9% NaCl solution or within 6 h if the solvent was 5% Glucose solution.
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