Язвенная болезнь желудка и двенадцатиперстной кишки (в т.ч. профилактика рецидивов); эрадикация Helicobacter pylori у инфицированных больных с язвенной болезнью желудка и двенадцатиперстной кишки (в составе комбинированной терапии); рефлюкс-эзофагит; гиперсекреторные состояния (синдром Золлингера-Эллисона, полиэндокринный аденоматоз, системный мастоцитоз, ...
Повышенная чувствительность к омепразолу или другим компонентам препарата; детский возраст; период лактации. С осторожностью: печеночная и/или почечная недостаточность.
Ингибитор протонного насоса, снижает кислотопродукцию - тормозит активность H /К -АТФ-азы в париетальных клетках желудка и блокирует тем самым заключительную стадию секреции соляной кислоты. Препарат является пролекарством и активируется в кислой среде секреторных канальцев париетальных клеток. Снижает базальную и стимулированную секрецию независимо от природы раздражителя
Показания к применению
Язвенная болезнь желудка и двенадцатиперстной кишки (в т.ч. профилактика рецидивов); эрадикация Helicobacter pylori у инфицированных больных с язвенной болезнью желудка и двенадцатиперстной кишки (в составе комбинированной терапии); рефлюкс-эзофагит; гиперсекреторные состояния (синдром Золлингера-Эллисона, полиэндокринный аденоматоз, системный мастоцитоз, стрессовые язвы ЖКТ); профилактика и лечение повреждений слизистой оболочки желудка и двенадцатиперстной кишки, обусловленных приемом НПВС (диспепсия, эрозии слизистой оболочки, пептическая язва).
Противопоказания
Повышенная чувствительность к омепразолу или другим компонентам препарата; детский возраст; период лактации. С осторожностью: печеночная и/или почечная недостаточность.
Применение при беременности и в период грудного вскармливания
Применение омепразола во время беременности возможно только в том случае, если предполагаемая польза для матери превышает потенциальный риск для плода. При приеме препарата в период лактации следует решить вопрос о прекращении грудного вскармливания
Способ применения и дозы
Внутрь. Капсулы Ортанол принимают перед едой (обычно утром перед завтраком). Капсулу следует проглатывать целиком, запивая достаточным количеством жидкости. Если пациент не может проглотить капсулу Ортанол целиком, можно растворить ее содержимое в небольшом количестве воды или фруктового сока (например, яблочного или апельсинового). Язвенная болезнь двенадцатиперстной кишки: по 20 мг 1 раз в сутки в течение 2 нед. в случае, если после первого курса приема препарата не наступает полное рубцевание, назначают повторный 2-недельный курс терапии. При язвенной болезни двенадцатиперстной кишки, резистентной к терапии, назначают Ортанол капсулы 40 мг 1 раз в сутки, курс лечения может быть продлен до 4 нед. Язвенная болезнь желудка: по 20 мг 1 раз в сутки в течение 4 нед. в случае, если после первого курса приема препарата не наступает полное рубцевание, назначают повторный 4-недельный курс терапии. При язвенной болезни желудка, резистентной к терапии, назначают Ортанол капсулы 40 мг 1 раз в сутки, курс лечения может быть продлен до 8 нед. Эрадикация Helicobacter pylori в составе комбинированной терапии: Ортанол капсулы по 20 мг 2 раза в сутки перед едой в течение 2 нед в сочетании с антибактериальными препаратами. Рефлюкс-эзофагит: 20 мг 1 раз в сутки в течение 4 нед. в случае, если после первого курса приема препарата не наступает полное излечение, назначают повторный четырехнедельный курс терапии. При тяжелых формах эзофагеального рефлюкса курс лечения может быть продлен до 8 нед. Гиперсекреторные состояния: доза Ортанола и продолжительность курса лечения для пациентов с синдромом Золлингера-Эллисона подбирается индивидуально. Рекомендуемая начальная доза для взрослых составляет 60 мг 1 раз в сутки, максимальная - 120 мг/сут. При назначении дозы, превышающей 80 мг/сут, ее делят на несколько приемов. Профилактика и лечение повреждений слизистой оболочки желудка и двенадцатиперстной кишки, обусловленных приемом НПВС: профилактика - по 1 капс. Ортанол 20 мг ежедневно перед завтраком в течение всего курса лечения НПВС. Лечение - по 20 мг/сут в течение 4-8 нед. Суточная доза для пациентов старшей возрастной группы и для пациентов с тяжелыми заболеваниями печени не должна превышать 20 мг. Для пациентов с нарушениями функции почек коррекция доз не требуется
Побочное действие
Побочное эффекты, наблюдаемые при применении препарата Ортанол, обычно слабо выражены и носят преходящий характер. Аллергические реакции: редко - крапивница, кожный зуд, очень редко - эозинофилия, лихорадка, ангионевротический отек, бронхоспазм, анафилактоидные реакции, интерстициальный нефрит. Со стороны ЖКТ: редко - тошнота, рвота, боль в животе, диарея или запор, метеоризм, очень редко - сухость во рту, стоматит, повышение активности трансаминаз и ЩФ, у больных с предшествующим тяжелым заболеванием печени - гепатит, нарушение функции печени. Со стороны нервной системы: у больных с тяжелыми сопутствующими соматическими заболеваниями - головная боль, редко - головокружение, парестезии, нарушение вкусовых ощущений, сонливость, бессонница, очень редко - возбуждение, депрессия, обратимая спутанность сознания, на фоне тяжелого заболевания печени - энцефалопатия. Со стороны кожных покровов: фотосенсибилизация, мультиформная экссудативная эритема, алопеция. Со стороны опорно-двигательного аппарата: миалгия, артралгия, в отдельных случаях - мышечная слабость. Со стороны органов кроветворения: в отдельных случаях - лейкопения, агранулоцитоз, тромбоцитопения, панцитопения. Прочие: усиление потоотделения, периферические отеки, нарушение зрения, гинекомастия, редко - образование желудочных гландулярных кист во время длительного лечения (следствие ингибирования секреции HCl, носит доброкачественный, обратимый характер).
Передозировка
Симптомы: сухость во рту, тошнота, рвота, усиление потоотделения, головная боль, сонливость, спутанность сознания, нарушение зрения, тахикардия. Лечение: симптоматическое. Специфического антидота нет. Гемодиализ неэффективен для удаления омепразола из организма в связи с высокой степенью связывания с белками
Особые указания
Перед началом терапии омепразолом необходимо исключить наличие злокачественного процесса, т.к. лечение, маскируя симптоматику, может отсрочить постановку правильного диагноза. Данных о клинически значимом влиянии омепразола на способность управлять автомобилем и механизмами нет
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