"Omez" with gastritis is often prescribed as part of complex therapy, when together with him you have to take other drugs from different groups. In addition, many patients have in addition to gastritis and other diseases, for which they again have to take certain drugs. In these cases, it is very important to consider the interaction of drugs, because omeprazole as an inhibitor of the proton pump reduces the acidity of the stomach, which can disrupt the habitual absorption of oral agents.
Thus, the absorption of oral forms of antifungal agents containing poza-, keto- or intraconazole, as well as a drug for the treatment of large-cell cancers of internal organs called "Erlotinib" with a decrease in gastric acidity will also decrease. But "Digoxin" (cardiac glycoside, used to treat heart failure) will behave differently. Its absorption increases by an average of 10 percent, which is considered harmless, but with an increase of 30 percent or more, toxic effects were noted.
Drugs for the therapy of retrovirus infection, the active substances of which are nelfinavir and atazanavir, do not combine well with "Omez", the active substance of which reduces the content of these components in the patient's blood, and hence the effect of taking medications will be significantly lower. Simultaneous take omeprazole and nelfinavir is contraindicated, since the effectiveness of the latter decreases by more than half regardless of the dose. But the interaction with atazanavir is dose-dependent. In this case, in order to achieve a more or less good antiviral effect, it is necessary to reduce the dose of omeprazole and increase the dosage of the antiretroviral agent, which is also considered not the best option.
Other antiretroviral agents in combination with omeprazole may behave differently. So the concentration of sankvinavir in the blood can increase, and some other drugs do not respond to a change in the acidity of the stomach.
"Omez" negatively affects the absorption in the gastrointestinal tract of the antiplatelet drug "Klopidogrel". This combination leads to a decrease in the duration of the drug and a decrease in the therapeutic effect, which is a reduction in platelet aggregation, which is the reason for the requirement to avoid such treatment regimens.
Omeprazole is considered an inhibitor of the enzyme CYP2C19. Simultaneous intake of drugs with it, the metabolism of which occurs with the participation of the same enzyme (for example, Diazepam, Warfarin, Phenytoin, Cilastazol, etc.), can inhibit metabolism and increase the time the drug is in the patient's body.
In this regard, with the simultaneous appointment of "Omez" and the above funds, it is recommended to monitor the dose of medicines in the body and, if necessary, to reduce it.
The immunosuppressive drug "Tacrolimus, which prevents the rejection of implants of vital internal organs, is also more slowly excreted by the action of omeprazole, which leads to an increase in its concentration in the blood and a negative effect on the kidney function. Simultaneous reception of such drugs requires monitoring of the level of immunosuppressant in the blood and, if necessary, reducing its dosage.
Caution should be observed and, if necessary, to take the antitumor agent "Methotrexate". In this case, it is better to refuse reception of "Omez" and its analogues.
Omeprazole is metabolized in the liver with the participation of another enzyme - CYP3A4, although it does not decrease its activity. But other drugs that are able to inhibit this enzyme or both enzymes involved in the metabolism of omeprazole (such as antibiotic clarithromycin and antifungal agent voriconazole), while taking with "Omez" increase the level of its active substance in the blood plasma. Overdose of omeprazole in this case is unlikely, but for patients with severe liver diseases, correction of its dose is not out of place.
Drugs that can enhance the action of enzymes, through which omeprazole is metabolized (for example, rifampicin antibiotic and St. John's Wort preparations), accelerate the metabolism of omeprazole, so that its concentration in the blood can quickly decrease and the effect of the drug will not be so effective and long-term.
If the gastritis is exacerbated with increased acidity, if the symptoms of the disease are particularly pronounced, doctors often resort to a treatment regimen that involves taking two drugs that affect the acidity of the stomach: an inhibitor of a proton pump based on omeprazole and a bismuth drug (eg, widely advertised De-Nol ). Both drugs have as their goal the protection of the stomach and duodenum, affected by the disease, but they act quite differently. De-Nol forms a protective film on the mucosal surface, which can interfere with the absorption of other oral agents.
"Omez" and "De-nol" with gastritis is quite acceptable to take simultaneously, but the absorption of omeprazole will be somewhat lower. In the therapeutic regimens recommended by doctors, the medications should be taken at an interval of about an hour and a half. Ideally, one drug can be taken half an hour before meals, and another one half an hour or so after meals.
The drugs "Omez D" and "Omez DSR", prescribed for gastritis, you need to consider the drug interaction domperidona. The action of this substance can reduce the "no" anticholinergics. Antacids and antisecretory drugs significantly reduce its absorption in the intestine.
Inhibitors of the enzyme CYP3A4, involved in the metabolism of both active substances, increase the concentration of domperidone in the blood and lead to an extension of the QT interval on the cardiogram. Strong inhibitors of this enzyme in combination with domperidone can worsen the condition of patients with a weak heart, so such interactions should be excluded. The drug "Omez" enriched with prokinet is forbidden to combine with azole antifungal drugs, macrolides, protease inhibitors, including antiretroviral therapy agents, calcium antagonists and some other drugs.
Domperidone intensifies the action of neuroleptics and reduces the severity of the side effects of dopamine antagonists. In any case, before starting treatment with a single-agent or its combination analogue, you should consult your doctor about the interaction of these drugs with other drugs that you have to take to the patient.