Pylobakt - instructions for use, reviews, analogs and forms of release (combined set of tablets and capsules No. 7, AM, Neo) for the treatment of stomach and duodenal ulcers in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Pylobact. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of the Pilobakt 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 the Pilobakt in the presence of existing structural analogs.Use to treat stomach and duodenal ulcers in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Pylobact - Triple therapy, including omeprazole, Clarithromycin and amoxicillin, allows a high percentage of Helicobacter pylori eradication (Helicobacter pylori) (85-94%).

Omeprazole oppresses the secretion of gastric acid due to specific inhibition of H-K-ATPase - an enzyme located in the membranes of parietal cells of the gastric mucosa. Reduces basal and stimulated secretion irrespective of the nature of the stimulus. After a single dose of the drug inside the action of Omeprazole occurs within the first hour and lasts for 24 hours, the maximum effect is achieved after 2 hours. After discontinuation of the drug, the secretory activity is completely restored after 3-5

Clarithromycin is an antibiotic from the macrolide group, a semisynthetic derivative of Erythromycin A. It has an antimicrobial effect, which is associated with the suppression of protein synthesis by interaction with the 50Sibosomal subunit of the microbial cell. Effective against a large number of Gram-positive, Gram-negative aerobic and anaerobic microorganisms, including Helicobacter pylori.The metabolite 14-hydroxyclarithromycin formed in the body also has a pronounced antimicrobial activity. Amoxicillin is a semisynthetic penicillin, has a bactericidal action, has a wide spectrum of action. The antimicrobial effect is associated with the inhibition of the synthesis of peptidoglycan (the supporting polymer of the cell wall) during the period of division and growth. Has a pronounced activity with respect to Helicobacter pylori. The resistance of Helicobacter pylori to amoxicillin is rare.

The combination of amoxicillin and clarithromycin has a potentiated antimicrobial effect against Helicobacter pylori.

Composition

Omeprazole + Clarithromycin + Tinidazole + excipients.

Omeprazole + Clarithromycin + Amoxicillin (500 mg) + excipients (Pylobact AM).

Omeprazole + Clarithromycin + Amoxicillin (1000 mg) + excipients (Pylobacter Neo).

Pharmacokinetics

All three drugs that make up the Pylobacter have good absorption by oral administration.

Omeprazole is rapidly absorbed after ingestion, and its bioavailability is 30-40%. Eating does not affect the bioavailability of omeprazole. The connection with plasma proteins is 90%.It is almost completely metabolized in the liver. The main way of excretion is with urine (80%).

Clarithromycin is rapidly absorbed from the digestive tract. Food intake slightly slows the onset of absorption of clarithromycin and the formation of 14-hydroxyclarithromycin, but does not affect bioavailability. The half-life of clarithromycin is 3-4 hours. Clarithromycin is widely distributed in the body. The concentration of clarithromycin in tissues exceeds that in serum. The connection with proteins ranges from 42% to 70%. It is excreted by the kidneys and with fecal masses (20-30% in unchanged form, the rest in the form of metabolites). Simultaneous administration of clarithromycin and omeprazole improves the pharmacokinetic properties of clarithromycin. The concentration of clarithromycin in the gastric mucosa while concomitantly administered with omeprazole is also increased.

Amoxicillin is rapidly absorbed from the digestive tract. The intake of food does not affect the absorption of amoxicillin. Its bioavailability is 75-90%. The drug is quickly distributed in the tissues of the body. The half-life is 1-1.5 hours. The connection with proteins is 20%. About 60% of the dose is excreted in the urine unchanged, a small amount is excreted with feces.

Indications

• eradication therapy Helicobacter pylori with peptic ulcer of the stomach and duodenum.

Forms of release

Combination set (daily dose) of tablets and capsules 7 blisters in a package.

Instructions for use and reception scheme

Pylobact

Each Pylobacte strip contains two capsules of omeprazole (20 mg each), two clarithromycin tablets (250 mg each) and two tablets of tinidazole (500 mg each), and are calculated for 1 day of treatment.

Take one capsule of omeprazole, one tablet of clarithromycin and one tablet of tinidazole 2 times a day during or after meals in the morning and in the evening. Tablets and capsules can not be broken and chewed, they should be swallowed whole.

Duration of treatment is 7 days.

Pylobact AM

Each strip containing tablets and capsules of the Pylobact AM kit is designed for one day of treatment and consists of two parts: red with the inscription "morning" and blue with the inscription "evening".

In the morning before the meal, you should take the contents of the "morning" part completely (one capsule of omeprazole, one tablet of clarithromycin and two capsules of amoxicillin). In the evening before the meal, you should take the contents of the "evening" part completely (one capsule of omeprazole, one tablet of clarithromycin and two capsules of amoxicillin).Tablets and capsules can not be broken and chewed, they should be swallowed whole. The duration of treatment is 7 days.

Pilot Neo

Neo-Pilobakt was developed specifically to ensure the correct dosage of omeprazole, clarithromycin and amoxicillin. Packaging for 1 day contains 2 capsules of omeprazole (20 mg each), 2 tablets of clarithromycin (500 mg each) and 2 tablets of amoxicillin (1 g each). Such packaging provides one-day treatment.

Capsules of omeprazole (20 mg twice a day) + clarithromycin tablets (500 mg twice a day) + amoxicillin tablets (1 g 2 times a day) is prescribed for 7 days. Packaging Pylobakt Neo provides a complete 7-day eradication course.

If the symptoms recur and the patient is positive for Helicobacter pylori, the treatment can be repeated. If the result of the test for Helicobacter pylori is negative, the treatment is performed as with reflux disease.

To guarantee a cure in patients with peptic ulcer during the exacerbation phase, further dosage recommendations for duodenal ulcers and benign gastric ulcers should be observed.

Neo should be taken in the morning and evening (before eating).

Capsules and tablets should be swallowed whole.

Side effect

• dysbiosis;
• diarrhea or constipation;
• nausea, vomiting;
• flatulence;
• abdominal pain;
• dry mouth;
• a taste disorder;
• metallic taste in the mouth;
• decreased appetite;
• stomatitis;
• encephalopathy;
• pseudomembranous enterocolitis;
• headache;
• dizziness;
• excitation;
• increased fatigue;
• weakness;
• drowsiness;
• insomnia;
• depression;
• confusion of consciousness;
• hallucinations;
• epileptic reactions;
• peripheral neuropathy;
• convulsions;
• fear;
• nightmarish dreams;
• noise in ears;
• muscle weakness;
• myalgia;
• arthralgia;
• leukopenia, neutropenia, thrombocytopenia, thrombocytopenic purpura, anemia;
• skin rash;
• photosensitization;
• multiforme exudative erythema;
• alopecia;
• hives;
• angioedema;
• bronchospasm;
• anaphylactic shock;
• tachycardia;
• interstitial nephritis;
• impaired vision;
• peripheral edema;
• increased sweating;
• fever;
• gynecomastia.

Contraindications

• increased sensitivity to omeprazole, clarithromycin or tinidazole, as well as antibiotics of the macrolide group;
• Combined use with cisapride, pimozide, astemizole, terfenadine, ethanol (alcohol) is prohibited;
• pregnancy;
• lactation period;
• organic diseases of the central nervous system;
• porphyria;
• oppression of bone marrow hematopoiesis;
• childhood;
• renal and / or liver failure.

Application in pregnancy and lactation

Contraindicated in pregnancy and lactation.

Use in children

Pylobacter is contraindicated in childhood.

special instructions

Before the beginning of therapy it is necessary to exclude the presence of malignant process, t. treatment, masking the symptoms, can delay the setting of the correct diagnosis.

With caution appoint Pylobacterum on the background of taking medicines metabolized by the liver. In the case of co-administration with Warfarin or other indirect anticoagulants, prothrombin time should be monitored.

With heart disease in the anamnesis, simultaneous administration with terfenadine, cisapride, astemizole is not recommended.

Tinidazole causes dark staining of urine.

Impact on the ability to drive vehicles and manage mechanisms

During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Drug Interactions

Simultaneous appointment of theophylline and clarithromycin is accompanied by an increase in the concentration of theophylline. Clarithromycin decreases the absorption of zidovudine (between the use of drugs should be an interval of at least 4 hours). It is possible to develop cross-resistance between clarithromycin, Lincomycin and clindamycin.

Simultaneous administration of clarithromycin with terfinadine increases the concentration of the latter and may lead to an elongation of the QT interval.

Simultaneous administration of clarithromycin with indirect anticoagulants can potentiate the effect of the latter.

At simultaneous appointment with clarithromycin levels of carbamazepine, cyclosporine, phenytoin, disopyramide, lovastatin, valproate, cisapride, pimozide, astemizole, Digoxin can be increased.

Omeprazole can slow the elimination of phenytoin, diazepam, warfarin, and also affect the absorption of ketoconazole, ampicillin and iron salts by inhibiting the secretion of acid in the stomach. Increases the inhibitory effect on the hemopoietic system and other medicines.

Tinidazole enhances the effect of indirect anticoagulants and the action of ethanol (alcohol) - possibledisulfiram-like reactions. It is not recommended to administer with ethionamide. Phenobarbital accelerates the metabolism of tinidazole.

Analogues of the drug Pylobact

Structural analogs for the active substance:

• Peptipack;
• Pylobakt AM;
• Pylobakt Neo.

Analogues on the curative effect (remedies for the treatment of duodenal ulcers):

• Almagel Neo;
• Almagel;
• Alfogel;
• Alumag;
• Amoxisar;
• Anacid forte;
• Acidex;
• Betamax;
• Befungin;
• Bifidumbacterin forte;
• Venter;
• Galavit;
• Galidor;
• Gastal;
• Gastricid;
• Gelusil;
• De Nol;
• Derinat;
• Digestal;
• Drotaverine;
• Zantak;
• A zerocide;
• Zitrolide;
• Iberogast;
• Kwamatel;
• Clarithromycin;
• Clacid;
• Lanzap;
• Losek;
• Maalox;
• Milk of magnesia;
• But the spine;
• Omez;
• Omeprazole;
• Papaverine;
• Pepticum;
• Ranigast;
• Ranitidine;
• Sumamed;
• Tinidazole;
• Ulgastran;
• Ultop;
• Famotidine;
• Phosphalugel;
• Fromromide;
• Cigapan;
• Eglonyl;
• Erbisol.

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