Таблетки, покрытые плёночной оболочкой, белого с сероватым оттенком цвета, круглые, двояковыпуклые. На поперечном разрезе видны два слоя, внутренний слой почти белого цвета.
Фармакотерапевтическая группа
желез желудка секрецию понижающее средство - H2-гистаминовых рецепторов блокатор
Фармакологические свойства
Блокатор Н2-гистаминовых рецепторов III поколения. Подавляет базальную и стимулированную гистамином гастрином и ацетилхолином продукцию соляной кислоты. Одновременно со снижением продукции соляной кислоты и увеличением pH снижается и активность пепсина.
Усиливает защитные механизмы слизистой оболочки желудка за счет увеличения образования желудочной слизи и содержания в ней гликопротеинов а также стимуляции секреции гидрокарбоната и эндогенного синтеза в ней Pg способствует заживлению ее повреждений (в т.ч. рубцеванию стрессовых язв) и прекращению желудочно-кишечных кровотечений. Слабо подавляет оксидазную систему цитохрома Р450 в печени.
После приёма внутрь действие начинается через 1 ч достигает максимума в течение 3 ч и продолжается в зависимости от дозы от 12 до 24 ч.
Фармакокинетика:
При приёме внутрь абсорбция - неполная; биодоступность - 40-45% увеличивается при приёме с пищей и снижается на фоне антацидов. Связь с белками плазмы - 15-20%. Время необходимое для достижения максимальной концентрации - 1-3 ч. Проникает в спинномозговую жидкость через плацентарный барьер и в грудное молоко.
Период полувыведения - 25-35 ч; у пациентов с тяжелой почечной недостаточностью (клиренс креатина ниже 10 мл/мин) возрастает до 20 ч (требуется коррекция дозы). 30-35% препарата метаболизируется в печени с образованием S-оксида.
Выводится почками путём клубочковой фильтрации и канальцевой секреции. 25-30% принятой внутрь дозы обнаруживается в моче в неизменном виде.
Показания к применению
Язвенная болезнь желудка и 12-перстной кишки гиперацидность желудочного сока изжога (связанная с гиперхлоргидрией) симптоматические и стрессовые язвы желудочно- кишечного тракта эрозивный рефлюкс-эзофагит НПВП-гастропатия синдром Золлингера-Эллисона системный мастоцитоз полиэндокринный аденоматоз профилактика рецидивов кровотечений в послеоперационном периоде.
Профилактика аспирации желудочного сока у больных которым проводятся операции под общей анестезией (синдром Мендельсона).
Аспирационный пневмонит (профилактика).
Диспепсия с эпигастральными или загрудинными болями возникающими в ночное время или связанными с приёмом пищи.
Противопоказания
Гиперчувствительность детский возраст.
С осторожностью
Печёночная и/или почечная недостаточность цирроз печени с портосистемной энцефалопатией (в анамнезе) иммунодефицит беременность период лактации.
Применение при беременности и в период грудного вскармливания
С осторожностью. Категория действия на плод В.
Способ применения и дозы
Внутрь. При обострениях язвенной болезни желудка и 12-перстной кишки - по 40 мг 1 раз в сутки перед сном или по 20 мг 2 раза в сутки. При необходимости суточную дозу можно увеличить до 80-160 мг. Продолжительность лечения - 4-8 нед.
Для профилактики обострений язвенной болезни - по 20 мг 1 раз в сутки перед сном.
При синдроме Золлингера-Эллисона - в начальной дозе по 20 - 40 мг 4 раза в сутки; при необходимости суточную дозу можно увеличить до 240-480 мг. Лечение продолжают столь длительное время сколько это необходимо (тяжелые формы синдрома - до 160 мг каждые 6 ч).
При рефлюкс-эзофагите начальная доза - 20 мг 2 раза/сут до 6 нед (при необходимости - 20-40 мг 2 раза в сутки до 12 нед).
Для предупреждения аспирации желудочного содержимого - 40 мг накануне операции или утром в день операции.
Больным с клиренсом креатинина ниже 10 мл/мин внутрь по 20 мг перед сном. Временной интервал между дозами можно увеличить до 36-48 ч.
Побочное действие
Со стороны пищеварительной системы: сухость во рту тошнота рвота снижение аппетита боль в животе повышение активности "печеночных" трансаминаз запор диарея желтуха гепатоцеллюлярный холестатический или смешанный гепатит острый панкреатит.
Со стороны нервной системы: головная боль астения сонливость бессонница усталость беспокойство депрессия нервозность психоз головокружение спутанность сознания галлюцинации гипертермия.
Со стороны сердечно-сосудистой системы: снижение артериального давления брадикардия атриовентрикулярная блокада аритмия васкулит.
Симптомы: рвота двигательное возбуждение тремор снижение артериального давления тахикардия коллапс.
Лечение: при пероральном приёме показана индукция рвоты или/и промывание желудка симптоматическая и поддерживающая терапия.
Взаимодействие с другими лекарственными средствами
Увеличивает всасывание амоксициллина и клавулановой кислоты.
Антациды и сукральфат замедляет абсорбцию.
Уменьшает всасывание итраконазола и кетоконазола.
Лекарственные средства угнетающие костный мозг увеличивают риск развития нейтропении.
Особые указания
Симптомы язвенной болезни 12- перстной кишки могут исчезать в течение 1-2 нед терапию следует продолжать до тех пор пока рубцевание не подтверждено данными эндоскопического или рентгеновского исследования. Может маскировать симптомы связанные с карциномой желудка поэтому перед началом лечения необходимо исключить наличие злокачественного новообразования. Отменяют постепенно из-за риска развития синдрома "рикошета" при резкой отмене.
При длительном лечении у ослабленных больных а также при стрессе возможны бактериальные поражения желудка с последующим распространением инфекции. Блокаторы Н2 - гистаминовых рецепторов следует принимать через 2 ч после приёма итраконазола или кетоконазола во избежание значительного уменьшения их всасывания. Противодействует влиянию пентагастрина и гистамина на кислотообразующую функцию желудка поэтому в течение 24 ч предшествующих тесту применять блокаторы Н2-гистаминовых рецепторов не рекомендуется.
Подавляет кожную реакцию на гистамин приводя т.о. к ложноотрицательным результатам (перед проведением диагностических кожных проб для выявления аллергической кожной реакции немедленного типа использование блокаторов Н2-гистаминовых рецепторов рекомендуется прекратить).
Во время лечения следует избегать употребления продуктов питания напитков и др. лекарственных средств которые могут вызвать раздражение слизистой оболочки желудка. Эффективность препарата в ингибировании ночной секреции кислоты в желудке может снижаться в результате курения.
Больным с ожогами может потребоваться увеличение дозы препарата вследствие повышенного клиренса.
Форма выпуска
Таблетки покрытые плёночной оболочкой 20 мг и 40 мг.
Упаковка:
По 10 таблеток в контурных ячейковых упаковках из пленки поливинилхлоридной и фольги алюминиевой.
1 2 (с дозировкой 40 мг) или 2 3 (с дозировкой 20 мг) контурные ячейковые упаковки вместе с инструкцией по применению помещают в пачку из картона.
Условия хранения
В сухом защищенном от света месте при температуре не выше 25 °С.
Хранить в местах недоступных для детей.
Срок годности
3 года.
Не использовать препарат после истечения срока годности указанного на упаковке.
Условия отпуска
По рецепту
Производитель
Открытое акционерное общество "Акционерное Курганское общество медицинских препаратов и изделий "Синтез" (ОАО "Синтез"), 640008, Курганская обл., г. Курган, проспект Конституции, д. 7
Организация, принимающая претензии потребителей
ОАО "Синтез"
Для описания товара использована информация от партнера 36.6
Мобильное приложение «Все аптеки»
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мг, 1,8 мг, тальк 0,136 мг, 0,272 мг."}}]},{"id":5,"name":"Описание","slug":"common_description","body":[{"type":"paragraph","data":{"text":"Таблетки, покрытые плёночной оболочкой, белого с сероватым оттенком цвета, круглые, двояковыпуклые. На поперечном разрезе видны два слоя, внутренний слой почти белого цвета."}}]},{"id":6,"name":"Фармакотерапевтическая группа","slug":"","body":[{"type":"paragraph","data":{"text":"желез желудка секрецию понижающее средство - H2-гистаминовых рецепторов блокатор"}}]},{"id":7,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"paragraph","data":{"text":"Блокатор Н\u003csub\u003e2\u003c/sub\u003e-гистаминовых рецепторов III поколения. Подавляет базальную и стимулированную гистамином гастрином и ацетилхолином продукцию соляной кислоты. Одновременно со снижением продукции соляной кислоты и увеличением pH снижается и активность пепсина."}},{"type":"paragraph","data":{"text":"Усиливает защитные механизмы слизистой оболочки желудка за счет увеличения образования желудочной слизи и содержания в ней гликопротеинов а также стимуляции секреции гидрокарбоната и эндогенного синтеза в ней Pg способствует заживлению ее повреждений (в т.ч. рубцеванию стрессовых язв) и прекращению желудочно-кишечных кровотечений. Слабо подавляет оксидазную систему цитохрома Р450 в печени."}},{"type":"paragraph","data":{"text":"После приёма внутрь действие начинается через 1 ч достигает максимума в течение 3 ч и продолжается в зависимости от дозы от 12 до 24 ч."}},{"type":"header","data":{"text":"Фармакокинетика:","level":3}},{"type":"paragraph","data":{"text":"При приёме внутрь абсорбция - неполная; биодоступность - 40-45% увеличивается при приёме с пищей и снижается на фоне антацидов. Связь с белками плазмы - 15-20%. Время необходимое для достижения максимальной концентрации - 1-3 ч. Проникает в спинномозговую жидкость через плацентарный барьер и в грудное молоко."}},{"type":"paragraph","data":{"text":"Период полувыведения - 25-35 ч; у пациентов с тяжелой почечной недостаточностью (клиренс креатина ниже 10 мл/мин) возрастает до 20 ч (требуется коррекция дозы). 30-35% препарата метаболизируется в печени с образованием S-оксида."}},{"type":"paragraph","data":{"text":"Выводится почками путём клубочковой фильтрации и канальцевой секреции. 25-30% принятой внутрь дозы обнаруживается в моче в неизменном виде."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Язвенная болезнь желудка и 12-перстной кишки гиперацидность желудочного сока изжога (связанная с гиперхлоргидрией) симптоматические и стрессовые язвы желудочно- кишечного тракта эрозивный рефлюкс-эзофагит НПВП-гастропатия синдром Золлингера-Эллисона системный мастоцитоз полиэндокринный аденоматоз профилактика рецидивов кровотечений в послеоперационном периоде."}},{"type":"paragraph","data":{"text":"Профилактика аспирации желудочного сока у больных которым проводятся операции под общей анестезией (синдром Мендельсона)."}},{"type":"paragraph","data":{"text":"Аспирационный пневмонит (профилактика)."}},{"type":"paragraph","data":{"text":"Диспепсия с эпигастральными или загрудинными болями возникающими в ночное время или связанными с приёмом пищи."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Гиперчувствительность детский возраст."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Печёночная и/или почечная недостаточность цирроз печени с портосистемной энцефалопатией (в анамнезе) иммунодефицит беременность период лактации."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"С осторожностью. Категория действия на плод В."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутрь. При обострениях язвенной болезни желудка и 12-перстной кишки - по 40 мг 1 раз в сутки перед сном или по 20 мг 2 раза в сутки. При необходимости суточную дозу можно увеличить до 80-160 мг. Продолжительность лечения - 4-8 нед."}},{"type":"paragraph","data":{"text":"Для профилактики обострений язвенной болезни - по 20 мг 1 раз в сутки перед сном."}},{"type":"paragraph","data":{"text":"При синдроме Золлингера-Эллисона - в начальной дозе по 20 - 40 мг 4 раза в сутки; при необходимости суточную дозу можно увеличить до 240-480 мг. Лечение продолжают столь длительное время сколько это необходимо (тяжелые формы синдрома - до 160 мг каждые 6 ч)."}},{"type":"paragraph","data":{"text":"При рефлюкс-эзофагите начальная доза - 20 мг 2 раза/сут до 6 нед (при необходимости - 20-40 мг 2 раза в сутки до 12 нед)."}},{"type":"paragraph","data":{"text":"Для предупреждения аспирации желудочного содержимого - 40 мг накануне операции или утром в день операции."}},{"type":"paragraph","data":{"text":"Больным с клиренсом креатинина ниже 10 мл/мин внутрь по 20 мг перед сном. Временной интервал между дозами можно увеличить до 36-48 ч."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Со стороны пищеварительной системы: сухость во рту тошнота рвота снижение аппетита боль в животе повышение активности \"печеночных\" трансаминаз запор диарея желтуха гепатоцеллюлярный холестатический или смешанный гепатит острый панкреатит."}},{"type":"paragraph","data":{"text":"Со стороны нервной системы: головная боль астения сонливость бессонница усталость беспокойство депрессия нервозность психоз головокружение спутанность сознания галлюцинации гипертермия."}},{"type":"paragraph","data":{"text":"Со стороны сердечно-сосудистой системы: снижение артериального давления брадикардия атриовентрикулярная блокада аритмия васкулит."}},{"type":"paragraph","data":{"text":"Аллергические реакции: крапивница кожная сыпь зуд бронхоспазм ангионевротичекий отек многоморфная эритема эксфолиативный дерматит синдром Стивенса-Джонсона токсический эпидермальный некролиз анафилактический шок."}},{"type":"paragraph","data":{"text":"Со стороны органов кроветворения: нейтропения лейкопения тромбоцитопения гемолитическая анемия агранулоцитоз панцитопения."}},{"type":"paragraph","data":{"text":"Со стороны органов чувств: звон в ушах."}},{"type":"paragraph","data":{"text":"Со стороны мочеполовой системы: при длительном приёме больших доз - снижение потенции и либидо."}},{"type":"paragraph","data":{"text":"Со стороны опорно-двигательного аппарата: артралгия миалгия."}},{"type":"paragraph","data":{"text":"Прочие: бронхоспазм сухость кожи алопеция гинекомастия."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: рвота двигательное возбуждение тремор снижение артериального давления тахикардия коллапс."}},{"type":"paragraph","data":{"text":"Лечение: при пероральном приёме показана индукция рвоты или/и промывание желудка симптоматическая и поддерживающая терапия."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Увеличивает всасывание амоксициллина и клавулановой кислоты."}},{"type":"paragraph","data":{"text":"Антациды и сукральфат замедляет абсорбцию."}},{"type":"paragraph","data":{"text":"Уменьшает всасывание итраконазола и кетоконазола."}},{"type":"paragraph","data":{"text":"Лекарственные средства угнетающие костный мозг увеличивают риск развития нейтропении."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Симптомы язвенной болезни 12- перстной кишки могут исчезать в течение 1-2 нед терапию следует продолжать до тех пор пока рубцевание не подтверждено данными эндоскопического или рентгеновского исследования. Может маскировать симптомы связанные с карциномой желудка поэтому перед началом лечения необходимо исключить наличие злокачественного новообразования. Отменяют постепенно из-за риска развития синдрома \"рикошета\" при резкой отмене."}},{"type":"paragraph","data":{"text":"При длительном лечении у ослабленных больных а также при стрессе возможны бактериальные поражения желудка с последующим распространением инфекции. Блокаторы Н\u003csub\u003e2\u003c/sub\u003e - гистаминовых рецепторов следует принимать через 2 ч после приёма итраконазола или кетоконазола во избежание значительного уменьшения их всасывания. Противодействует влиянию пентагастрина и гистамина на кислотообразующую функцию желудка поэтому в течение 24 ч предшествующих тесту применять блокаторы Н\u003csub\u003e2\u003c/sub\u003e-гистаминовых рецепторов не рекомендуется."}},{"type":"paragraph","data":{"text":"Подавляет кожную реакцию на гистамин приводя т.о. к ложноотрицательным результатам (перед проведением диагностических кожных проб для выявления аллергической кожной реакции немедленного типа использование блокаторов Н\u003csub\u003e2\u003c/sub\u003e-гистаминовых рецепторов рекомендуется прекратить)."}},{"type":"paragraph","data":{"text":"Во время лечения следует избегать употребления продуктов питания напитков и др. лекарственных средств которые могут вызвать раздражение слизистой оболочки желудка. Эффективность препарата в ингибировании ночной секреции кислоты в желудке может снижаться в результате курения."}},{"type":"paragraph","data":{"text":"Больным с ожогами может потребоваться увеличение дозы препарата вследствие повышенного клиренса."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки покрытые плёночной оболочкой 20 мг и 40 мг."}},{"type":"header","data":{"text":"Упаковка:","level":3}},{"type":"paragraph","data":{"text":"По 10 таблеток в контурных ячейковых упаковках из пленки поливинилхлоридной и фольги алюминиевой."}},{"type":"paragraph","data":{"text":"1 2 (с дозировкой 40 мг) или 2 3 (с дозировкой 20 мг) контурные ячейковые упаковки вместе с инструкцией по применению помещают в пачку из картона."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В сухом защищенном от света месте при температуре не выше 25 °С."}},{"type":"paragraph","data":{"text":"Хранить в местах недоступных для детей."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"Не использовать препарат после истечения срока годности указанного на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":17,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Открытое акционерное общество \"Акционерное Курганское общество медицинских препаратов и изделий \"Синтез\" (ОАО \"Синтез\"), 640008, Курганская обл., г. 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