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Omez with erosive, atrophic and chronic gastritis
One of the most common diseases of the digestive system is gastritis. Despite the multifactoriality of this pathology, its pathogenesis is reduced to the development of the inflammatory process in the stomach, which prevents the normal functioning of the organ. And if acute gastritis (a fast-flowing state with characteristic severe pains in the abdomen) is a temporary phenomenon, although extremely unpleasant, the chronic form of the disease with its inherent relapses is already a "thorn" for life, which can also have unpleasant and dangerous effects. Treatment of pathology in any case should be comprehensive, and one of its important points is the maintenance in the stomach of conditions that help reduce the symptoms of inflammation. It is with this goal in mind that doctors prescribe "Omez" for gastritis, since the control of gastric irritation produces irritating symptoms and prevents recurrences of chronic gastritis, regardless of the causes of the disease.
Indications Omeza with gastritis
According to the division into pharmacotherapeutic groups, "Omez" refers to the number of agents for the treatment of peptic ulcer of stomach and gastroepophagial reflux disease. Most often it is prescribed as part of a complex therapy for the following gastrointestinal diseases:
- Reflux esophagitis (inflammation of the walls of the esophagus, provoked by a reverse throw of food from the stomach), especially its erosive-ulcerative, when bleeding tissues of the esophagus form bleeding wounds.
- Peptic ulcer of the stomach and duodenum, i.e. The occurrence of wounds on the gastric mucosa, provoked by an increased secretory function of the organ, when gastric juice enzymes (and in particular pepsin) corrode their own tissues of the digestive tract.
- Medication ulcer, i.e. The process of destruction of cells of the gastric mucosa and intestines under the influence of drugs (the most aggressive with respect to the delicate stomach tissues are non-steroidal anti-inflammatory drugs of NSAIDs).
- Gastric ulcer provoked by stress factors.
- Zollinger-Ellison syndrome with characteristic for him education in the pancreas or DPC of the tumor, which increases the production of a special hormone (gastrin), under the influence of which the synthesis of aggressive enzymes of gastric juice (pepsin and hydrochloric acid) is enhanced.
Somewhat less often, "Omez" is prescribed for the treatment of exacerbations of pancreatitis (inflammation of the pancreas), as a result of which the load on other organs of the digestive system increases. Food, flavored with gastric juice, lingers in the stomach and provokes inflammation of its tissues. Apply the drug in the therapy of systemic mastocytosis (accumulation in the organs of mast cells, provoking inflammatory processes, which can affect the digestive system, causing erosive and ulcerative processes in the stomach and intestines).
Among the many diseases in the treatment of which "Omez" or its analog "Omeprazole" is used, there is no mention of a pathology characterized by inflammatory processes in the gastric mucosa. In this regard, a logical question arises, and whether it is possible "Omez" with gastritis or this drug is not intended for the treatment of this pathology?
It seems a little strange that in the indications for the use of the drug gastritis is not indicated at all, although there is a reference to the fact that the drug can be used to treat a diarrheal syndrome provoked by high acidity of the stomach. In fact, "Omez" with gastritis, doctors prescribe at least, than with gastric ulcer and reflux disease with developing esophagitis (inflammation of the esophagus tissues).
The fact is that erosive and ulcerative processes usually develop against the background of inflammation of the tissues, which makes them more sensitive to various irritating factors, therefore taking "Omez" with inflammation of the gastric mucosa can prevent its dangerous complications, including ulcers and stomach cancer.
Such a popular disease as gastritis can acquire a variety of forms and flow, so the advisability of taking a drug that reduces the production of gastric juice enzymes should be considered in terms of its usefulness in treating a particular form of the disease.
Acute gastritis. Pathology is characterized by an active inflammatory process in the gastric mucosa that causes severe pain syndrome and disrupts the normal functioning of the organ. Gastric enzymes have an aggressive effect, due to which the digestion of food takes place. But if the tissues of the stomach are inflamed, these same enzymes will potentiate the inflammation and strengthen it, especially if they are produced in overestimated amounts.
The most relevant is "Omez" with gastritis with high acidity of gastric juice, because it is acid that acts as the main stimulus for the mucous in the absence of a bacterial factor. By reducing the production of hydrochloric acid and the aggressiveness of gastric juice, the drug thus removes the main factor that supports the inflammatory process in the stomach
And even if we are talking about Helicobacter pylori, for which the acidic environment of the stomach is the most comfortable, "Omez" is used as part of complex antimicrobial therapy. After all, the medicine can create conditions unsuitable for life and reproduction of the bacterium, which weakens the pathogen and facilitates the work of antibiotics.
"Omez" can be prescribed to patients with superficial gastritis, considered the most mild form of the disease, since only the outer layers of the gastric mucosa undergo inflammatory changes. The factor influencing the choice of the drug, in this case, just and will be an increased acidity of the stomach.
With more severe forms of gastritis, for example, with erosive gastritis, "Omez" can be prescribed regardless of the acidity of the stomach, in contrast to antacids, alkalizing gastric juice and assigned only at a low pH. The presence of erosions and sores on the mucosa complicates the course of gastritis, so you have to do everything so that they do not increase and quickly heal.
Low acidity of gastric juice is no less dangerous than high. Decreased secretion of gastric juice leads to the fact that food is slowly digested in the stomach, and stagnant phenomena provoke irritation and inflammation of the mucosa. Low acidity also reduces immunity and is a fertile environment for the development of various bacteria, whose vital activity products also have an irritating effect on the stomach tissue, complicating the situation.
But what can help "Omez" in this situation, and is there any sense in taking the drug, which further reduces the acidity of gastric juice? Ironically, doctors can prescribe "Omez" and with a reduced acidity of the stomach, but only to combat certain symptoms (heartburn, the effects of reflux). Course treatment, prescribed with increased acidity, is not applicable here.
Gastritis is a pathology that quickly passes into a chronic form with a characteristic recurring course. In chronic gastritis, depending on the acidity of the stomach, "Omez" can be prescribed courses or as a symptomatic treatment. In any case, it reduces the severity of the inflammatory process and promotes the onset of remission.
During periods of remission and absence of constant discomfort, "Omez" can be taken as a remedy for fighting heartburn and preventing relapses, and with exacerbation of gastritis - as a therapeutic agent that controls the pH of the stomach and thus protects the mucosa from additional irritation.
A special form of chronic pathology is atrophic gastritis, which often occurs against the background of a decrease in the acidity of the stomach. For pathology, the thinning of the gastric mucosa is characteristic, as a result of which the number of glands produced by the gastric juice decreases. When the glands completely atrophy, the acidity of the stomach becomes zero and the food can not be digested without the introduction of special enzyme preparations. Moreover, atrophic gastritis is considered a precancerous condition.
The factor causing degenerative changes in the gastric mucosa is again an inflammatory process. Appointing "Omez" with atrophic gastritis, doctors are aiming to reduce the inflammation of the stomach tissues, which allows to slow down the degenerative changes in them. True, it is not possible to restore damaged cells any more.
Release form
The drug "Omez" is an analogue of the domestic "Omeprazole" with the same active substance. The medicine is developed by the Indian pharmaceutical company, and for some reason the doctors liked even the more native preparation.
The most popular and popular form of release of a medicine are capsules, which most manufacturers produce in two colors. Inside the gelatin capsules, you can find small white granules of round shape, and on the cap and capsules you can see an inscription in the form of the name of the drug in English.
The active substance "Omeza" is omeprazole, which is what we find inside the capsules, which contain the auxiliary substances specified in the instructions. The capsule contains 10 or 20 mg of omeprazole.
On sale today, you can find and various modifications of this drug. For example, "Omez-D" is a complex drug, the active substances of which are omeprazole and prokinetic domperidone, used to stimulate the digestive process. Both components are contained in capsules in a dosage of 10 mg.
"Omez-Dsr" is a combination drug of prolonged action with increased dosage of both active substances, also released in the form of capsules, which allows it to act at the right time in the right place. Each capsule "Omeza-Dsr" contains a double dose of omeprazole (20 mg) and triple domperidone (30 mg).
Preparations containing omeprazole and domperidone have the same indications for use as a simple "Omez", but with gastritis with a decreased acidity of the stomach, their intake will be even more beneficial, since domperidone will accelerate the progress of food along the digestive tract, stimulating the contractile movements of the muscles of the stomach and KDP. "Omez-D" and "Omez-DSR" can also be used in the complex treatment of atrophic gastritis. These drugs are considered effective prevention of congestion in the gastrointestinal tract, considered a risk factor for development and complication of inflammatory processes.
Domestic drug "Omeprazol", considered an analogue of the Indian "Omeza" is available in the form of tablets and capsules with various dosages, while the capsules are considered the most successful form that controls the release of the active substance in the lower parts of the stomach and the area of its connection with the duodenum. The foreign producer did not waste time on creating less effective forms, but also foresaw the fact that the use of capsules does not suit everyone.
"Omez-Insta" is a variant of the popular drug, manufactured in the form of omeprazole powder with a dosage of 20 mg, placed in sachets (sachets). It is used to prepare a suspension for oral administration. Packaging contains from 5 to 30 soy. This form of the drug is suitable for the treatment of children and adults who have difficulty in swallowing capsules. It is better to use it in the treatment of atrophic gastritis, instead of pre-dissolving the capsules of the usual "Omez" in water.
Pharmacodynamics
After we figured out the possibilities of prescribing "Omez" for gastritis and forms of the drug, it's time to understand how this drug, popular in the treatment of diseases of the digestive system, works.
Pharmacodynamics of the drug is based on its ability to influence the spontaneous and stimulated secretion of gastric juice. Omeprazole is considered an inhibitor of the proton pump. An inhibitor is a substance that suppresses the activity of others. The proton pump is a specific protein (hydrogen-potassium adenosine triphosphate) in the gastric mucosa, which regulate the transport of hydrogen and potassium ions. They are responsible for activating the production of hydrochloric acid.
Thus, the active substance of the drug "Omez" with gastritis reduces the activity of cells that produce hydrochloric acid, a decrease in the concentration of which leads to a decrease in the acidity of gastric juice. This is good for the damaged mucosa, as it reduces its irritation.
But on the other hand hydrochloric acid is simply necessary for active digestion of food, and its reduction may not have a very good effect on the work of the stomach, if gastritis occurs against the background of normal or reduced acidity of gastric juice. This moment prompted the producers to create modified forms of "Omez", in which prokinetic is the second active substance.
Prokinetics are substances that stimulate gastrointestinal motility. Domperidone is a dopamine receptor antagonist that has antiemetic and stimulatory effects. Thanks to him, the period of active contractions of the muscles of the esophagus, the upper and lower parts of the stomach and duodenum is prolonged, which facilitates and speeds up the removal of food from the stomach, flavored with aggressive enzymes of gastric juice. Thanks to such training, the tone of the lower esophageal sphincter increases, which prevents the appearance of such an unpleasant phenomenon as reflux, i.e. Throwing food from the stomach into the esophagus.
Useful properties of "Omez" and its combined analogs with the same name is considered to be drug assistance in the fight against Helicobacter pylori. The drug reduces the acidity of the stomach and the activity of bacteria, which, combined with the use of antibacterial agents, allows rapid reduction in the severity of symptoms of gastritis, helps to heal microdamages on the mucous in the erosive-ulcerous variety, contributes to a longer remission in the chronic course of the pathology.
Even with prolonged treatment with the drug, there is no decrease in its activity, which allows, if necessary, to repeat the treatment courses "Omez" with exacerbation of gastritis several times a year.
Studies of patients with gastritis combined with reflux disease and esophagitis showed a marked decrease in the symptoms and frequency of reflux.
Not very pleasant effect, characteristic of all drugs that reduce the acidity of the stomach, is considered a high probability of growth in the number of opportunistic microorganisms that were previously present in the digestive tract in small quantities. Infringement of a microflora of an organism in turn raises risk of every possible intestinal infections.
Pharmacokinetics
The proton pump inhibitor "Omez" and preparations with a combined composition have a noticeable speed. Reduction of acidity of gastric juice is observed already within the first hour after oral administration of the drug, which indicates the rapid and good absorption of active substances in the digestive tract. The capsule shell protects the active substance from early activation under the influence of gastric juice. Absorbed omeprazole in the lumen of the small intestine for 3-6 hours, whence it enters the blood. Already after 1-2 hours after taking the drug, the concentration of omeprazole in the blood plasma reaches its maximum.
Simultaneous food intake does not affect the absorption and bioavailability of the drug, so you can take the pill before, during or after a meal. Preparations containing domperidone, the absorption of which slows down with a decrease in the acidity of the stomach, is recommended to be taken before meals and with an interval between taking this medication and antacids or inhibitors of histamine receptors prescribed in the treatment of gastritis with increased gastric acidity.
Both active substances do not accumulate in the body, although subsequent preparations of the drug have a relatively greater effect than the first. Neither omeprazole nor domperidone contribute to the induction of their own metabolism. These are corrective means of temporary action.
In the overwhelming majority of cases, "Omez" with gastritis is prescribed only once a day. This is enough to maintain the acidity of the stomach at the appropriate level during the day. The four-day course helps to temporarily stabilize the production of hydrochloric acid and reduce it by 70 or more percent with daily intake in a dosage of 20 mg.
Blocking the production of hydrochloric acid with omeprazole, necessary for the gastric mucosa to recover, is reversible. After 3 days after the last dose of the drug, the synthesis of enzymes returns to the previous indices, and the effective digestion of food is carried out naturally.
Metabolism of the active substances "Omeza" is carried out in the liver, and for excretion of metabolites, the kidneys and intestines respond. Most of the metabolites are excreted in the urine.
Use Omeza with gastritis during pregnancy
The use of the drug during pregnancy is not prohibited, but not strongly encouraged. The fact is that studies on animals have shown some negative effect of the drug on the fetus, but for pregnant women, for understandable reasons, such experiments were not put. And since there are no serious consequences for the child, doctors prescribe the drug to expectant mothers if the disease and its symptoms pose a danger to the life and health of a woman who exceeds the risk for the baby. It is impossible to make a decision on the admission of "Omez" and especially its combined analogs during this period.
When breastfeeding a woman will have to choose: either take the drug, or breast-feed the baby. The fact is that omeprazole is able to penetrate into breast milk, which can adversely affect the performance of the digestive tract of the baby. In addition, the baby's body may not respond as favorably to the components of the drug as the body of its mother.
Combined drugs during pregnancy and lactation are not recommended. For the treatment of children they are appointed from the age of 12.
Contraindications
"Omez" is a drug with proven effectiveness, which has been used for many years in the treatment of gastritis, stomach ulcers, reflux disease and some other gastrointestinal diseases. But this does not mean that the medicine does not have any contraindications to the use, so before you buy and start taking the drug, it is worth familiarizing yourself with the above paragraph of the instruction.
The main contraindication to the reception of "Omez" and its combined analogs is the increased sensitivity of the patient's body to the main or auxiliary substances of the dosage form. Preparations that contain, in addition to omeprazole, also domperidone, are not prescribed for mechanical intestinal obstruction, bleeding from the gastrointestinal tract, damage to the walls of the stomach and intestines, when stimulation of the motor activity of the walls of the organs can complicate the situation.
Other contraindications are: the presence in the pituitary gland of a tumor provoked by prolactin, lengthening the intervals of cardiac conduction in various heart diseases, serious violations of electrolyte balance, severe liver and kidney pathologies with a violation of their functionality.
Powder for preparation of the oral suspension is not prescribed for hereditary disorders of glucose metabolism and metabolic alkalosis.
When carrying out antiretroviral therapy, it must be taken into account that the drugs used in this case do not combine with omeprazole.
Caution in treating "Omega" should be observed for patients with liver and kidney disease, as the metabolism and excretion of the drug is carried out by these organs.
Side effects Omeza with gastritis
"Omez" is considered one of those drugs that are well tolerated by most patients, which is the reason for such a high popularity of this drug. However, doctors do not exclude the appearance of some side effects.
Most often, taking "Omez" with gastritis or other pathologies of the gastrointestinal tract, patients complain of the appearance of headaches, epigastric pain, stool disorders (usually constipation, less often diarrhea), flatulence, attacks of nausea and vomiting. It is believed that these symptoms may be associated with drug therapy, although it must be understood that they are also characteristic for most pathologies in connection with which the "Omez" is prescribed.
"Omez" and its combined analogs can adversely affect the patient's appetite, change the perception of food taste, provoke intestinal spasms. Taking medications occasionally can make changes in the blood composition, which is diagnosed as leukopenia, agranulocytosis and some other hematological abnormalities.
Hypersensitivity reactions to the drug and anaphylaxis are also very rare.
A prolonged intake of "Omez" can adversely affect the content of sodium and magnesium in the body, causing hypokalemia or hypomagnesemia. The latter manifests itself in the form of increased fatigue, seizures, fainting.
Not often reported and cases of insomnia, increased sleepiness, dizziness, impaired body sensitivity against the background of taking the drug, even less often - about the development of depression or the appearance of hallucinations.
Visual impairment, the appearance of tinnitus, the development of bronchospasm, hepatitis, or symptoms of impaired renal function, reactions from the skin or bones of the skeleton are also considered rare side effects.
The result of prolonged intake of proton pump inhibitors may be the formation of glandular cysts in the stomach. These are benign neoplasms, which themselves disappear after the abolition of drugs that reduce the acidity of gastric juice.
Dosing and administration
In the instructions for the drug "Omez" you can find a way to apply and dose the medication to treat the pathologies indicated in the indications for its use, so a logical question arises as to how to take the drug with gastritis, which can not be mentioned in the annotation.
An effective therapeutic dosage of the drug for the treatment of gastritis is 20 mg, although in the case of normal and reduced acidity of the gastric juice, a dose of 10 mg of omeprazole will be taken once a day. Increase the dose can only be prescribed by the doctor in the absence of the desired effect.
One-component "omeprazole" is recommended before or during meals, although with atrophic gastritis the drug can be prescribed for admission after 15-30 minutes after eating. Two-component preparations containing prokinetic domperidone are recommended for taking 15-30 minutes before meals.
Preparations in the form of capsules are not chewed, squeezed with enough liquid, but not milk or dairy products. If a person can not swallow a capsule, it can be opened, the contents mixed with a little water and citrus juice, and a drink. Dairy and carbonated beverages are not used for these purposes.
It should be understood that the drug is not in vain produced in the form of gelatin capsules, which provide activation of the active substance, not in the stomach, but in the lumen of the intestine. If the capsule is opened, the effect of taking the drug may be less, since some part of it will be destroyed by digestive enzymes. If it is not possible to swallow the capsules, it is better to use a special form of "Omez-Insta".
Powdered form requires the preliminary preparation of a suspension, for which the contents of one soy (20 mg of omeprazole) are mixed with two tablespoons of water. Drink the medicine is not necessary, but it is allowed to rinse a container with a small amount of water, in which the suspension was prepared, and drink this liquid.
Suspension should be taken an hour before eating freshly prepared. The finished suspension is not subject to storage.
How much it is necessary to drink "Omez" at a gastritis solves the attending physician, leaning against the form of a gastritis, indicators of acidity of a gastric juice, a status of the patient. The minimum effective course of "Omez" for gastritis is 4 days, but for the treatment of reflux and heartburn in pathologies with a decreased acidity of the stomach, the drug can be administered once to remove unpleasant symptoms. Course treatment in this case can only aggravate the situation with the digestion of food.
With gastritis in the increased acidity of the stomach, the drug is usually given a course of one and a half to two weeks, although if necessary, the duration of the course of treatment can be increased, especially if the disease is combined in reflux esophagitis, whose treatment can last for 4-8 weeks.
For the treatment of gastritis, associated with Helicobacter pylori, the drug is prescribed as part of 2-3-4 component schemes of irradiation of the bacteria in combination with antibiotics. In this case, the dosage of the drug and the duration of the course of treatment depend on the intended scheme. So "Omez" can be taken twice a day for 20 mg in combination with amoxicillin (1 g 2 times a day) or a combination of clarithromycin and metronidazole. Duration of treatment in different irradiation schemes can vary from 7 to 14 days.
Application for children. "Omez" is not considered an absolutely safe drug for children, so when gastritis it is prescribed only from the age of 12 years. At an earlier age, the drug can be used only for the treatment of reflux disease (from 2 years) and gastric and duodenal ulcer (from 4 years), although there is information about the appointment of a short course of reflux treatment and in infants. No information that the reception of "Omez" can have a negative impact on the growth, development and puberty of the child, no.
Overdose
With gastritis "Omez" is usually prescribed in a dosage of 20 mg per day. To combat Helicobacter pylori dosage may be increased to 40 mg or higher. In the absence of allergic reactions, these doses are considered absolutely safe for people who do not have contraindications to the use of the drug.
Neither omeprazole nor domperidone accumulates in the body, so overdose due to long-term use of drugs is excluded. All the negative effects are not due to intoxication of the body, but to disturbances caused by insufficient amount of hydrochloric acid involved in the digestion process.
Symptoms of overdose in the study appeared only after the use of a single oral dose, exceeding the recommended 100-120 times. In this case, patients complained of headaches, epigastric discomfort, diarrhea, nausea, vomiting, described in the paragraph on side effects of "Omez". Even with such high doses, confusion, apathy and depression were noted only in isolated cases.
All symptoms of an overdose are short-lived and not life-threatening for patients. If necessary, you can conduct symptomatic treatment.
Interactions with other drugs
"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.
Special instructions
To treat "Omega" was more effective, it is not worth taking this drug and other drugs that reduce the acidity of gastric juice. Such drugs should be taken at intervals of not less than 1 hour. At the same time, do not prescribe medication yourself only on the basis of the fact that you have increased the acidity of the stomach. A strong decrease in the acidity of gastric juice can lead to stagnant phenomena in the stomach associated with slow digestion of food, thus, inadequate treatment of gastritis can turn into harm to the patient.
Before taking "Omez" with gastritis, you need to exclude the possibility of malignant process in the gastrointestinal tract. In and of themselves, omeprazole and domperidone will not in any way affect cancer cells, but they are capable of masking the symptoms of the disease (for example, stomach cancer), which in deadly stages is deadly.
Patients with severe liver disorders are undesirable to prescribe a drug with domperidone or it is necessary to reduce the recommended dose.
Prolonged intake of proton pump inhibitors or combined treatment with digoxin can lead to hypomagnesemia, therefore, such patients should be regularly monitored for magnesium levels in the body.
Analogues
The drug of Indian manufacture "Omez" is not the only representative of proton pump inhibitors. Similar properties are possessed by all preparations, the active substances of which are omeprazole, rabeprazole, lansoprazole, pantoprazole and other blockers of the proton pump. On pharmacy shelves, you can find a lot of popular and new drugs of this class: Russian "Omeprazole", Indian "Omitox", Swedish "Nexium", preparations "Emanera" and "Nolpaza" produced in Slovenia, "Pantoprazole" of Chinese production,
Whatever it was, the most popular drugs among proton pump inhibitors, prescribed for gastritis, are still "Omez" and "Omerzal", which doctors prescribe most often. Answer directly to the question, which is better, very difficult, because in spite of the fact that the preparations are full analogues of the active substance, they can differ in the auxiliary components. The composition of the Russian drug includes substances that reduce the likelihood of allergic reactions, but when treating an Indian medicine of the same form of release, other side effects are less likely. And, of course, there is a difference in price. Foreign medicines always have a higher price than analogues produced in the countries of the former CIS.
The drug "De-nol", appointed by doctors instead of or in conjunction with proton pump inhibitors, although it has a similar effect (refers to antisecretory drugs, protects the mucous membrane and promotes its recovery), is not an analogue of "Omez". This medicine increases the synthesis of enzymes that increase the pH of the stomach, and forms a protective film on the surface of the mucosa.
A big plus of the drug "De-Nol" is its bactericidal activity against Helicobacter pylori. Therefore, when it comes to fighting this pest, the drug of choice is still the "De-Nol", But despite all the effectiveness attributed to this medicine, he can not permanently destroy Helicobacter, so "De-Nol", like "Omez" , the bacteria are prescribed as part of irrigation schemes using antibiotics.
Reviews
It's no secret that gastroenterologists dealing with digestive system diseases refer to proton pump inhibitors as effective drugs for gastric ulcer, reflux esophagitis and gastritis, helping to keep stomach acid in check. Thanks to the action of "Omez" and its analogs, the cessation of the inflammatory process and scarring of microdamages on the stomach and intestinal mucosa occurs faster and more efficiently, which makes it possible to accelerate the onset of remission in the chronic course of gastritis.
The love of "Omez" in doctors can be justified also by the fact that this drug relatively rarely causes side effects, due to which patients have to change medicine.
The responses of those who took "Omez" with gastritis are not as rosy as the opinion of doctors. Nevertheless, almost all patients agree that this is one of the best drugs that help to cope with such an unpleasant symptom as heartburn. And in fact a heartburn is one of displays of the raised acidity of a stomach. If heartburn disappears, then the acidity of the body has returned to normal.
Negative reviews, if they can be called so, are indicative not so much of the ineffectiveness of the drug as of the overestimated requirements for it. Acute symptoms of gastritis against the background of taking "Omega", despite the speed of the drug, go for 4-5 days. It is clear that in order for the inflammatory process to subside, a single dose of medication is small, which is far from being understood by all patients.
In addition, omeprazole belongs to the category of proton pump inhibitors, which affect the acidity of the stomach indirectly, in contrast to antacids, which extinguish the acid upon direct ingestion into the stomach. It is clear that antacids will help to remove heartburn faster than other antisecretory drugs, but they are not able to correct the production of enzymes that negatively affect the gastric mucosa.
If also such patients who hoped that with the help of "Omez" they will cure chronic gastritis (and is it possible?). This is a great misconception, because this drug is rather a preventive tool that reduces the likelihood of remission of the inflammatory process. In the chronic course of the pathology, it is necessary to drink it for a long time.
Counting with the help of "Omez" get rid of Helicobacter pylori is also not worth it. The drug helps antibiotics to actively fight a bacterium that provokes gastritis and stomach ulcers, but does not possess bactericidal properties. If taking "Omez" with gastritis not see any improvement, it is worth considering whether there is a "lodger" in the stomach that does not allow inflammation to subside. In most cases, the absence of the effect of omeprazole and other inhibitors of the proton pump, special studies reveal the presence of the infamous Helicobacter in the stomach.
There are also such reviews, which indicate that the drug could not completely get rid of heartburn and other manifestations of increased acidity of gastric juice. The reason for this may be the same Helicobacter pylori, which irritates the gastric mucosa and its receptors, stimulating the production of hydrochloric acid and pepsin (and omeprazole is not a substance with antimicrobial activity). There is also a possibility that the acidity of the stomach is very high and an increase in the dose of the drug is required (most often in such cases, "Omez" is prescribed in combination with other antisecretory drugs).
As we see, in the absence or weakness of the effect, the reason for this in most cases is not the uselessness of the drug for the treatment of a specific pathology, but the patient's under-examination or lack of understanding of the principle of the drug's action. It is not surprising that in the absence of antibiotic therapy, "Omez" does not really help patients who have gastritis caused by a bacterium, and for the quick removal of heartburn, it does not quite fit (in this case, antacids are more effective).
In general, "Omez" with gastritis shows good results, if it is taken as prescribed by the doctor and meaningful. Especially it helps those who have increased gastric acidity, which is likely to lead to the formation of ulcers on the mucous membrane. Such drugs as "Omez" and "Omeprazole" help to avoid such unpleasant and dangerous consequences, even if their action is not always noticeable from the outside.
Medical expert editor
Portnov Alexey Alexandrovich
Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"
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Attention!
To simplify the perception of information, this instruction for use of the drug "Omez with erosive, atrophic and chronic gastritis" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.