ое средство для лечения пептической язвы, ассоциированной с Helicobacter pylori, состоящее из 2 кларитромицина, 2 омепразола и 4 амоксициллина х 7 стрипов.Внутрь, проглатывая целиком; таблетки и капсулы нельзя разламывать и разжевывать. По 1 капс. омепразола, 1 табл. кларитромицина и 2 капс. амоксициллина 2 раза в сутки перед едой утром и вечером. Продолжительность лечения ? 7 дней.
Фармакологические свойства
Тройная терапия, включающая омепразол, кларитромицин и амоксициллин позволяет достичь высокий процент эрадикации Helicobacter pylori (85-94%).
Омепразол угнетает секрецию желудочной кислоты за счет специфического ингибирования H+ К+-АТФазы - фермента, находящегося в мембранах париетальных клеток слизистой оболочки желудка. Снижает базальную и стимулированную секрецию независимо от природы раздражителя. После однократного приема препарата внутрь действие омепразола наступает в течение первого часа и продолжается в течение 24 ч, максимум эффекта достигается через 2 ч. После прекращения приема препарата секреторная активность полностью восстанавливается через 3-5 сут.
Кларитромицин - антибиотик из группы макролидов, полусинтетическое производное эритромицина А. Оказывает противомикробное действие, которое связано с подавлением синтеза белка путем взаимодействия с 50Sрибосомальной субъединицей микробной клетки. Эффективен в отношении большого числа грамположительных, грамотрицательных аэробных и анаэробных микроорганизмов, включая Helicobacter pylori. Образующийся в организме метаболит 14-гидроксикларитромицин также обладает выраженной противомикробной активностью. Амоксициллин - полусинтетический пенициллин, обладает бактерицидным действием, имеет широкий спектр действия. Противомикробное действие связано с ингибированием синтеза пептидогликана (опорного полимера клеточной стенки) в период деления и роста. Обладает выраженной активностью по отношению к Helicobacter pylori. Резистентность Helicobacter pylori к амоксициллину проявляется редко.
Комбинация амоксициллина и кларитромицина обладает потенцированным антимикробным эффектом по отношению к Helicobacter pylori.
Показания к применению
Эрадикационная терапия Helicobacter pylori при язвенной болезни двенадцатиперстной кишки.
Противопоказания
Запрещается сочетанное применение с цизапридом, пимозидом, астемизолом и терфенадином;
беременность;
период лактации;
порфирия;
детский возраст;
почечная и/или печеночная недостаточность;
повышенная чувствительность к омепразолу, кларитромицину или амоксициллину, а также антибиотикам группы макролидов.
Противопоказан в детском возрасте. Противопоказан при печеночной недостаточности.
Применение при беременности и в период грудного вскармливания
Противопоказан во время беременности и в период лактации.
Способ применения и дозы
Каждый стрип, содержащий таблетки и капсулы набора Пилобакт AM, рассчитан на один день лечения и состоит из двух частей: красной с надписью "утро" и синей с надписью "вечер".
В утренний прием перед едой следует принять содержимое части "утро" полностью (одну капсулу омепразола, одну таблетку кларитромицина и две капсулы амоксициллина). В вечерний прием перед едой следует принять содержимое части "вечер" полностью (одну капсулу омепразола, одну таблетку кларитромицина и две капсулы амоксициллина). Таблетки и капсулы нельзя разламывать и разжевывать, их следует проглотить целиком. Продолжительность лечения составляет 7 дней.
Побочное действие
Со стороны органов пищеварения: дисбактериоз, диарея или запор, тошнота, рвота, метеоризм, боль в животе, сухость во рту, нарушения вкуса, стоматит, транзиторное повышение активности «печеночных» ферментов в плазме, нарушение функции печени, редко - псевдомембранозный энтероколит.
Со стороны нервной системы: головная боль, головокружение, возбуждение, сонливость, бессонница, атаксия, парестезии, депрессия, спутанность сознания, галлюцинации, эпилептические реакции, периферическая невропатия.
Со стороны опорно-двигательного аппарата: мышечная слабость, миалгия, артралгия.
Со стороны системы кроветворения: лейкопения, нейтропения, тромбоцитопения, тромбоцитопеническая пурпура, анемия.
Со стороны кожных покровов: зуд; редко - кожная сыпь, в отдельных случаях -фотосенсибилизация, мультиформная экссудативная эритема, алопеция.
Аллергические реакции: крапивница, ангионевротический отек, бронхоспазм и анафилактический шок.
Взаимодействие с другими лекарственными средствами
Одновременное назначение теофиллина и кларитромицина сопровождается повышением концентрации теофиллина.
Одновременное назначение кларитромицина с терфинадином повышает концентрацию последнего и может привести к удлинению интервала QT.
Одновременное назначение кларитромицина с непрямыми антикоагулянтами может потенцировать действие последних,
При одновременном назначении с кларитромицином уровни карбамазепина, циклоспорина, фенитоина, дизопирамида, ловастатина, вальпроата, цизаприда, пимозида, астемизола, дигоксина могут быть повышены.
Омепразол может замедлять элиминацию фенитоина, диазепама, варфарина, а также влиять на абсорбцию кетоконазола, ампициллина и солей железа за счет ингибирования секреции кислоты в желудке.
При одновременном назначение амоксициллина с пероральными контрацептивами возможно снижение эффекта последних.
Особые указания
Перед началом терапии необходимо исключить наличие злокачественного процесса (особенно при язве желудка), т. к. лечение, маскируя симптоматику, может отсрочить постановку правильного диагноза.
С осторожностью назначают на фоне приема лекарственных средств, метаболизируюшихся печенью. В случае совместного назначения с варфарином или другими непрямыми антикоагулянтами необходимо контролировать протромбиновое время.
При заболеваниях сердца в анамнезе не рекомендуется одновременный прием с терфенадином, цизапридом, астемизолом.
Форма выпуска
Таблетки.
Условия хранения
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После прекращения приема препарата секреторная активность полностью восстанавливается через 3-5 сут."}},{"type":"paragraph","data":{"text":"Кларитромицин - антибиотик из группы макролидов, полусинтетическое производное эритромицина А. Оказывает противомикробное действие, которое связано с подавлением синтеза белка путем взаимодействия с 50Sрибосомальной субъединицей микробной клетки. Эффективен в отношении большого числа грамположительных, грамотрицательных аэробных и анаэробных микроорганизмов, включая Helicobacter pylori. Образующийся в организме метаболит 14-гидроксикларитромицин также обладает выраженной противомикробной активностью. Амоксициллин - полусинтетический пенициллин, обладает бактерицидным действием, имеет широкий спектр действия. Противомикробное действие связано с ингибированием синтеза пептидогликана (опорного полимера клеточной стенки) в период деления и роста. Обладает выраженной активностью по отношению к Helicobacter pylori. Резистентность Helicobacter pylori к амоксициллину проявляется редко."}},{"type":"paragraph","data":{"text":"Комбинация амоксициллина и кларитромицина обладает потенцированным антимикробным эффектом по отношению к Helicobacter pylori."}}]},{"id":7,"name":"Показания к применению","slug":"indications","body":[{"type":"list","data":{"style":"ordered","items":["Эрадикационная терапия Helicobacter pylori при язвенной болезни двенадцатиперстной кишки."]}}]},{"id":8,"name":"Противопоказания","slug":"contraindications","body":[{"type":"list","data":{"style":"ordered","items":["Запрещается сочетанное применение с цизапридом, пимозидом, астемизолом и терфенадином;","беременность;","период лактации;","порфирия;","детский возраст;","почечная и/или печеночная недостаточность;","повышенная чувствительность к омепразолу, кларитромицину или амоксициллину, а также антибиотикам группы макролидов."]}},{"type":"paragraph","data":{"text":"Противопоказан в детском возрасте. Противопоказан при печеночной недостаточности."}}]},{"id":10,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Противопоказан во время беременности и в период лактации."}}]},{"id":11,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Каждый стрип, содержащий таблетки и капсулы набора Пилобакт AM, рассчитан на один день лечения и состоит из двух частей: красной с надписью \"утро\" и синей с надписью \"вечер\"."}},{"type":"paragraph","data":{"text":"В утренний прием перед едой следует принять содержимое части \"утро\" полностью (одну капсулу омепразола, одну таблетку кларитромицина и две капсулы амоксициллина). В вечерний прием перед едой следует принять содержимое части \"вечер\" полностью (одну капсулу омепразола, одну таблетку кларитромицина и две капсулы амоксициллина). Таблетки и капсулы нельзя разламывать и разжевывать, их следует проглотить целиком. Продолжительность лечения составляет 7 дней."}}]},{"id":12,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны органов пищеварения:\u003c/i\u003e дисбактериоз, диарея или запор, тошнота, рвота, метеоризм, боль в животе, сухость во рту, нарушения вкуса, стоматит, транзиторное повышение активности «печеночных» ферментов в плазме, нарушение функции печени, редко - псевдомембранозный энтероколит."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны нервной системы:\u003c/i\u003e головная боль, головокружение, возбуждение, сонливость, бессонница, атаксия, парестезии, депрессия, спутанность сознания, галлюцинации, эпилептические реакции, периферическая невропатия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны опорно-двигательного аппарата:\u003c/i\u003e мышечная слабость, миалгия, артралгия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны системы кроветворения:\u003c/i\u003e лейкопения, нейтропения, тромбоцитопения, тромбоцитопеническая пурпура, анемия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны кожных покровов:\u003c/i\u003e зуд; редко - кожная сыпь, в отдельных случаях -фотосенсибилизация, мультиформная экссудативная эритема, алопеция."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАллергические реакции:\u003c/i\u003e крапивница, ангионевротический отек, бронхоспазм и анафилактический шок."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПрочие:\u003c/i\u003e тахикардия, интерстициальный нефрит, нарушение зрения, периферические отеки, усиление потоотделения, лихорадка, гинекомастия."}}]},{"id":14,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Одновременное назначение теофиллина и кларитромицина сопровождается повышением концентрации теофиллина."}},{"type":"paragraph","data":{"text":"Одновременное назначение кларитромицина с терфинадином повышает концентрацию последнего и может привести к удлинению интервала QT."}},{"type":"paragraph","data":{"text":"Одновременное назначение кларитромицина с непрямыми антикоагулянтами может потенцировать действие последних,"}},{"type":"paragraph","data":{"text":"При одновременном назначении с кларитромицином уровни карбамазепина, циклоспорина, фенитоина, дизопирамида, ловастатина, вальпроата, цизаприда, пимозида, астемизола, дигоксина могут быть повышены."}},{"type":"paragraph","data":{"text":"Омепразол может замедлять элиминацию фенитоина, диазепама, варфарина, а также влиять на абсорбцию кетоконазола, ампициллина и солей железа за счет ингибирования секреции кислоты в желудке."}},{"type":"paragraph","data":{"text":"При одновременном назначение амоксициллина с пероральными контрацептивами возможно снижение эффекта последних."}}]},{"id":15,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Перед началом терапии необходимо исключить наличие злокачественного процесса (особенно при язве желудка), т. к. лечение, маскируя симптоматику, может отсрочить постановку правильного диагноза."}},{"type":"paragraph","data":{"text":"С осторожностью назначают на фоне приема лекарственных средств, метаболизируюшихся печенью. В случае совместного назначения с варфарином или другими непрямыми антикоагулянтами необходимо контролировать протромбиновое время."}},{"type":"paragraph","data":{"text":"При заболеваниях сердца в анамнезе не рекомендуется одновременный прием с терфенадином, цизапридом, астемизолом."}}]},{"id":17,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки."}}]},{"id":18,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить в сухом месте при температуре не выше 25°С. 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