Kwamatel - instructions for use, reviews, analogs and formulations (tablets 10 mg mini, 20 mg and 40 mg, injections in ampoules for intravenous injection in solution) drug for the treatment of ulcers and gastritis in adults, children and pregnancy

In this article, you can read the instructions for using the drug Kwamatel. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Kwamatel in their practice are presented. 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 Kwamatel in the presence of existing structural analogs.Use to treat stomach and duodenal ulcers and gastritis in adults, children, as well as during pregnancy and lactation.

Kwamatel - blocker of histamine H2-receptors. Reduces the basal and stimulated gastrin, pentagastrin, betazol, caffeine, histamine, acetylcholine and physiological vagal reflex secretion of hydrochloric acid. This increases the pH and reduces the activity of pepsin. Virtually does not affect fasting gastrin levels after eating. Does not affect gastric motility, exocrine pancreatic activity, blood circulation in the portal system, hormone levels, does not have an antiandrogenic effect.

Famotidine (the active substance of the drug Kwamatel) has little effect on microsomal enzymes of the liver.

After taking the drug inside the action occurs after 1 hour, the maximum of the action - 3 hours after the administration, the duration of the effect varies within 12-24 hours, depending on the dose.

After intravenous administration, the maximum effect occurs within the first 30 minutes. The drug in the form of lyophilizate for the preparation of a solution for intravenous administration after administration in a single dose of 20 or 40 mg in the evening inhibits basal and nightsecretion for 10-12 hours.

Composition

Famotidine + excipients.

Pharmacokinetics

After oral administration, it is not absorbed completely from the digestive tract. Bioavailability - 40-45%, increases with simultaneous intake of food and decreases with simultaneous administration of antacids. Binding to plasma proteins is 10-20%. Penetrates through the placental barrier and through the blood-brain barrier (BBB). Excreted in breast milk. 30-35% of the drug is metabolized in the liver to form an S-oxide. After oral administration of 30-35% famotidine, and after intravenous administration of 65-70% of Famotidine is excreted in the urine unchanged.

Indications

• peptic ulcer of the duodenum and stomach in the phase of exacerbation, prevention of relapses;
• treatment and prevention of symptomatic gastric and duodenal ulcers (associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs), stressful, postoperative ulcers);
• erosive gastroduodenitis;
• functional dyspepsia associated with increased secretory function of the stomach;
• reflux esophagitis;
• Zollinger-Ellison syndrome;
• prevention of recurrence of bleeding from the upper gastrointestinal tract;
• prevention of aspiration of gastric juice in general anesthesia (Mendelssohn syndrome);
• symptomatic treatment of dyspepsia associated with high acidity of gastric juice (heartburn, acidic eructation, etc.) (Kwamatel mini).

Forms of release

Tablets coated with 10 mg (Kwamatel mini), 20 mg and 40 mg.

Lyophilizate for the preparation of a solution for intravenous administration (injections in ampoules for injections).

Instructions for use and dosing regimen

Pills

With gastric ulcer and duodenal ulcer in the phase of worsening, Kwamatel is prescribed at a dose of 40 mg once a day at bedtime or 20 mg twice a day, in the morning and in the evening. If necessary, the daily dose can be increased to 80-160 mg. The duration of treatment is an average of 4-8 weeks.

In order to prevent exacerbations of gastric ulcer and duodenal ulcer, Kwamatel is prescribed in a dose of 20 mg 1 time per day before bedtime.

When reflux-esophagitis drug prescribed in a dose of 20 mg 2 times a day (morning and evening) for 6 weeks; if necessary, 40 mg twice a day.

With Zollinger-Ellison syndrome, the initial dose is 20-40 mg every 6 hours; if necessary, the daily dose can be increased to 240-480 mg.The duration of the drug depends on the clinical condition of the patient.

To prevent aspiration of gastric contents during general anesthesia, Kwamatel is prescribed at a dose of 40 mg on the eve of surgery and / or on the morning of the day of surgery.

Kwamatel mini

In case of heartburn or other symptoms of dyspepsia, one tablet should be taken. The tablet should be swallowed whole, washed down with a small amount of water. Do not use more than 2 tablets per day. If symptoms persist for at least 2 weeks, the doctor should be consulted.

Ampoules

Kwamatel is used intravenously, jet or drip (dropper) only in severe cases or when it is not possible to take the drug inside.

It is intended for hospital use only. At the first opportunity, you should switch to oral famotidine. The average dose is 20 mg twice a day (every 12 hours). Single dose should not exceed 20 mg.

With Zollinger-Ellison syndrome, the initial dose is 20 mg every 6 hours, then the dose of the drug is adjusted depending on the secretion of hydrochloric acid and the clinical state of the patient.

To prevent the aspiration of gastric contents before the general anesthesia is administered iv 20 mg of the drug on the eve of the operation or at least 2 hours prior to the commencement of the operation.

Patients with impaired renal function (QC less than 30 ml / min), or with a serum creatinine level of more than 3 mg / dl, daily dose of the drug (for ingestion and intravenous administration) is reduced to 20 mg or increase the interval between the use of individual doses of the drug to 36-48 hours.

If the liver function is impaired, the drug is administered with caution, in reduced doses.

Rules for the preparation and administration of injection solutions

To prepare the solution, the contents of one ampoule with the active substance should be previously diluted in 5-10 ml of physiological solution (ampoule with a solvent). The prepared solution remains stable at room temperature for 24 hours. The drug is administered for at least 2 minutes. With IV injection, the duration of infusion should be 15-30 minutes. The shelf life of the infusion solution, prepared using a solution of Dextrose with potassium chloride or sodium lactate, is 4 hours; with the use of isodes - 5 h, Ringer's solutions,Ringer-lactate or Salsola A-8 h. The solution should be prepared immediately before administration.

Side effect

• dry mouth;
• nausea, vomiting;
• stomach ache;
• flatulence;
• constipation;
• diarrhea;
• decreased appetite;
• acute pancreatitis;
• agranulocytosis, pancytopenia, leukopenia, thrombocytopenia;
• hives;
• skin rash;
• itching;
• bronchospasm;
• angioedema;
• anaphylactic shock;
• arrhythmia;
• bradycardia;
• AV blockade;
• a decrease in blood pressure;
• headache;
• dizziness;
• drowsiness;
• hallucinations;
• confusion of consciousness;
• increased fatigue;
• decreased visual acuity;
• noise in ears;
• hyperprolactinemia;
• gynecomastia;
• amenorrhea;
• decreased libido;
• myalgia;
• arthralgia;
• alopecia;
• common acne;
• dry skin;
• fever.

Contraindications

• pregnancy;
• lactation period (breastfeeding);
• childhood;
• hypersensitivity to the components of the drug;
• increased sensitivity to other histamine H2-receptor blockers.

Application in pregnancy and lactation

The drug is contraindicated for use in pregnancy. If it is necessary to use the drug, breastfeeding should be discontinued.

special instructions

The use of Kwamatel can mask the symptoms of stomach cancer, so before starting treatment with famotidine, it is necessary to exclude the presence of malignant neoplasm.

With a sharp discontinuation of treatment, famotidine can cause withdrawal syndrome, so treatment is stopped, gradually reducing its dose.

Patients with violations of liver function Kwamatel should be administered with caution and in lower doses.

With prolonged treatment of weakened patients or patients under stress, bacterial lesions of the stomach with further spread of infection are possible.

Kwamatel should be taken 2 hours after taking Itraconazole or Ketoconazole in order to avoid a significant reduction in their absorption. Also, you should observe a 1-2 hour break between taking Kwamatel and antacids.

The blockers of histamine H2 receptors (including Kwamatel) can inhibit the acid-stimulating effect of pentagastrin and histamine, therefore, for 24 hours before the test, the use of Kwamatel should be discarded.

The blockers of histamine H2 receptors can suppress the skin reaction to histamine, thus leading to false negative results.Therefore, before conducting diagnostic skin tests to detect an allergic skin reaction immediate type of Kwamatel should be discarded.

During treatment, avoid eating foods, drinks (including alcohol) and other medicines that can cause irritation of the gastric mucosa.

Impact on the ability to drive vehicles and manage mechanisms

During the period of taking Kwamatel, patients should be careful when driving vehicles and engaging in potentially dangerous activities that require a high concentration of attention and speed of psychomotor reactions.

Drug Interactions

Due to the increase in the pH of the contents of the stomach, Kwamatel, when used at the same time, reduces the absorption of ketoconazole and itraconazole; increases the absorption of Amoxicillin and clavulanic acid.

Antacids and sucralfate, used simultaneously with Kwamatel, slow the absorption of famotidine.

With the simultaneous administration of Kwamatel and drugs that inhibit bone marrow hematopoiesis, the risk of developing neutropenia increases.

Analogues of the drug Kwamatel

Structural analogs for the active substance:

• Hysterogen;
• Gastrosidin;
• Kwamatel mini;
• Pepsidine;
• Ulfamide;
• Famopsin;
• Famosan;
• Famotel;
• Famotidine.

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