В качестве альтернативы пероральной терапии при невозможности её проведения: при язвенной болезни желудка и двенадцатиперстной кишки (в том числе, профилактика рецидивов), при гастроэзофагеальной рефлюксной болезни (ГЭРБ), при гиперсекреторных состояниях (синдром Золлингера-Эллисона, стрессовые язвы желудочно- кишечного тракта, полиэндокринный аденоматоз, ...
Повышенная чувствительность к омепразолу или другим компонентам препарата. Одновременный прием с эрлотинибом, позаконазолом, нелфинавиром и атазанавиром. Период грудного вскармливания. Детский возраст до 18 лет (эффективность и безопасность не установлены для данной лекарственной формы).
Омез - противоязвенный препарат, специфический ингибитор протонового насоса. Является пролекарством и активируется в кислой среде секреторных канальцев париетальных клеток желудка. Однократный прием в сутки обеспечивает быстрое и эффективное угнетение дневной и ночной желудочной секреции, достигающее своего максимума через 4 дня лечения и исчезающее к исходу 3-4 дня после окончания приема.
Фармакологические свойства
Специфический ингибитор протонного насоса: тормозит активность Н+/К+-АТФ-азы в париетальных клетках желудка, блокируя заключительную стадию секреции соляной кислоты, тем самым снижает кислотопродукцию. Снижает базальную и стимулированную секрецию независимо от природы раздражителя. Омепразол является пролекарством и активируется в кислой среде секреторных канальцев париетальных клеток желудка. Воздействие является дозозависимым и обеспечивает эффективное ингибирование и базальной, и стимулированной секреции кислоты, независимо от природы стимулирующего фактора. Антисекреторный эффект после приема 20 мг наступает в течение первого часа, максимум - через 2 ч. Ингибирование 50% максимальной секреции продолжается 24 ч. Однократный прием в сутки обеспечивает быстрое и эффективное угнетение дневной и ночной желудочной секреции, достигающее своего максимума через 4 дня лечения и исчезающее к исходу 3-4 дня после окончания приема. У больных с язвенной болезнью 12-перстной кишки прием 20 мг омепразола поддерживает внутрижелудочный pH на уровне 3 в течение 17 ч.
Показания к применению
В качестве альтернативы пероральной терапии при невозможности её проведения: при язвенной болезни желудка и двенадцатиперстной кишки (в том числе, профилактика рецидивов), при гастроэзофагеальной рефлюксной болезни (ГЭРБ), при гиперсекреторных состояниях (синдром Золлингера-Эллисона, стрессовые язвы желудочно- кишечного тракта, полиэндокринный аденоматоз, системный мастоцитоз). Для профилактики и лечения повреждений слизистой оболочки желудка и двенадцатиперстной кишки, обусловленных приемом нестероидных противовоспалительных препаратов (НПВП-гастропатия): диспепсия, эрозии слизистой оболочки, пептическая язва. Для профилактики аспирации кислого содержимого желудка в дыхательные пути во время общей анестезии (синдром Мендельсона).
Противопоказания
Повышенная чувствительность к омепразолу или другим компонентам препарата. Одновременный прием с эрлотинибом, позаконазолом, нелфинавиром и атазанавиром. Период грудного вскармливания. Детский возраст до 18 лет (эффективность и безопасность не установлены для данной лекарственной формы).
Применение при беременности и в период грудного вскармливания
Применение препарата во время беременности возможно только в том случае, если предполагаемая польза для матери превышает потенциальный риск для плода. При лактации следует прекратить грудное вскармливание.
Способ применения и дозы
Препарат вводится внутривенно в течение 20-30 минут. Рекомендуется вводить раствор для инфузии сразу же после его приготовления. Дозы подбираются индивидуально, иногда требуется введение более высокой дозы. Если величина суточной дозы превышает 60 мг, то доза должна быть разделена на два приема.
Побочное действие
Нарушения со стороны кожи и подкожных тканей: нечасто дерматит, кожный зуд, кожная сыпь, крапивница, редко - алопеция, реакции фоточувствительности, мультиформная эритема, синдром Стивенса-Джонсона, токсический эпидермальный некролиз. Нарушения со стороны скелетно- мышечной и соединительной ткани: нечасто - переломы бедра, костей запястья, позвонков, редко - артралгия, миалгия, мышечная слабость. Нарушения со стороны нервной системы: часто - головная боль, нечасто - головокружение, парестезии, сонливость, редко - нарушение вкуса. Нарушения психики: нечасто - бессонница, редко - повышенная возбудимость, агрессивность, нарушение сознания, депрессия, галлюцинации. Нарушения со стороны желудочно-кишечного тракта: часто - абдоминальная боль, запор, диарея, метеоризм, тошнота, рвота, редко - сухость во рту, стоматит, гастроинтестинальный кандидоз, микроскопический колит. Нарушения со стороны печени и желчевыводящих путей: нечасто - повышение активности "печеночных" ферментов, редко - гепатит с/без желтухи, печеночная недостаточность, энцефалопатия у пациентов с предшествующими тяжелыми заболеваниями печени. Нарушения со стороны половых органов и молочной железы: редко - гинекомастия. Нарушения со стороны крови и лимфатической системы: лейкопения, тромбоцитопения, агранулоцитоз, панцитопения. Нарушения со стороны иммунной системы: редко - реакции гиперчувствительности: лихорадка, ангионевротический отек, анафилактическая реакция/анафилактический шок. Нарушения со стороны дыхательной системы, органов грудной клетки и средостения: редко - бронхоспазм. Нарушения со стороны почек и мочевыводящих путей: редко - интерстициальный нефрит. Нарушения со стороны органа слуха и лабиринтные нарушения: нечасто - вертиго. Нарушения со стороны органа зрения: редко - нечеткость зрения. Нарушения со стороны обмена веществ и питания: редко - гипонатриемия, очень редко - гипомагниемия, гипокальциемия вследствие тяжелой гипомагниемии, гипокалиемия вследствие гипомагниемии. Общие расстройства: нечасто - недомогание, редко - повышенное потоотделение, периферические отеки.
Передозировка
По данным клинических исследований при внутривенном введении до 270 мг препарата за сутки и в дозе до 650 мг за три дня дозозависимых побочных эффектов не было выявлено. Симптомы: спутанность сознания, нечеткость зрения, сонливость, сухость во рту, головная боль, тошнота, тахикардия, аритмия. Лечение: симптоматическое. Гемодиализ недостаточно эффективен.
Особые указания
При подозрении на язву желудка на ранних стадиях необходимо пройти рентгеновское или эндоскопическое обследование для установки правильного диагноза и назначения адекватного лечения. При наличии любых тревожных симптомов, таких как значительная спонтанная потеря массы тела, частая рвота, дисфагия, рвота с кровью или мелена, а также при наличии язвы желудка (или при подозрении на язву желудка) следует исключить возможность злокачественного новообразования, поскольку лечение препаратом Омез может привести к сглаживанию симптоматики и отсрочить постановку диагноза. Пациенты с риском развития остеопороза или переломов на его фоне должны находиться под соответствующим клиническим наблюдением, хотя причинно- следственная связь применения омепразола/эзомепразола с переломами на фоне остеопороза не установлена. Вследствие снижения секреции соляной кислоты повышается концентрация хромогранина А (CgA). Повышение концентрации CgA в плазме крови может оказывать влияние на результаты обследований для выявления нейроэндокринных опухолей. Для предотвращения данного влияния терапию ингибиторами протонной помпы необходимо приостановитьза 5 дней до проведения исследования концентрации CgA. Если за это время концентрация CgA не вернулась к нормальному значению, исследование следует повторить.
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Воздействие является дозозависимым и обеспечивает эффективное ингибирование и базальной, и стимулированной секреции кислоты, независимо от природы стимулирующего фактора. Антисекреторный эффект после приема 20 мг наступает в течение первого часа, максимум - через 2 ч. Ингибирование 50% максимальной секреции продолжается 24 ч. Однократный прием в сутки обеспечивает быстрое и эффективное угнетение дневной и ночной желудочной секреции, достигающее своего максимума через 4 дня лечения и исчезающее к исходу 3-4 дня после окончания приема. У больных с язвенной болезнью 12-перстной кишки прием 20 мг омепразола поддерживает внутрижелудочный pH на уровне 3 в течение 17 ч."}}]},{"id":4,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"В качестве альтернативы пероральной терапии при невозможности её проведения: при язвенной болезни желудка и двенадцатиперстной кишки (в том числе, профилактика рецидивов), при гастроэзофагеальной рефлюксной болезни (ГЭРБ), при гиперсекреторных состояниях (синдром Золлингера-Эллисона, стрессовые язвы желудочно- кишечного тракта, полиэндокринный аденоматоз, системный мастоцитоз). Для профилактики и лечения повреждений слизистой оболочки желудка и двенадцатиперстной кишки, обусловленных приемом нестероидных противовоспалительных препаратов (НПВП-гастропатия): диспепсия, эрозии слизистой оболочки, пептическая язва. Для профилактики аспирации кислого содержимого желудка в дыхательные пути во время общей анестезии (синдром Мендельсона)."}}]},{"id":5,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к омепразолу или другим компонентам препарата. Одновременный прием с эрлотинибом, позаконазолом, нелфинавиром и атазанавиром. Период грудного вскармливания. Детский возраст до 18 лет (эффективность и безопасность не установлены для данной лекарственной формы)."}}]},{"id":6,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Применение препарата во время беременности возможно только в том случае, если предполагаемая польза для матери превышает потенциальный риск для плода. При лактации следует прекратить грудное вскармливание."}}]},{"id":7,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат вводится внутривенно в течение 20-30 минут. Рекомендуется вводить раствор для инфузии сразу же после его приготовления. Дозы подбираются индивидуально, иногда требуется введение более высокой дозы. Если величина суточной дозы превышает 60 мг, то доза должна быть разделена на два приема."}}]},{"id":8,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Нарушения со стороны кожи и подкожных тканей: нечасто дерматит, кожный зуд, кожная сыпь, крапивница, редко - алопеция, реакции фоточувствительности, мультиформная эритема, синдром Стивенса-Джонсона, токсический эпидермальный некролиз. Нарушения со стороны скелетно- мышечной и соединительной ткани: нечасто - переломы бедра, костей запястья, позвонков, редко - артралгия, миалгия, мышечная слабость. Нарушения со стороны нервной системы: часто - головная боль, нечасто - головокружение, парестезии, сонливость, редко - нарушение вкуса. Нарушения психики: нечасто - бессонница, редко - повышенная возбудимость, агрессивность, нарушение сознания, депрессия, галлюцинации. Нарушения со стороны желудочно-кишечного тракта: часто - абдоминальная боль, запор, диарея, метеоризм, тошнота, рвота, редко - сухость во рту, стоматит, гастроинтестинальный кандидоз, микроскопический колит. Нарушения со стороны печени и желчевыводящих путей: нечасто - повышение активности \"печеночных\" ферментов, редко - гепатит с/без желтухи, печеночная недостаточность, энцефалопатия у пациентов с предшествующими тяжелыми заболеваниями печени. Нарушения со стороны половых органов и молочной железы: редко - гинекомастия. Нарушения со стороны крови и лимфатической системы: лейкопения, тромбоцитопения, агранулоцитоз, панцитопения. Нарушения со стороны иммунной системы: редко - реакции гиперчувствительности: лихорадка, ангионевротический отек, анафилактическая реакция/анафилактический шок. Нарушения со стороны дыхательной системы, органов грудной клетки и средостения: редко - бронхоспазм. Нарушения со стороны почек и мочевыводящих путей: редко - интерстициальный нефрит. Нарушения со стороны органа слуха и лабиринтные нарушения: нечасто - вертиго. Нарушения со стороны органа зрения: редко - нечеткость зрения. Нарушения со стороны обмена веществ и питания: редко - гипонатриемия, очень редко - гипомагниемия, гипокальциемия вследствие тяжелой гипомагниемии, гипокалиемия вследствие гипомагниемии. Общие расстройства: нечасто - недомогание, редко - повышенное потоотделение, периферические отеки."}}]},{"id":9,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"По данным клинических исследований при внутривенном введении до 270 мг препарата за сутки и в дозе до 650 мг за три дня дозозависимых побочных эффектов не было выявлено. Симптомы: спутанность сознания, нечеткость зрения, сонливость, сухость во рту, головная боль, тошнота, тахикардия, аритмия. Лечение: симптоматическое. Гемодиализ недостаточно эффективен."}}]},{"id":10,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"При подозрении на язву желудка на ранних стадиях необходимо пройти рентгеновское или эндоскопическое обследование для установки правильного диагноза и назначения адекватного лечения. При наличии любых тревожных симптомов, таких как значительная спонтанная потеря массы тела, частая рвота, дисфагия, рвота с кровью или мелена, а также при наличии язвы желудка (или при подозрении на язву желудка) следует исключить возможность злокачественного новообразования, поскольку лечение препаратом Омез может привести к сглаживанию симптоматики и отсрочить постановку диагноза. Пациенты с риском развития остеопороза или переломов на его фоне должны находиться под соответствующим клиническим наблюдением, хотя причинно- следственная связь применения омепразола/эзомепразола с переломами на фоне остеопороза не установлена. Вследствие снижения секреции соляной кислоты повышается концентрация хромогранина А (CgA). Повышение концентрации CgA в плазме крови может оказывать влияние на результаты обследований для выявления нейроэндокринных опухолей. Для предотвращения данного влияния терапию ингибиторами протонной помпы необходимо приостановитьза 5 дней до проведения исследования концентрации CgA. Если за это время концентрация CgA не вернулась к нормальному значению, исследование следует повторить."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Специфический ингибитор протонного насоса: тормозит активность Н+/К+-АТФ-азы в париетальных клетках желудка, блокируя заключительную стадию секреции соляной кислоты, тем самым снижает кислотопродукцию. Снижает базальную и стимулированную секрецию независимо от природы раздражителя. Омепразол является пролекарством и активируется в кислой среде секреторных канальцев париетальных клеток желудка. Воздействие является дозозависимым и обеспечивает эффективное ингибирование и базальной, и стимулированной секреции кислоты, независимо от природы стимулирующего фактора. 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