Omeprazole as an over-the-counter treatment for heartburn

Omeprazole is an antisecretory drug used in the treatment of peptic ulcers and erosive-inflammatory diseases of the upper gastrointestinal tract. Acting at the molecular level, Omeprazole suppresses the production and reduces the damaging effect of hydrochloric acid on the gastric mucosa, restores the pH of gastric juice and reduces its activity after meals.

The drug is used for stomach ulcers

By provoking a persistent decrease in acidity, the drug creates optimal conditions for the destruction of H. pylory, which is often the cause of gastritis and peptic ulcers. It is worth noting that Omeprazole becomes active only when it enters the acidic environment of the stomach.

Omeprazole not only significantly improves the well-being of patients, causes a rapid regression of diseases of the stomach and/or duodenum caused by acid disorders, and reduces the likelihood of relapse and the development of complications. Its action begins within 1 hour after ingestion and continues throughout the day.

Pharmacodynamics

Omeprazole inhibits the enzyme H+-K+-ATPase (“proton pump”) in the parietal cells of the stomach and thereby blocks the final stage of hydrochloric acid synthesis. This leads to a decrease in the level of basal and stimulated secretion, regardless of the nature of the stimulus. After a single oral dose of the drug, the effect of omeprazole occurs within the first hour and continues for 24 hours, the maximum effect is achieved after 2 hours. In patients with duodenal ulcer, taking 20 mg of omeprazole maintains intragastric pH = 3 for 17 hours. After stopping the intake of the drug, secretory activity is completely restored after 3–5 days.

Prevention of ulcers and gastritis

• All prevention of gastritis and ulcers is aimed at protecting the stomach and gastrointestinal tract as a whole from unfavorable factors that can become a trigger for the development of gastritis and ulcers. The very first thing is a balanced diet, in which “harmful” foods are excluded or strictly limited: fried foods, smoked and spicy foods, spices, semi-cooked and raw dishes from meat, poultry and fish, alcohol and smoking.

Important: Tobacco smoke spreads throughout the circulatory system instantly and, having a negative effect on blood vessels, can cause spasm, including spasm of the stomach vessels. Which can worsen the quality of the organ’s work.

• The temperature of the food is also important. Too cold or too hot - drinks and solid foods can injure not only the gastric mucosa, but also the esophagus. Which can also cause serious illness.
• The diet in general is also important. Long hungry breaks, constant overeating to the point of “breathing hard”, different meal times, eating before bed - all this is a sure harbinger of imminent problems not only with the stomach, but also with the nervous system.
• Important: do not overuse medications and reach for the first aid kit at the slightest provocation. Uncontrolled use of vitamins, medications and dietary supplements is also a direct path to gastrointestinal disorders.

Interesting Facts:

• It takes 7-10 seconds for food to enter the stomach.
• The stomach of an adult can hold 1.5 liters of liquid
• The stomach is not able to “stretch”. Even after overeating, he is able to return to his true size.
• The muscles of the stomach are so strong that even if we eat upside down, the food will fall where it is needed and remain there.
• The concentration of hydrochloric acid in the stomach is so high that if there were no protective substances in the gastric juice and mucous membrane, it would burn out its own stomach. The stomach acidity coefficient (pH) is 1.2. Which allows you to digest small bones, wood and even plastic!
• The stomach is very closely connected with the parts of the brain that are responsible for emotions. Thus, our emotions can directly influence the functioning of the stomach. The psychosomatics of stomach diseases says that if there is a disease, it means that a person does not “digest” the situation or people in his life well.

So keep an eye on your emotions to stay healthy and happy!

Pharmacokinetics

Omeprazole is rapidly absorbed from the gastrointestinal tract, Cmax in plasma is achieved in 0.5–1 hour. Bioavailability is 30–40%. Plasma protein binding is about 90%. Omeprazole is almost completely metabolized in the liver. T1/2 - 0.5–1 hour. Excreted mainly by the kidneys in the form of metabolites. In chronic renal failure, excretion decreases in proportion to the decrease in creatinine clearance. In elderly patients, excretion decreases and bioavailability increases. In case of liver failure, bioavailability is 100%, T1/2 is 3 hours.

Contraindications

Omeprazole should not be taken in the following cases:

• individual intolerance to the components of the drug;
• pregnancy and lactation;
• age up to 5 years;
• severe forms of liver and kidney failure (with caution);
• malignant tumors of the digestive tract;
• gastrointestinal infections (Omeprazole may increase their reproduction);
• osteoporosis (Omeprazole leaches calcium from bones).

As for osteoporosis, in extreme cases, the attending physician may prescribe complex therapy, including calcium supplements and vitamin D.

The drug should not be taken during pregnancy

Omeprazole also helps reduce the acidity of gastric juice. In this regard, it is not prescribed for gastritis with low acidity and atrophic gastritis.

Side effects

In rare cases, the following usually reversible side effects may occur.

From the digestive system: diarrhea or constipation, nausea, vomiting, flatulence, abdominal pain, dry mouth, taste disturbances, stomatitis, transient increase in the level of liver enzymes in plasma; in patients with previous severe liver disease - hepatitis (including jaundice), impaired liver function.

From the nervous system: headache, dizziness, agitation, drowsiness, insomnia, paresthesia, depression, hallucinations; in patients with severe concomitant somatic diseases, in patients with previous severe liver disease - encephalopathy.

From the musculoskeletal system: muscle weakness, myalgia, arthralgia.

From the hematopoietic system: leukopenia, thrombocytopenia; in some cases - agranulocytosis, pancytopenia.

From the skin: itching; rarely (in some cases) - photosensitivity, erythema multiforme, alopecia.

Allergic reactions: urticaria, angioedema, bronchospasm, interstitial nephritis and anaphylactic shock.

Other: blurred vision, peripheral edema, increased sweating, fever, gynecomastia; rarely - the formation of gastric glandular cysts during long-term treatment (a consequence of inhibition of hydrochloric acid secretion, which is benign and reversible).

Omeprazole

Omeprazole

(lat.
omeprazole
) - antiulcer drug, proton pump inhibitor.

Omeprazole is a chemical compound

As a chemical compound, omeprazole is a derivative of benzimidazole and has the following name: (RS)-6-Methoxy-2-[[(4-methoxy-3,5-dimethyl-2-pyridinyl)methyl]sulfinyl]-1H-benzimidazole. The empirical formula is C17H19N3O3S. Characteristics of omeprazole
: white or off-white crystalline powder, highly soluble in ethanol and methanol, slightly soluble in acetone and isopropanol, very slightly soluble in water. It is a weak base, its stability depends on the acidity of the environment: it undergoes rapid degradation in an acidic environment, but is relatively stable in an alkaline environment.

Omeprazole is a medicine

Omeprazole is the international nonproprietary name (INN) of the drug.
According to the pharmacological index, it belongs to the group “Proton pump inhibitors”. According to ATC, it belongs to the group “Proton pump inhibitors” and has the code A02BC01. "Omeprazole"

, in addition, the trade name of a number of drugs.

Indications for use of omeprazole

• peptic ulcer of the stomach and duodenum (acute phase and anti-relapse treatment), incl. associated with Helicobacter pylori
  (only as part of combination therapy!)
• reflux esophagitis
• erosive and ulcerative lesions of the stomach and duodenum associated with taking NSAIDs, stress ulcers
• Zollinger-Ellison syndrome.

Method of administration of omeprazole and dose

• Orally,
  before meals, with a small amount of water (the contents of the capsule must not be chewed).
• Duodenal ulcer in the acute phase
  - 20 mg/day for 2-4 weeks (in resistant cases - up to 40 mg/day).
• Gastric ulcer in the acute phase and erosive-ulcerative esophagitis
  - 20-40 mg/day for 4-8 weeks.
• Erosive and ulcerative lesions of the gastrointestinal tract caused by taking NSAIDs
  - 20 mg/day for 4–8 weeks.
• Eradication of Helicobacter pylori
  - 20 mg 2 times a day for 7 or 14 days (depending on the treatment regimen used) in combination with antibacterial agents (see also Standards for the diagnosis and treatment of acid-dependent and
  Helicobacter pylori-
  diseases, which include and other eradication schemes).
• Anti-relapse treatment of gastric and duodenal ulcers
  - 10–20 mg/day.
• Anti-relapse treatment of reflux esophagitis
  - 20 mg/day for a long time. Available upon request.
• Zollinger-Ellison syndrome
  - the dose is selected individually depending on the initial level of gastric secretion, usually starting from 60 mg/day. If necessary, the dose is increased to 80–120 mg/day, in which case it is divided into 2 doses.
• In patients with severe liver failure, the daily dose should not exceed 20 mg.

Omeprazole is not used to eradicate Helicobacter pylori without simultaneous use of antibiotics (that is, outside of special eradication regimens).

Publications for healthcare professionals regarding the use of omeprazole

• Maev I.V., Vyuchnova E.S., Shchekina M.I. Experience of using OMEPRAZOLE ULTOP (“KRKA”, Slovenia) in patients with duodenal ulcer. MGMSU.

• Vasiliev Yu.V. Omeprazole in the treatment of gastroesophageal reflux disease and peptic ulcer of the stomach and duodenum // RMJ. – 2007. – T. 15. – No. 4.
• Gorbakov V.V., Makarov Yu.S., Golochalova T.V. Comparative characteristics of antisecretory drugs of various groups according to daily pH monitoring // Attending physician. 2001. – No. 5–6.
• Khavkin A.I., Zhikhareva N.S. Clinical experience with the use of omeprazoles from different manufacturers // Application of Consulium Medicum. Gastroenterology. 2012. No. 2. pp. 72–75.
• Bestebreurtje P., de Koning B.A.E., Roeleveld N., et al. Rectal Omeprazole in Infants With Gastroesophageal Reflux Disease: A Randomized Pilot Trial. European Journal of Drug Metabolism and Pharmacokinetics (2020) 45:635–643.. — Abstract in Russian
  .

On the website GastroScan.ru in the “Literature” section there is a subsection “Omeprazole”, containing publications by healthcare professionals addressing the treatment of gastrointestinal diseases with omeprazole.

Contraindications to the use of omeprazole

• hypersensitivity to omeprazole
• pregnancy
• lactation
• simultaneous use with erlotinib, posaconazole *)

Restrictions on the use of omeprazole

• chronic liver diseases
• childhood (exception - Zollinger-Ellison syndrome)
• Long-term use of omeprazole or use in large doses increases the risk of hip, wrist and spine fractures (“FDA warning”).

Omeprazole therapy has no effect on driving Due to decreased secretion of hydrochloric acid, the concentration of chromogranin A (CgA) increases. Increased concentrations of CgA in blood plasma may affect the results of examinations to detect neuroendocrine tumors. To prevent this effect, it is necessary to temporarily stop taking omeprazole 5 days before the CgA concentration test *)

Use of omeprazole during pregnancy and breastfeeding

Taking omeprazole to treat GERD during the first trimester of pregnancy more than doubles the risk of having a baby with heart defects (GI & Hepatology News, August 2010).
During pregnancy, taking omeprazole is possible only for health reasons. The FDA category of risk to the fetus when treating a pregnant woman with omeprazole is “C”. Breastfeeding should be stopped during treatment with omeprazole.

At the same time, there is a position of the Ministry of Health of the Russian Federation: “Omeprazole is approved for use during pregnancy and during breastfeeding, in children over 2 years of age for the treatment of gastroesophageal reflux disease, in children over 4 years of age for the treatment of duodenal ulcers caused by Helicobacter pylori

» *).

MAPS form of omeprazole

AstraZeneca, the “successor” of Astra, which developed omeprazole, has created and patented a new dosage form of omeprazole, called its Multiple Unit Pellet System
, abbreviated MUPS or, in Russian, MAPS.

MAPS tablets contain about 1000 acid-resistant microcapsules, the tablet quickly disintegrates in the stomach into microcapsules protected from the acidic environment, then enters the small intestine, where, under the influence of alkaline pH, the microcapsules dissolve, omeprazole is released and absorbed. The MAPS form provides better delivery of omeprazole to the parietal cell, and as a result, a predictable and reproducible antisecretory effect. For erosive and ulcerative lesions of the gastroduodenal zone, MAPS tablets are as effective as omeprazole capsules. MAPS omeprazole can be dissolved in water or juice, which provides ease of use. The possibility of administering dissolved MAPS tablets through a nasogastric tube is especially relevant for seriously ill patients - the contingent of intensive care units, in whom the prevention of acute ulcers and erosions is an urgent task (Lapina T.L.).

Comparison of omeprazole with other proton pump blockers

Currently, there is no consensus among gastroenterologists regarding the comparative effectiveness of specific types of proton pump inhibitors.
Some of them argue that, despite the differences that exist between PPIs, today there is no strict evidence to judge the effectiveness of any PPI in relation to others that is noticeable for the average patient (Vasiliev Yu.V. et al.). Also, a number of gastroenterologists believe that during eradication, the type of PPI used in combination with antibiotics does not matter (Nikonov E.K., Alekseenko S.A.). Others argue that, for example, esomeprazole is fundamentally different from the other four PPIs: omeprazole, pantoprazole, lansoprazole and rabeprazole (Lapina T.L., Demyanenko D., etc.). Still others write that the antisecretory effect of Losec MAPS (omeprazole MAPS) and Pariet (rabeprazole), according to 24-hour pH measurements, is significantly superior to Nexium (esomeprazole) (Ivashkin V.T. et al.). According to Bordin D.S., the effectiveness of all PPIs for long-term treatment of GERD is similar. In the early stages of therapy, lansoprazole has some advantages in the speed of onset of effect, which potentially increases patient adherence to treatment. If it is necessary to take several drugs for the simultaneous treatment of different diseases, pantoprazole is the safest.

The differences in the antisecretory effect of lansoprazole and omeprazole are explained by the fact that the half-life of lansoprazole and omeprazole is 1.3 and 0.7 hours, respectively. The bioavailability of lansoprazole is more than 85% with the first dose and remains constant with repeated doses. When taking the first dose of omeprazole, bioavailability is only 35%, with repeated doses it increases by the third to fifth day to 60%. In addition, omeprazole is metabolized in the liver primarily by the CYP2C19 isoform of the cytochrome P450 system, and lansoprazole is additionally metabolized by the CYP3A4 isoenzyme. As a result, when taking omeprazole, a more pronounced variability of the antisecretory effect is observed depending on the heterogeneity of the CYP2C19 gene (Alekseenko S.A.).

In countries - former republics of the USSR, omeprazole is widely available in generic versions. Prices for generic omeprazole are much lower than the prices for original drugs, such as Losek, Losek MAPS, Pariet or Nexium, which is of no small importance for the patient and often determines the choice of drug based on financial capabilities, especially for long-term use. Due to possible differences in the quality of drugs, an objective assessment of their clinical effectiveness is often necessary. Currently, 24-hour monitoring of intragastric pH levels is an objective and accessible method for testing antisecretory agents in clinical practice (Alekseenko S.A.).

Comparison of different omeprazole preparations

There are studies proving the advantages of some omeprazole drugs over others. For example, in a study by Khavkin A.I. and Zhikhareva N.S. it was concluded that:

1. Generic omeprazole Ortanol and Omez effectively relieve the clinical symptoms of acid-related diseases in children.
2. A single dose of Ortanol is more effective in comparison with Omez according to 24-hour pH measurements.
3. Relief of clinical symptoms when taking the drug Ortanol occurs earlier than when taking Omez.
4. Relief of symptoms on the 14th day is more complete when taking the drug Orthanol than Omeza.
5. Both drugs are well tolerated.

Night Acid Breakthrough

Omeprazole, like other proton pump inhibitors, is characterized by the phenomenon of “night acid breakthrough” - a phenomenon in which, at night, regardless of the dose of the drug, there is a prolonged, more than hour, increase in acidity in the stomach (pH < 4), which sometimes makes therapy acid-related diseases are less effective.
Prof. O.A. Sablin talks about the phenomenon of “night acid breakthrough” (conference “Esophagus-2014

«)

Omeprazole resistance

The widespread use of omeprazole has determined the emergence of the term “omeprazole resistance” in modern gastroenterology, denoting the ineffectiveness of omeprazole therapy in individual patients. Resistance to omeprazole is understood as maintaining a pH in the body of the stomach below 4 for more than 12 hours with daily pH monitoring despite taking a standard dose of the drug twice. Resistance to any proton pump inhibitor is a relatively rare phenomenon and the hypothesis of its presence must be confirmed by excluding other, more common causes of ineffectiveness. The reasons for omeprazole resistance are still not fully understood. An abnormal structure of the proton pump in certain individuals is assumed, which does not allow the binding of molecules (Belmer S.V.).

Frame “Omeprazole resistance” from a video lecture for 3rd year students of the Faculty of Medicine of PSPbSMU named after. acad. I.P. Pavlova: Melnikov K.N. Drugs affecting the gastrointestinal tract

On the website in the “Video” section there is a subsection for patients “Popular Gastroenterology” and subsections “For Doctors” and “For Medical Students and Residents”, containing video recordings of reports, lectures, webinars in various areas of gastroenterology for healthcare professionals and medical students.

Interaction of omeprazole with other drugs

Omeprazole changes the bioavailability of any drug whose absorption depends on the acidity of the medium (ketoconazole, iron salts, etc.).
Slows down the elimination of drugs metabolized in the liver by microsomal oxidation (warfarin, diazepam, phenytoin, etc.). Omeprazole enhances the effect of coumarins and diphenin, but does not change the effect of NSAIDs. May increase the leukopenic and thrombocytopenic effects of drugs that inhibit hematopoiesis. The substance for intravenous infusion is compatible only with saline and dextrose solution (when using other solvents, the stability of omeprazole may decrease due to changes in the acidity of the infusion medium).

If it is necessary to take proton pump inhibitors and clopidogrel simultaneously, the American Heart Association recommends taking pantoprazole instead of omeprazole (Bordin D.S.).

When methotrexate was co-administered with proton pump inhibitors, a slight increase in plasma methotrexate concentrations was observed in some patients. When treated with high doses of methotrexate, omeprazole should be temporarily discontinued. When omeprazole is taken together with clarithromycin or erythromycin, the concentration of omeprazole in the blood plasma increases. Co-administration of omeprazole with amoxicillin or metronidazole does not affect the concentration of omeprazole in the blood plasma. There was no effect of omeprazole on antacids, theophylline, caffeine, quinidine, lidocaine, propranolol, ethanol.*)

Clarithromycin 500 mg 3 times a day in combination with omeprazole at a dose of 40 mg per day helps to increase the half-life T½ and AUC24 of omeprazole. In all patients receiving combination therapy, compared with those receiving omeprazole alone, there was an 89% increase in AUC24 and a 34% increase in T½ of omeprazole. For clarithromycin, Cmax, Cmin and AUC8 increased by 10, 27 and 15%, respectively, compared with data when clarithromycin alone was used without omeprazole. At steady state, clarithromycin concentrations in the gastric mucosa 6 hours after administration in patients receiving the combination were 25 times higher than those in patients receiving clarithromycin alone. Concentrations of clarithromycin in gastric tissue 6 hours after taking the two drugs were 2 times higher than data obtained in patients receiving clarithromycin alone.

Trade names of drugs with the active substance omeprazole

The following drugs are (were) registered in Russia: Bioprazole, Vero-Omeprazole, Gastrozol, Demeprazole, Zhelkizol, Zerotsid, Zolser, Chrismel, Lomak, Losek, Losek MAPS, Omal, Omegast, Omez, Omez Insta, Omezol, Omecaps, Omepar, Omeprazole, Omeprazole pellets, Omeprazole-AKOS, Omeprazole-Akri, Omeprazole-E.K., Omeprazole Zentiva, Omeprazole-Richter, Omeprazole Sandoz, Omeprazole-FPO, Omeprazole-Stada, Omeprazole-OBL, Omeprazole-SZ, Omeprazole-Teva, Omeprazole-Yukea, Omeprol, Omeprus, Omefez, Omizak, Omipix, Omitox, Ortanol, Otsid, Pepticum, Pleom-20, Promez, Risek, Romesek, Sopral, Ulzol, Ulkozol, Ultop, Helitsid, Helol, Cisagast.
On the pharmaceutical markets of the countries of the former republics of the USSR, a number of drugs with the active substance omeprazole are presented, which are not registered in Russia, in particular: Gasek (Mepha Lda, Switzerland), Losid (Flamingo Pharmaceutical, India), Omeprazole-Astrapharm (TOV Astrapharm, Ukraine ), Omeprazole-Darnitsa (CJSC Pharmaceutical Company Darnitsa, Ukraine), Omeprazole-KMP (JSC Kievmedpreparat, Ukraine), Omeprazole-Lugal (Lugansk Chemical Pharmaceutical Plant, Ukraine), Onex (Aarya Lifesciences Pvt. Ltd., India), Tserol (Neon Antibiotics Private Limited, India) and others.

A branded medicine with the active ingredient omeprazole on the US and Canadian markets is Prilosec (formerly called Losec). This brand is sold in Russia under the trademarks Losek Maps and Losek, in Germany, Italy and Switzerland - under the trademarks Antra and Antra MUPS.

In each of the developed countries, a large number of different drugs from different manufacturers with the active substance omeprazole are registered. For example, in Spain, omeprazole is sold (sold) under the trade names: Losec, Arapride, Audazol, Aulcer, Belmazol, Ceprandal, Dolintol, Elgam, Emeproton, Gastrimut, Miol, Norpramin, Novek, Nuclosina, Omapren, Omeprazol Abdrug, Omeprazol Accord, Omeprazol Actavis, Omeprazol Acygen, Omeprazol Almus, Omeprazol Alter, Omeprazol Apotex, Omeprazol Aristo, Omeprazol Asol, Omeprazol Aurobindo, Omeprazol Bexal, Omeprazol Biotecnet, Omeprazol Cinfa, Omeprazol Cinfamed, Omeprazol Combino Pharm, Omeprazol Combix, O meprazol Cuve, Omeprazol Cuvefarma, Omeprazol Davur , Omeprazol Desgen, Omeprazol EDG, Omeprazol Edigen, Omeprazol Esteve, Omeprazol Genericos Juventus, Omeprazol GES, Omeprazol Kern Pharma, Omeprazol Korhispana, Omeprazol Lareq, Omeprazol Liconsa, Omeprazol Mabo, Omeprazol Mede, Omeprazol Mylan, Omeprazol Normon, Omeprazol Nupral, Omeprazol Onedose , Omeprazol Ortodrol, Omeprazol Pensa, Omeprazol Pharmagenus, Omeprazol Placasod, Omeprazol Qualigen, Omeprazol Ranbaxy, Omeprazol Ratio, Omeprazol Rimazol, Omeprazol Rubio, Omeprazol Sandoz, Omeprazol Serraclinics, Omeprazol STADA, Omeprazol Sumol, Omeprazol Tar bis, Omeprazol Tecnigen, Omeprazol Teva, Omeprazol Tevagen, Omeprazol Ulcometion, Omeprazol Urlabs, Omeprazol Vir, Ompranyt, Parizac, Pepticum, Prysma, Ulceral, Ulcesep, Zimor and others.

By Order of the Government of the Russian Federation of December 30, 2009 No. 2135-r, omeprazole (capsules; lyophilisate for the preparation of a solution for intravenous administration; lyophilisate for the preparation of a solution for infusion; film-coated tablets) is included in the List of vital and essential medicines.

Instructions for medical use of omeprazole

Instructions from some manufacturers of medications containing omeprazole as the only active ingredient (pdf):

• For Russia:
• instructions for use of the drug Omez (enteric capsules, 10 mg), approved by the Ministry of Health of Russia on May 30, 2016.
• instructions for use of the drug Omeprazole-Teva (enteric capsules, 10, 20 and 40 mg), approved by the Ministry of Health of Russia on May 18, 2016.
• instructions for use of the drug Omeprazole-Ukea (lyophilisate for the preparation of solution for infusion)
• instructions for use of the drug Omeprazole-Akri, capsules containing 20 mg of omeprazole, JSC Akrikhin
• instructions for use of the drug Ultop (enteric capsules, 10 and 40 mg); changes No. 1 from 08/01/2011 to the instructions for use of the medicinal product Ultop (enteric capsules, 10 and 40 mg)
• information for healthcare professionals regarding the drug Omeprazole-Richter, capsules containing 20 mg of omeprazole, Gedeon Richter

• instructions for medical use of the drug Omeprazole, capsules containing 20 mg of omeprazole, OJSC "Kievmedpreparat"

• instructions (medical guide) for patients “Medication Guide Prilosec (omeprazole) Delayed-Release Capsules, Prilosec (omeprazole magnesium) for Delayed-Release Oral Suspensions”, AstraZeneca Pharmaceuticals LP, February 2014.

Omeprazole in the USA

Branded omeprazole in the USA is Prilosec.
In addition to it, a number of generics of omeprazole are sold in the United States. OTC (over-the-counter) in the USA Prilosec OTC and Omeprazole differ from prescription ones in the reduced amount of omeprazole in one tablet (capsule) - 20 mg. In addition, Zegerid, a drug with the active ingredient omeprazole + sodium bicarbonate, is presented on the US market. Its over-the-counter option is Zegerid OTC.

In the United States, the number of prescriptions for omeprazole is increasing annually. In 2011, omeprazole was the sixth-largest prescription drug sold in the U.S. in 2011, ahead of all digestive system drugs (although it is behind esomeprazole Nexium in terms of sales in 2011):

Note.
*) Letter of the Ministry of Health of Russia dated August 15, 2014 No. 20-2/10/2-6169. On amendments to the instructions for use of medicinal products registered in the Russian Federation for medical use containing omeprazole as an active substance. Omeprazole has contraindications, side effects and application features; consultation with a specialist is necessary. Back to section

Directions for use and doses

Orally, with a small amount of water (the contents of the capsule must not be chewed).

Duodenal ulcer in the acute phase - 1 caps. (20 mg) per day for 2–4 weeks (in resistant cases - up to 2 capsules per day).

Gastric ulcer in the acute phase and erosive-ulcerative esophagitis - 1-2 caps. per day for 4–8 weeks.

Erosive and ulcerative lesions of the gastrointestinal tract caused by taking NSAIDs - 1 caps. per day for 4–8 weeks.

Eradication of Helicobacter pylori - 1 caps. 2 times a day for 7 days in combination with antibacterial agents.

Anti-relapse treatment of gastric and duodenal ulcers - 1 caps. per day.

Anti-relapse treatment of reflux esophagitis - 1 caps. per day for a long time (up to 6 months).

Zollinger-Ellison syndrome - the dose is selected individually depending on the initial level of gastric secretion, usually starting from 60 mg/day. If necessary, the dose is increased to 80–120 mg/day, in which case it is divided into 2 doses.

Indications

Omeprazole has wide indications for diseases of the upper gastrointestinal tract. The drug is usually prescribed to adults and children over 5 years of age in the following cases:

• stomach and duodenal ulcers;
• erosive and ulcerative esophagitis;
• NSAID gastropathy (ulcerative process resulting from potentiated use of non-steroidal anti-inflammatory drugs);
• Zollinger-Ellinson syndrome;
• systemic mastocytosis;
• polyendocrine adenomatosis;
• stress, aspirin and chronic duodenal ulcers of the digestive tract;
• therapy for reflux esophagitis (including long-term treatment of patients with an inactive form of the disease);
• treatment of symptomatic GERD;
• treatment of ulcerogenic adenoma of the pancreas;
• eradication of H. pylori in peptic ulcer disease (in combination with appropriate antibacterial agents);
• to eliminate uncomplicated heartburn that lasts more than 2 days during the week.

special instructions

Before starting therapy, it is necessary to exclude the presence of a malignant process (especially with a stomach ulcer), because Treatment, masking symptoms, can delay the correct diagnosis.

Taking with food does not affect effectiveness.

If you have difficulty swallowing a whole capsule, you can swallow its contents after opening or dissolving the capsule, or you can mix the contents of the capsule with a slightly acidified liquid (juice, yogurt) and use the resulting suspension for 30 minutes.

In patients with severe liver failure, the daily dose should not exceed 20 mg.

Omeprazole analogues

The high effectiveness and positive recommendations of Omeprazole naturally pushed the pharmaceutical market to offer analogues and generic drugs that contain the same main active ingredient, but differ in price, contraindications and side effects. So, in the pharmacy you can find:

Synonyms (based on the same active ingredient as Omeprazole): Omeprazole-Acri, Omeprazole-Teva, Gastrozole, Omeprazole-STADA, Zerocid, Omez, Omipix, Omitox, Omizak, Omeprazole-Richter, Promez, Ultop, Helitsid.

Omeprazole analogues

Analogs (drugs with a similar therapeutic effect): Helicol, Crosacid, Lansofed, Lancid, Pariet, Parkour, Ontime, Nolpaza, Nexium, Ulthera, Epicurus, Neo-Zext, Razo, Peptazol, Pantoprazole, Rabeprazole, De-Nol, Esomeprazole.

Omez or Omeprazole?

Often, to treat certain problems with the gastrointestinal tract, the attending physician can prescribe medications or replace drugs that seem to be similar in composition and therapeutic effect with one another. A reasonable question arises: which is better - Omez or Omeprazole? Both drugs are based on the same active ingredient - omeprazole - which enters the acidic environment of the stomach and affects its mucous membranes. This determines the similarity of the therapeutic effect.

Therefore, the treatment regimen according to which Omez or Omeprazole should be taken for gastritis or ulcers is identical.

The difference between the drugs is the presence of auxiliary components. This should not be underestimated, because the patient may be allergic to some of them, or this will provoke an adverse reaction.

Also, Omeprazole represents the active substance in the maximum volume, and Omez is a drug that contains omeprazole and excipients that mitigate side effects and help the perception of the medicine.

As a result, the choice between these two drugs must be made by the doctor, based on the course of the disease, the severity of its symptoms and the individual indications of the patient.