Domperidone, Omeprazole

Pharmacological properties

combined drug, the effect of which is due to the components that make up its composition.

Omeprazole refers to antiulcer drugs that inhibit basal and stimulated secretion of hydrochloric acid in the lining cells of the stomach due to specific blocking of H⁺/ K⁺-ATPase (proton pump). The antisecretory effect of omeprazole develops during the first hour after administration and persists throughout the day. Omeprazole due to its high lipophilicity easily penetrates into the parietal cells of the stomach, concentrates in them and has a cytoprotective effect. The inhibitory effect increases in the first 4 days of administration. Omeprazole does not affect gastrointestinal motility.

Domperidone blocks peripheral dopamine receptors, eliminates the inhibitory effect of dopamine on the motor function of the gastrointestinal tract, in particular, stimulates the motor-evacuation activity of the stomach. Eliminates nausea and hiccups, has an antiemetic effect. It penetrates poorly through the BBB and practically does not affect dopamine receptors in the brain.

Pharmacokinetics has not been studied.

Indications

Treatment of peptic ulcer of the stomach and duodenum in the absence of h. pylori, with delayed evacuation of the contents of the stomach, gastroparesis, reflux esophagitis, functional dyspepsia.

Application

Capsules are taken whole inside, without opening and not chewing. the recommended dose and duration of the course of treatment depend on the course of the disease and are set individually. The average recommended dose for adults and children over the age of 12 years is 1 capsule 1 time per day 10-15 minutes before meals (drink with a glass of water).

In elderly patients and patients with renal failure, an individual approach to dose selection is required, however, in many cases, dose adjustment is not required.

Contraindications

Hypersensitivity to the components of the drug, gastrointestinal bleeding, mechanical intestinal obstruction, perforation of the stomach or intestines, prolactinoma, period of pregnancy and lactation, age up to 12 years.

Side effects

Most patients tolerate the drug well. with prolonged use, skin reactions (rash, itching, urticaria, erythema multiforme) may be noted; dry mouth, diarrhea, constipation, intestinal colic, headache, photosensitivity, alopecia, Quinckes edema, dizziness, paresthesia, drowsiness, insomnia, blurred vision, change in taste, agitation, depression, leukopenia, thrombocytopenia, pancytopenia, myranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulocytes, agranulcy, arthralgia, bronchospasm, interstitial nephritis, very rarely - galactorrhea, gynecomastia. domperidone may cause the development of extrapyramidal disorders, especially in elderly patients.

special instructions

Before and after the completion of omeprazole therapy, an endoscopic examination is necessary to exclude cases of an undiagnosed malignant process, since treatment with omeprazole can mask the symptoms and delay the correct diagnosis.

Patients with chronic liver diseases need to constantly (at least 1 time in 2 weeks) conduct laboratory blood tests to determine the activity of liver enzymes. In case of changes in these indicators, the drug should be discontinued.

During treatment with the drug, care must be taken when driving vehicles or working with complex mechanisms.

Interactions

Antacid preparations slow down and reduce the absorption of the limser, so they should be used no earlier than 2 hours after its administration.

Since omeprazole metabolism is carried out in the liver through the cytochrome P450 system, it is necessary to take it with caution with diazepam, phenytoin, warfarin, propranolol, prednisolone, theophylline (while omeprazole can reduce their elimination, which requires lower doses of these drugs). With the simultaneous use of omeprazole and clarithromycin, their concentration in the blood plasma increases.

Cimetidine and sodium bicarbonate reduce the bioavailability of domperidone.

Anticholinergics neutralize the effect of domperidone.

Overdose

Symptoms: drowsiness, disorientation, vomiting, tachycardia, extrapyramidal disorders.

Treatment: the use of activated carbon, symptomatic therapy.

Storage conditions

In a dry, dark place at temperatures up to 25 ° C.