Medicines - omez

Release form and composition of the drug

Omez is produced in the form of enteric capsules for oral administration and lyophilized powder composition for infusion into the systemic circulation in order to eliminate acute conditions, reduce pathological losses of the body and prevent them.

The most common and actively used for the treatment of chronic gastric ulcers and intestinal perforation is the first dosage form. Hard capsules in a natural gelatin shell have a transparent body with a pinkish lid, filled with small white granules.

Antiulcer medicine is supplied to pharmacies in cardboard boxes. Each of them holds 10 or 30 units of medicine. The capsules are packaged in a sealed and sterile aluminum foil block. Lyophilized powder is intended for use in medical hospitals.

Omez (there are numerous reviews from patients who have taken it, which is explained by the popularity of the antiulcer drug) in this form of release is packaged in glass bottles with a hermetically sealed rubber cap. The volume of each is 40 mg.

The bottle is intended not only for storing medicine, but also for preparing an infusion solution. The pharmacologically active component of the drug is omeprazole.

Excipients:

• sodium lauryl sulfate – a formative element that gives the medicine a homogeneous structure;
• sodium phosphate of a dibasic molecular structure is a chemical compound that plays the role of a laxative;
• sucrose is a fast carbohydrate with preservative properties;
• Distilled water is a natural solvent for pharmacologically active substances.

The composition of the lyophilized powder for the preparation of an infusion solution additionally includes dehydrated sodium, which has desensitizing, antiseptic and anti-inflammatory activity.

Release form, composition and manufacturer

Produced in capsules and lyophilisate:

• Gelatin transparent capsules with a pink cap and white granular contents. A pack may contain 10-30 capsules.
• Powdered lyophilisate for the preparation of intravenous injections, 40 mg of powder substance is placed in the bottle.

Photo of Omez tablets packaging

The active component of Omez is omeprazole, and the auxiliary composition is made up of purified water and sucrose, sodium phosphate dibasic or sodium lauryl sulfate. In the lyophilisate, the auxiliary components are presented in the form of anhydrous sodium carbonate.

Omez is produced by the Indian company Dr. Reddy's Laboratories Ltd.

Pharmacological properties

Omeprazole belongs to the category of inhibitors of the protogonal pump, an integral protein of cell membranes that performs the physiological function of moving protons through the cytoplastic membrane.

The pharmacological properties of the drug are based on the ability of its main active ingredient to suppress excess production of hydrochloric acid and reduce its content in the gastric cavity.

The medicine responds by increasing the level of serum gastrin, a key hormone of the digestive system that ensures its normal functioning. The antiulcer effect of Omez is due to a decrease in the intensity of the basal and stimulated secretory mechanism of the gastrointestinal tract.

The therapeutic effect of the drug is not associated with the origin of the pathological process and the nature of chemical irritants. The medication has antiemetic properties.

It improves the tonic state of the lower esophageal sphincter and accelerates bowel movements while slowing or inhibiting bowel movements. Omeprazole specifically affects adenosine triphosphatase (ATP), a special enzymatic compound in the parietal cells of the gastric cavity.

The physiologically active component of the antiulcer medicine slows down the work of the protogonal pump, inhibits the activity of sodium and calcium ions, which are part of the molecular structure of ATP. The drug inhibits the final stage of hydrochloric acid secretion.

pharmachologic effect

The mechanism of action of the drug Omez is extremely simple. Omeprazole, which is part of the drug, is quickly absorbed into the blood. Most of this substance is excreted by the kidneys. Omeprazole significantly reduces the concentration of the enzyme responsible for the production of hydrochloric acid.

Omez quickly copes with his task. The concentration of gastric juice begins to decrease within 1 day after starting the medication. After discontinuation of the drug, the production of hydrochloric acid returns to normal within 3-5 days.

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Instructions for use of Gedelix for children and adults

The capsule form of the medicine acts gradually. It is designed in such a way that the release of the active substance occurs smoothly. As a result, after using one capsule, its effect continues for 24 hours.

For the medicine to be most effective, it must be used in accordance with the instructions or doctor's prescriptions. It is worth understanding that for the treatment of different pathological conditions you need to select the dosage individually.

Pharmacodynamics and pharmacokinetics

Omeprazole, due to its molecular structure, is sharply activated in an acidic-organic environment, transforming into a sulfenamide derivative. This chemical compound has the ability to irreversibly bind ATP and the entire enzyme system of the secretory surface of the parietal cell components of the gastrointestinal tract.

Omez collected reviews from patients and gastroenterologists in large quantities. They note an improvement in the breakdown of ingested food after taking the drug. The pharmacodynamic properties of the drug are based on the ability to block the final phase of hydrogen ion transport.

Omeprazole is unstable in acid-organic environments. The enteric coating increases the stability of the active substance and improves absorption pharmacokinetics. Maximum plasma saturation is achieved 1-2 hours after oral administration.

Omez is absorbed through the small intestine into the systemic circulation. Food intake does not affect the bioavailability of the active components of the drug. For patients with stomach ulcers and other chronic gastrointestinal pathologies, it is 40% after a single use and increases to 60% with a course method.

The volume of distribution of the physiologically active substances of the drug reaches 0.3 l/1 kg of weight. Omeprazole binds to protein fragments of blood plasma by 97%. The active components of the medicinal composition are metabolized under the influence of cytochrome P450 dependent monooxygenase.

The drug does not tend to accumulate in body tissues and is eliminated in full. When taken orally, 80% of the medication is excreted during deurination, the rest through feces and bile secretion.

The elimination parameters and metabolism of Omez depend on the functional isoenzymes CYP2C19 and CYP3A4. About 3% of Europeans and 20% of Asians have reduced activity of these compounds. In patients with liver dysfunction, there may be difficulties with the systemic clearance of the active substances of Omez and their metabolites.

Omez®

Substances with
pH -dependent absorption
Like other drugs that reduce gastric acidity, treatment with omeprazole may lead to decreased absorption of ketoconazole, itraconazole, posaconazole, erlotinib, iron supplements and cyanocobalamin. Their co-administration with omeprazole should be avoided.

Digoxin

The bioavailability of digoxin when used simultaneously with omeprazole increases by 10% (adjustment of the digoxin dosage regimen may be required). Caution should be exercised when these drugs are used concomitantly in elderly patients.

Clopidogrel

According to the results of the study, an interaction was noted between clopidogrel (loading dose 300 mg, maintenance dose 75 mg/day) and omeprazole (80 mg/day orally), which reduces the exposure of the active metabolite of clopidogrel and reduces the inhibition of platelet aggregation. The observed effect is likely due to the inhibitory effect of omeprazole on the CYP2C19 isoenzyme. Therefore, the simultaneous use of omeprazole and clopidogrel should be avoided.

Antiretroviral drugs

An increase in pH during omeprazole therapy may affect the absorption of antiretroviral drugs. Interaction at the level of the CYP2C19 isoenzyme is also possible. When omeprazole is co-administered with certain antiretroviral drugs, such as atazanavir and nelfinavir, a decrease in their serum concentrations is observed during omeprazole therapy. When used simultaneously with omeprazole, the area under the pharmacokinetic concentration-time curve of atazanavir decreases by 75%. In this regard, the combined use of omeprazole with antiretroviral drugs such as atazanavir and nelfinavir is contraindicated.

When used simultaneously with omeprazole, an increase in plasma concentrations of saquinavir/ritonavir is observed up to 70%, while the tolerability of treatment in patients with HIV infection does not deteriorate.

Tacrolimus

With simultaneous use of omeprazole and tacrolimus, an increase in the concentration of tacrolimus in the blood serum was noted, which may require dose adjustment. It is necessary to monitor creatinine clearance and plasma concentrations of tacrolimus when used together with omeprazole.

Methotrexate

When methotrexate was co-administered with proton pump inhibitors, a slight increase in plasma methotrexate concentrations was observed in some patients. When treated with high doses of methotrexate, omeprazole should be temporarily discontinued.

Drugs in which the
CYP 2 C 19
When used simultaneously with omeprazole, it is possible to increase the plasma concentration and increase the half-life of warfarin (R-warfarin), diazepam, phenytoin, cilostazol, imipramine, clomipramine, citalopram, hexobarbital, disulfiram, as well as other drugs metabolized in the liver with the participation of the CYP2C19 isoenzyme (a dose reduction of these drugs may be required). However, taking omeprazole 20 mg per day does not affect the concentration of phenytoin in the blood plasma in patients taking phenytoin for a long time. When using omeprazole in patients receiving warfarin or other vitamin K antagonists, monitoring of the international normalized ratio is necessary. At the same time, concomitant treatment with omeprazole at a daily dose of 20 mg does not lead to a change in coagulation time in patients taking warfarin for a long time.

Inhibitors of isoenzymes
CYP 2 C 19 and/or CYP 3 A 4
Concomitant use with inhibitors of isoenzymes CYP2C19 and/or CYP3A4 slows down the metabolism of omeprazole.

When omeprazole is taken together with clarithromycin or erythromycin, the concentration of omeprazole in the blood plasma increases.

The combined use of voriconazole and omeprazole leads to an increase in the area under the pharmacokinetic curve of omeprazole.

Dose adjustment of omeprazole when used concomitantly with inhibitors of CYP2C19 and/or CYP3A4 isoenzymes may be required in patients with severe hepatic impairment in case of long-term use of omeprazole. With short-term joint use, correction is not required due to the good tolerance of high doses of omeprazole.

Inducers of
the CYP 2 C 19 and CYP 3 A 4
isoenzymes Inducers of the CYP2C19 and CYP3A4 isoenzymes, such as rifampicin, preparations of St. John's wort ( Hypericum
perforatum ),
when used together with omeprazole, can lead to a decrease in the concentration of omeprazole in the blood plasma by accelerating the metabolism of omeprazole.

No effect on metabolism

Co-administration of omeprazole with amoxicillin or metronidazole does not affect the concentration of omeprazole in the blood plasma.

No clinically significant interaction of omeprazole with metoprolol, phenacetin, estradiol, budesonide, diclofenac, naproxen, piroxicam, S-warfarin has been established.

There was no effect of omeprazole on antacids, theophylline, caffeine, quinidine, lidocaine, propranolol, ethanol.

Indications for use

The medicine is prescribed for numerous digestive disorders and for preventive purposes. It is included in maintenance therapy for chronic gastrointestinal pathologies to reduce the frequency of exacerbations and increase the period of remission.

Omez is prescribed to protect the stomach when taking loading doses of corticosteroid hormones by infusion in patients with neurological and autoimmune pathologies.

Standard indications for use of the drug:

• peptic ulcer;
• intestinal perforation;
• erosive lesions of the gastric cavity caused by side effects of non-steroidal anti-inflammatory drugs;
• reflux esophagitis - pathological release of undigested stomach contents into the esophagus;
• inflammation of the duodenum;
• stress ulcers resulting from traumatic factors;
• Zollinger-Ellison syndrome is an adenoma of the islet element of the pancreas, in which excessive secretion of gastrin is observed.

Omez is part of combination therapy for ulcerative-erosive lesions of the gastrointestinal tract associated with hyperactivity of Helicobacter pylori, a microorganism that is part of the healthy gastric flora.

Gastroenterologists prescribe capsules to eliminate dyspeptic symptoms and esophageal reflux, which is difficult to treat with histamine H2 receptor antagonists.

Indications for use

Omez is mainly used to treat certain types of gastric or intestinal ulcers, but there are other pathological conditions for which its use is advisable. Among them are:

• Zollinger-Ellison syndrome;
• systemic mastocytosis;
• pancreatitis.

Some stomach diseases go away much faster if the amount and concentration of gastric juice is less. Reducing hydrochloric acid sometimes allows you to avoid serious illness, so the drug can be used as a preventive measure, but only if necessary.

Dosages are determined by the doctor based on the specific disease, the person’s condition and other factors. Diseases of the gastrointestinal tract should be treated under the supervision of a specialist. This medication should not be taken independently without undergoing examination.

Contraindications

The medicine has a small number of absolute clinical prohibitions on use. It is not prescribed during pregnancy and lactation, as well as in cases of biological immunity to the components of the chemical formula of the antiulcer drug.

Omez has several temporary limitations associated with the current pathological conditions of the body.

Omez

Reviews from those who have taken it say that gastroenterologists do not prescribe the medicine for:

• gastrointestinal bleeding;
• pituitary hyperplasia of prolactin-secreting genesis;
• multiple perforated injuries of the gastrointestinal tract;
• mechanical blockage of the lower part of the digestive system;
• renal failure.

Particular caution should be exercised in patients with chronic liver diseases and inflammation of the urinary tract.

Pharmacological properties of the drug Omez

Omeprazole (5-methoxy-2-[[(4-methoxy-3,5-dimethyl-2-pyridinyl)methyl]sulfinyl]-1–1 N-benzimidazole) is an antiulcer agent that inhibits basal and stimulated secretion of hydrochloric acid by parietal cells stomach due to a specific effect on the enzyme H+/K+-ATPase (proton pump). After oral administration, the effect of the drug develops very quickly, within the first hour, and persists for 24 hours. After stopping the drug, the secretory activity of the glands of the gastric mucosa is restored after 3–5 days. Omeprazole in the drug is contained in acid-resistant granules that dissolve in the intestines. Omeprazole is rapidly absorbed, the maximum concentration in the blood plasma is reached after 0.5–1 hour. Bioavailability is 30–40%, clearance is 500–600 ml/min. About 90% of omeprazole is bound to plasma proteins. Omeprazole is almost completely metabolized in the liver and is excreted primarily in the urine (about 80%). The main metabolic pathway is associated with the polymorphic specific isoform CYP 2C19 (S-mephenithiol hydroxylase), responsible for the formation of hydroxyomeprazole, the main metabolite of omeprazole detected in blood plasma. In patients with chronic liver diseases, the bioavailability of the drug increases to 100%, the half-life increases to 3 hours, and clearance decreases to 70 ml/min. In patients with chronic kidney disease (creatinine clearance 10–62 ml/min), the distribution of omeprazole is the same as in healthy volunteers. Since renal excretion is the main route of elimination of omeprazole metabolites, its elimination from the body slows down in proportion to the decrease in creatinine clearance. In elderly patients, omeprazole elimination is reduced and bioavailability increases. IV administration of omeprazole causes dose-dependent inhibition of gastric secretion. With intravenous administration of omeprazole at a dose of 40 mg, a rapid decrease in gastric secretion is observed, similar to what is achieved with repeated oral administration of the drug at a dose of 20 mg. The degree of inhibition of gastric secretion averages about 90% over 24 hours, both with intravenous jet administration and with intravenous infusion. The average half-life after intravenous administration of omeprazole is approximately 40 minutes; total plasma clearance - 0.3–0.6 l/min.

Instructions for use, dosage

The method of taking the drug depends on the dosage form. The capsules must be swallowed whole - without opening the gelatin shell or chewing. They are recommended to be taken in the morning before breakfast.

The solution for infusion is prepared immediately before connecting the drip system. The powder is diluted only in 5% glucose, which does not contain preservative components.

Add 5 ml of solvent to the bottle with the medicinal composition, then shake it in your hands until the lyophysiate takes on the appearance of a cloudy liquid without sediment. The duration of the infusion procedure when using 100 ml of the prepared composition is at least 30 minutes.

The dosage depends on the nature of the pathology and clinical indications of the patient. In case of exacerbation of gastric and duodenal ulcers, the standard dose is 1 capsule per day for a monthly course without breaks. By decision of the gastroenterologist, it is allowed to increase the daily volume by 2 times.

When treating adenoma of the islet system of the pancreas, Omez capsules are taken 3 times a day at equal time intervals. In some cases, with this pathological condition, intravenous infusions are prescribed.

Longer therapy is required for erosive and ulcerative lesions of the gastrointestinal tract. It takes up to 2 months. Take 1-2 capsules daily or 40 mg per day intravenously.

To eradicate Helicobacter pylori, Omez is taken in combination with antibiotics. Prescribe 1 capsule 2 times a day. The duration of the course of treatment is a week. To reduce the frequency of relapses, patients with reflux esophagitis are prescribed 1 capsule per day for 6 months.

Use of the drug Omez

Capsules are taken whole, without breaking or chewing. For peptic ulcer of the duodenum and stomach, reflux esophagitis, a dose of 20 mg is prescribed once a day (before breakfast) for 2 weeks. If after the first 2-week course of therapy the ulcer has not healed, the course of treatment is extended for another 2 weeks or until complete healing. When Omez is prescribed at a dose of 40 mg/day, the duodenal ulcer usually scars within 4 weeks after the start of treatment, and gastric ulcers and erosive reflux esophagitis after 8 weeks. For patients with Zollinger-Ellison syndrome, Omez is prescribed at an initial dose of 60 mg/day. The duration of therapy depends on the dynamics of clinical manifestations. The maintenance dose for Zollinger-Ellison syndrome is set individually and is 20–120 mg/day. If it is necessary to use the drug in a dose exceeding 80 mg/day, it must be divided into 2 doses. Helicobacter pylori eradication is carried out according to standard international schemes. In adult patients with gastric and duodenal ulcers or reflux esophagitis, it is administered as an infusion at a dose of 40 mg once a day. For patients with Zollinger-Ellison syndrome, the recommended initial dose of Omez in the form of intravenous infusion is 60 mg/day. It may be necessary to prescribe higher daily doses. If the daily dose exceeds 60 mg, it should be divided into 2 administrations. There is no need for dose adjustment in patients with impaired renal function and elderly patients. For patients with impaired liver function, the daily dose is 10–20 mg. Omez 40 mg is administered as an intravenous infusion (over 20–30 minutes), including for the eradication of Heliciobacter pylori . The contents of one bottle are dissolved in 100 ml of 0.9% sodium chloride solution or 100 ml of 5% dextrose solution for infusion. The solution should be used within 24 hours. For peptic ulcers complicated by gastrointestinal bleeding, Omez is prescribed IV at a dose of 80 mg (8 mg/h) and then 20 mg orally (from the 3rd to the 21st). th day).

Side effects

Undesirable consequences of taking the drug are extremely rare. Omez has a high safety profile. All negative effects are associated with individual intolerance to the components of the drug composition or with regularly exceeding the maximum recommended dose.

Theoretically, the following side effects of the drug are possible:

Omez reviews from people who have taken it are characterized as a completely safe drug. However, in the practice of its use, cases of visual disturbances after infusion administration, profuse sweating, and general malaise have been reported.

Contraindications and possible side effects

The drug Omez has its own contraindications for use, but there are very few of them. Obstacles to taking the drug may include:

• childhood;
• pregnancy and lactation;
• malignant lesions of the gastrointestinal tract;
• sensitivity to the components of the drug.

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Ascorutin: instructions for use of vitamins for adults and children

If a person is allergic to omeprazole, then taking this medicine is prohibited. Also, children under 12 years of age cannot use this drug for treatment, with the exception of cases when the benefits from it will be greater than the possible harm.

When using the medication, the following side effects may occur:

• diarrhea;
• constipation;
• stomach ache;
• rash on the body;
• dry mouth.

More dangerous side effects are liver damage and the development of gastric glandular cysts. This happens extremely rarely. The risk of dangerous side effects increases with long-term use, as well as if the dosage regimen is not followed.

The occurrence of abdominal pain, as well as diarrhea or constipation may be manifestations of the disease. It is necessary to indicate to the doctor that you are feeling unwell, so that he can conduct an examination and clarify whether it is worth changing the Omez dosage regimen. As a rule, to eliminate side effects, it is enough to change the dosage. Severe complications require discontinuation of the drug and selection of a new treatment regimen.

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Overdose

The active components of the antiulcer medicine do not have cumulative properties and are not deposited in the tissues of the body. Systematically exceeding the maximum therapeutic dose does not pose a threat to life, but increases the likelihood of developing side symptoms.

It manifests itself:

• short-term visual impairment;
• drying out of the oral mucosa;
• drowsiness;
• loss of strength;
• migraine;
• stomach pain;
• tachycardia;

An antidote to Omez has not been developed. If signs of drug intoxication occur, they resort to symptomatic therapy, take absorbent drugs and medications that cause a gag reflex.

Side effects

Among the adverse reactions to taking Omez, experts identify:

• Abdominal pain or nausea and vomiting, taste disturbances, hyperactivity of liver enzymes, bloating;
• Leukopenia or thrombocytopenia;
• Depressive states, dizziness, cephalalgia;
• Muscular pain or myasthenia gravis;
• Skin itching and rashes, photosensitivity;
• Allergic reactions such as urticaria, bronchospasms and fever;
• Visual disturbances or hypersweating, general malaise.

If side symptoms occur, you need to consult a specialist.

special instructions

Capsules can be taken with meals. This does not affect the effectiveness of treatment. Before intravenous administration of a lyophilized solution, you should ensure that there is no malignant hyperplasia.

Omez is able to hide and blur the symptoms of such neoplasms, distorting the results of laboratory and hardware diagnostics. Children are sometimes prescribed 1/2 capsule for a single dose. It must be carefully opened and half the contents mixed with fruit or vegetable puree from baby food.

There is no other way to take a partial dose. The average therapeutic volume of the drug does not slow down nervous reactions and does not affect psychomotor function. While using Omez, you can drive vehicles, perform important work and operate dangerous mechanisms.

Special instructions and interactions with other drugs

There are several points that need to be taken into account when taking omeprazole drugs. The most important thing is to rule out the malignancy of the disease before starting to use the medicine.

If a cancerous tumor has occurred, then taking Omez interferes with the correct diagnosis and does not have any therapeutic effect, so it is strictly contraindicated. First of all, you need to make a diagnosis, then prescribe the drug.

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Tamiflu: instructions for use of tablets (capsules), analogues

If you have liver disease, then use should be supervised. For concomitant diseases of this organ, a dose of more than 20 mg per day should not be prescribed. It is worth noting that eating does not affect the absorption of the medicine. This means that it can be used before or after meals.

If you use Omez with other drugs, its pharmacological effect will not change in any way. However, it may interfere with the absorption of other medications. There have been no large studies on interactions with other drugs. In general, you can use Omez without any concerns about its compatibility.

When using intravenous injections, you will need to be careful if the procedure is performed at home. The IV should be placed by a person with experience. It is almost impossible to do this on your own, so it is recommended to visit a clinic to carry out this procedure.

Drug interactions

Metabolization of the active ingredients of Omez occurs in the hepatocyte system with the participation of cytochrome P450. Therefore, it is necessary to carefully combine antiulcer medicine with drugs that have similar pharmacokinetics.

These include:

• Phenytoin is an antiepileptic drug;
• Diazepam is an anxiolytic, sedative, anticonvulsant and muscle relaxant tranquilizer;
• Warfarin is an indirect anticoagulant;
• Argathromban is a synthetic thrombin inhibitor.

In such drug combinations, omeprazole slows down the systemic clearance of other drugs, which requires a downward adjustment of their dosage.

With the parallel use of antiulcer capsules and Clarithromycin (semi-synthetic antibiotic), their mutual influence on the pharmacological properties is revealed. This leads to the injection of the active substances of both drugs into the blood plasma, which increases the risk of side effects.

Omez® Insta (Omez® Insta)

Interaction with other drugs

Substances with pH-dependent absorption

Like other drugs that reduce gastric acidity, treatment with omeprazole can lead to decreased absorption of ketoconazole, itraconazole, posaconazole, erlotinib, iron supplements and cyanocobalamin. Their co-administration with omeprazole should be avoided.

Digoxin

The bioavailability of digoxin when used simultaneously with omeprazole increases by 10% (adjustment of the digoxin dosage regimen may be required). Caution should be exercised when these drugs are used concomitantly in elderly patients.

Clopidogrel

According to the results of the studies, an interaction was noted between clopidogrel (loading dose 300 mg, maintenance dose 75 mg/day) and omeprazole (80 mg/day orally), which reduces the exposure of the active metabolite of clopidogrel and reduces the inhibition of platelet aggregation. The observed effect is likely due to the inhibitory effect of omeprazole on the CYP2C19 isoenzyme. Therefore, the simultaneous use of omeprazole and clopidogrel should be avoided.

Antiretroviral drugs

An increase in pH during omeprazole therapy may affect the absorption of antiretroviral drugs. Interaction at the level of the CYP2C19 isoenzyme is also possible. When omeprazole is co-administered with certain antiretroviral drugs, such as atazanavir and nelfinavir, a decrease in their serum concentrations is observed during omeprazole therapy. When used simultaneously with omeprazole, the area under the pharmacokinetic concentration-time curve of atazanavir decreases by 75%. In this regard, the combined use of omeprazole with antiretroviral drugs such as atazanavir and nelfinavir is contraindicated.

With simultaneous use with omeprazole, an increase in plasma concentrations of saquinavir/ritonavir is observed up to 70%, while the tolerability of treatment in patients with HIV infection does not deteriorate.

Tacrolimus

With simultaneous use of omeprazole and tacrolimus, an increase in the concentration of tacrolimus in the blood serum was noted, which may require dose adjustment. It is necessary to monitor creatinine clearance and plasma concentrations of tacrolimus when used together with omeprazole.

Methotrexate

When methotrexate was used concomitantly with proton pump inhibitors, some patients experienced

a slight increase in the concentration of methotrexate in the blood plasma. When treated with high doses of methotrexate, omeprazole should be temporarily discontinued.

Drugs metabolized by the CYP2C19 isoenzyme

When used simultaneously with omeprazole, it is possible to increase the plasma concentration and increase the half-life of warfarin (R-warfarin), diazepam, phenytoin, cilostazol, imipramine, clomipramine, citalopram, hexobarbital, disulfiram, as well as other drugs metabolized in the liver with the participation of the CYP2C19 isoenzyme (may dose reduction of these drugs may be required). However, taking omeprazole 20 mg per day does not affect the concentration of phenytoin in the blood plasma in patients taking phenytoin for a long time. When using omeprazole in patients receiving warfarin or other vitamin K antagonists, monitoring of the international normalized ratio is necessary. At the same time, concomitant treatment with omeprazole at a daily dose of 20 mg does not lead to a change in coagulation time in patients taking warfarin for a long time.

Inhibitors of CYP2C19 and/or CYP3A4 isoenzymes

Concomitant use with inhibitors of CYP2C19 and/or CYP3A4 isoenzymes slows down the metabolism of omeprazole.

When omeprazole is taken together with clarithromycin or erythromycin, the concentration of omeprazole in the blood plasma increases.

The combined use of voriconazole and omeprazole leads to an increase in the area under the pharmacokinetic curve of omeprazole.

Dose adjustment of omeprazole, when used concomitantly with inhibitors of CYP2C19 and/or CYP3A4 isoenzymes, may be required in patients with severe liver failure in case of long-term use of omeprazole. With short-term joint use, correction is not required due to the good tolerance of high doses of omeprazole.

Inducers of CYP2C19 and CYP3A4 isoenzymes

Inducers of the CYP2C19 and CYP3A4 isoenzymes, such as rifampicin, preparations of St. John's wort (Hypericum perforatum), when used together with omeprazole, can lead to a decrease in the concentration of omeprazole in the blood plasma by accelerating the metabolism of omeprazole.

No effect on metabolism

Co-administration of omeprazole with amoxicillin or metronidazole does not affect the concentration of omeprazole in the blood plasma.

No clinically significant interaction of omeprazole with metoprolol, phenacetin, estradiol, budesonide, diclofenac, naproxen, piroxicam, S-warfarin has been established.

There was no effect of omeprazole on antacids, theophylline, caffeine, quinidine, lidocaine, propranolol, ethanol.

Analogs

Omez (reviews from people who took it and gastroenterologists confirm this) can, if necessary, be successfully replaced with numerous cheap domestic drugs or expensive imported drugs with an identical mechanism of pharmacological action.

Top 5 available analogues:

• Touring. Natural plant-based product. Improves motility and secretory function of the digestive system. Suppresses inflammation in the gastrointestinal tract, relieves pain.
• Barol. A drug that reduces the secretion of hydrochloric acid in the gastric cavity. The active ingredient is sodium rabenzene. Has a pronounced antiulcer effect.
• Veloz. Protogonal pump inhibitor. Prescribed for peptic ulcers, gastritis, and other chronic pathologies of the gastrointestinal tract. Eliminates functional dyspepsia and stomach colic.
• Altan. A complex herbal medicine with a minimum number of contraindications and side effects. The product is universal and suitable for children over 9 years old. Prescribed for dysbacteriosis, duodenitis, dysentery, stomach ulcers. The composition contains tannin, polysaccharides, polyphenols, flavonoids, organic acids.
• Plantaglucid. Herbal medicine. Indications for use include hypoacid gastritis, dyspepsia, gastrointestinal inflammation, ulcerative and erosive intestinal destruction. Reduces swelling of the mucous membrane, has antibacterial activity, regulates acidity.

Among foreign analogues, gastroenterologists recommend giving preference to Cisagast, Ultop and Ortanol, which perform well both in monotherapy and in complex treatment of gastrointestinal pathologies.

Composition, release form

Composition – active ingredient of the drug – omeprazole MNN, excipients – sucrose, purified water, magnesium stearate. Release form: tablets, capsules, powder, intravenous ampoules, infusion. The capsules are transparent in a hard shell. Indications, cheaper substitutes, how to take, generic, name, antibiotic or not, what is the difference, stasis, drugs, pharmacological group - see information below. How much does it cost in Ukraine, in Russia, on the Russian market, and the cost depends on the country of origin.

Why is omez prescribed, indications for use

Omez can be quickly absorbed by the body, and the maximum concentration in the blood occurs approximately 2 hours after consumption. Almost completely metabolized by the liver and gastrointestinal tract, providing an auxiliary effect. It has been noted that in elderly patients the bioavailability of the drug is significantly higher than in younger patients.

Indications for use:

• 1. For gastritis
• 2. For pancreatitis
• 3. In case of poisoning
• 4. For low stomach acidity
• 5. For stomach pain
• 6. For diarrhea
• 7. For cholecystitis
• 8. For prevention
• 9. In veterinary medicine - dogs