Nolpaz - instructions for use, reviews, analogs and formulations (20 mg and 40 mg tablets) of the drug for the treatment of ulcers, gastritis and gastroesophageal reflux in adults, children and in pregnancy

In this article, you can read the instructions for using the drug Nolpaz. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Nolpazy in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Nolpase in the presence of existing structural analogues. Use for the treatment of ulcers, gastritis and gastroesophageal reflux in adults, children, as well as during pregnancy and lactation.

Nolpaz - antiulcer drug. It inhibits the enzyme H + -K + -ATP-asu (proton pump) in the parietal cells of the stomach and thereby blocks the final stage of the synthesis of hydrochloric acid. This leads to a decrease in the level of basal and stimulated secretion of hydrochloric acid, regardless of the nature of the stimulus.

After a single intake of the drug in a dose of 20 mg, the effect of Pantoprazole develops within the first hour, the maximum effect is achieved after 2-2.5 hours. It does not affect the motility of the gastrointestinal tract. After discontinuation of the drug secretory activity is completely restored after 3-4 days.

Composition

Pantoprazole sodium sesquihydrate + excipients.

Pharmacokinetics

Nolpase is rapidly absorbed from the digestive tract. Bioavailability of the drug is 77%. Simultaneous food intake does not affect the absorption index; there is only a change in the beginning of the drug. Pantoprazole is almost completely metabolized in the liver. Excretion of metabolites (80%) - mainly through the kidneys; the remainder is excreted with bile.

Indications

• Gastroesophageal reflux disease (GERD), incl.erosive-ulcerative reflux esophagitis and associated with GERD symptoms (heartburn, acid regurgitation, pain when swallowing);
• erosive and ulcerative lesions of the stomach and duodenum associated with the intake of NSAIDs;
• peptic ulcer of the stomach and duodenum, treatment and prevention;
• eradication of Helicobacter pylori in combination with two antibiotics;
• Zollinger-Ellison syndrome and other pathological conditions associated with increased gastric secretion.

Forms of release

Tablets of 20 mg and 40 mg.

Instructions for use and dosing regimen

The drug is taken orally. The tablet should be swallowed whole, not chewing and not breaking, squeezed with a small amount of liquid, before meals, usually before breakfast. When taking twice a second dose of the drug is recommended before dinner.

With GERD, incl. erosive-ulcerative reflux esophagitis and associated symptoms (heartburn, acid regurgitation, pain when swallowing) mild, the recommended dose is 20 mg per day, medium and severe - 40-80 mg per day. Relief of symptoms usually occurs within 2-4 weeks. The course of therapy is 4-8 weeks.

For prophylaxis, as well as supporting long-term therapy, appoint 20 mg per day, if necessary, increase the dose to 40-80 mg per day. It is possible to take the drug "on demand" when symptoms occur.

With erosive and ulcerative lesions of the stomach and duodenum associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs), the recommended dose is 40-80 mg per day. The course of therapy is 4-8 weeks.

For the prevention of erosive lesions against the background of prolonged use of NSAIDs - 20 mg each.

For treatment and prevention of peptic ulcer of the stomach and duodenum appoint 40-80 mg per day. The course of treatment for exacerbation of duodenal ulcer is usually 2 weeks, peptic ulcer of the stomach - 4-8 weeks. If necessary, the duration of therapy is increased.

For the eradication of Helicobacter pylori (in combination with antibiotics), the recommended dose is 40 mg 2 times a day in combination with two antibiotics, usually the course of anti-Helicobacter therapy is 7-14 days.

With Zollinger-Ellison syndrome and other pathological conditions associated with increased gastric secretion, the recommended starting dose of prolonged therapy with pantoprazole is 80 mg per day divided into 2 doses.In the future, the daily dose can be titrated depending on the initial level of gastric secretion. Perhaps a temporary increase in the daily dose of pantoprazole to 160 mg with the aim of adequate control of gastric secretion. The duration of therapy is selected individually.

Side effect

• leukopenia, thrombocytopenia;
• abdominal pain;
• diarrhea;
• constipation;
• flatulence;
• nausea, vomiting;
• dry mouth;
• arthralgia;
• myalgia;
• headache;
• dizziness;
• visual impairment (blurred vision);
• depression;
• interstitial nephritis;
• anaphylactic reactions, including anaphylactic shock;
• itching;
• rash;
• hives;
• angioedema;
• Stevens-Johnson syndrome;
• erythema multiforme or Lyell syndrome;
• photosensitization;
• peripheral edema;
• weakness;
• painful tension of the mammary glands.

Contraindications

• dyspepsia of neurotic genesis;
• children under 18 years of age (efficacy and safety not studied);
• hypersensitivity to pantoprazole or other components of the drug;
• It is not recommended for patients with rare hereditary intolerance to fructose (contains sorbitol).

Application in pregnancy and lactation

Experience with Nolpase in pregnant women is limited.During pregnancy and during lactation, you can only use it if the positive effect for the mother justifies the possible risk to the fetus and the baby. There is no data on the isolation of pantoprazole with breast milk.

special instructions

Before the start of therapy, it is necessary to exclude the presence of malignant neoplasm (endoscopic control, if necessary with biopsy - especially with stomach ulcer), since treatment, masking the symptoms, can delay the setting of the correct diagnosis.

If, after 4 weeks of pantoprazole therapy, the patient does not have the desired curative effect, he should undergo a second examination.

Like other inhibitors of the proton pump, Nolpaz can reduce the absorption of cyanocobalamin (vitamin B12) against hypo- and achlorhydria. Especially it should be considered in long-term treatment and in patients with risk factors for vitamin B12 deficiency.

Long-term therapy, especially for longer than 1 year, requires regular monitoring of the patient.

Impact on the ability to drive vehicles and manage mechanisms

The drug does not affect the ability to drive a car or other technical means.

Drug Interactions

Nolpase reduces the absorption of drugs whose bioavailability depends on the pH of the stomach and is absorbed at acidic pH values ​​(eg, ketoconazole).

Nolpase is metabolized in the liver by the cytochrome P450 enzyme system. It is impossible to exclude interactions of pantoprazole with drugs that are metabolized by the same system. Nevertheless, no significant interactions with digoxin, diazepam, diclofenac, ethanol, phenytoin, glibenclamide, carbamazepine, caffeine, metoprolol, naproxen, nifedipine, piroxicam, theophylline and oral contraceptives have not been revealed in clinical studies.

Although no significant interactions were detected in clinical pharmacokinetic studies with simultaneous use with warfarin, several separate reports of changes in MHO were noted. In patients receiving coumarin anticoagulants, concurrent with pantoprazole, it is recommended to monitor prothrombin time or MHO regularly.

At simultaneous reception of pantoprazole with antacids of any medicinal interactions is not registered.

Analogues of the drug Nolpaz

Structural analogs for the active substance:

• Zipantola;
• Controllers;
• Crosatide;
• Pantaz;
• Panum;
• Pepazol;
• Пиженума сановель;
• Puloreph;
• Sunpras;
• Ulter.

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