Ультоп Капсулы, 28 шт, 10 мг, для приема внутрь

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Около 80 % выводится в виде метаболитов почками, а остальная часть – через кишечник."}},{"type":"paragraph","data":{"text":"Особые группы пациентов"}},{"type":"paragraph","data":{"text":"Не отмечено значительных изменений биодоступности омепразола у пациентов пожилого возраста или у пациентов с нарушением функции почек. У пациентов с нарушением функции печени отмечается увеличение биодоступности омепразола и значительное уменьшение плазменного клиренса."}},{"type":"header","data":{"text":"Фармакодинамика","level":3}},{"type":"paragraph","data":{"text":"Омепразол ингибирует фермент Н(+)/К(+)-АТФ-азу («протонный насос») в париетальных клетках желудка, блокируя тем самым заключительную стадию секреции соляной кислоты. Это приводит к снижению уровня базальной и стимулированной секреции кислоты независимо от природы раздражителя. После однократного приема препарата внутрь действие омепразола наступает в течение первого часа и продолжается в течение 24 часов. Максимум эффекта достигается через 2 часа. После прекращения приема препарата секреторная активность полностью восстанавливается через 3-5 суток."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Симптомы гастроэзофагеального рефлюкса, такие как изжога, кислая отрыжка."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"list","data":{"style":"ordered","items":["Повышенная чувствительность к омепразолу, замещенным бензимидазолам или другим компонентам препарата.","Одновременное применение с препаратами нелфинавира, атазанавира, эрлотиниба, позаконазола.","Возраст до 18 лет.","Дефицит сахаразы/изомальтазы, непереносимость фруктозы, синдром глюкозо-галактозной мальабсорбции."]}},{"type":"paragraph","data":{"text":"Перед применением препарата необходимо проконсультироваться с врачом в следующих случаях:"}},{"type":"list","data":{"style":"ordered","items":["при наличии ранее диагностированной язвенной болезни желудка, тяжелого заболевания печени, сопровождающегося печеночной недостаточностью, желтухи, предшествующего хирургического вмешательства на желудочно-кишечном тракте;","при наличии «тревожных» симптомов: значительная спонтанная потеря массы тела, повторная рвота, рвота с примесью крови, изменения цвета кала (дегтеобразный стул – мелена), нарушение глотания;","при появлении новых симптомов или изменении уже имеющихся симптомов со стороны желудочно-кишечного тракта;","при наличии остеопороза;","на фоне проводимого симптоматического лечения по поводу нарушения пищеварения или устойчивой изжоги (в течение 4 недель или более);","при одновременном применении с одним или несколькими из перечисленных ниже препаратов: клопидогрел, дигоксин, эрлотиниб, кетоконазол, итраконазол, варфарин, цилостазол, диазепам, фенитоин, саквинавир, такролимус, кларитромицин, вориконазол, рифампицин, препараты Зверобоя продырявленного (см. раздел «Взаимодействие с другими лекарственными средствами»)."]}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Результаты трех проспективных эпидемиологических исследований (более 1000 наблюдений) показали, что применение омепразола у беременных женщин не оказывает отрицательного влияния на течение беременности и здоровье плода/новорожденного. Тем не менее, перед применением препарата при беременности рекомендуется проконсультироваться с врачом."}},{"type":"paragraph","data":{"text":"Омепразол проникает в грудное молоко. При необходимости применения препарата Ультоп® в период лактации следует решить вопрос о прекращении грудного вскармливания."}},{"type":"paragraph","data":{"text":"Противопоказан лицам в возрасте до 18 лет."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Для указания частоты встречаемости побочных эффектов была использована классификация частоты развития побочных эффектов, рекомендуемая Всемирной организацией здравоохранения (ВОЗ):"}},{"type":"paragraph","data":{"text":"очень часто ≥ 1/10"}},{"type":"paragraph","data":{"text":"часто от ≥ 1/100 до < 1/10"}},{"type":"paragraph","data":{"text":"нечасто от ≥ 1/1000 до < 1/100"}},{"type":"paragraph","data":{"text":"редко от ≥ 1/10000 до < 1/1000"}},{"type":"paragraph","data":{"text":"очень редко < 1/10000"}},{"type":"paragraph","data":{"text":"частота неизвестна не может быть оценена на основе имеющихся данных."}},{"type":"paragraph","data":{"text":"Нарушения со стороны крови и лимфатической системы:"}},{"type":"paragraph","data":{"text":"редко: лейкопения, тромбоцитопения;"}},{"type":"paragraph","data":{"text":"очень редко: агранулоцитоз, панцитопения."}},{"type":"paragraph","data":{"text":"Нарушения со стороны иммунной системы:"}},{"type":"paragraph","data":{"text":"нечасто: крапивница, кожная сыпь, кожный зуд;"}},{"type":"paragraph","data":{"text":"редко: лихорадка, крапивница, ангионевротический отек, анафилактоидные реакции;"}},{"type":"paragraph","data":{"text":"очень редко: эозинофилия."}},{"type":"paragraph","data":{"text":"Нарушения со стороны обмена веществ и питания:"}},{"type":"paragraph","data":{"text":"редко: гипонатриемия;"}},{"type":"paragraph","data":{"text":"очень редко: гипомагниемия, гипокальциемия вследствие тяжелой гипомагниемии."}},{"type":"paragraph","data":{"text":"Нарушения со стороны желудочно-кишечного тракта:"}},{"type":"paragraph","data":{"text":"часто: тошнота, рвота, боль в животе, диарея, запор, метеоризм;"}},{"type":"paragraph","data":{"text":"нечасто: повышение активности «печеночных» ферментов (трансаминаз) и щелочной фосфатазы (обратимого характера) в плазме крови, извращение вкуса (обычно проходит после прекращения терапии);"}},{"type":"paragraph","data":{"text":"редко: сухость слизистой оболочки полости рта, стоматит, кандидоз желудочно-кишечного тракта, гепатит (с желтухой или без), микроскопический колит, изменение цвета языка до коричнево-черного и появление доброкачественных кист слюнных желез при одновременном применении с кларитромицином (явления носят обратимый характер после прекращения терапии);"}},{"type":"paragraph","data":{"text":"очень редко: печеночная недостаточность (у пациентов с предшествующим тяжелым заболеванием печени);"}},{"type":"paragraph","data":{"text":"частота неизвестна: доброкачественные железистые полипы дна желудка."}},{"type":"paragraph","data":{"text":"Нарушения психики:"}},{"type":"paragraph","data":{"text":"нечасто: бессонница;"}},{"type":"paragraph","data":{"text":"редко: возбуждение, спутанность сознания, депрессия;"}},{"type":"paragraph","data":{"text":"очень редко: агрессия, галлюцинации, замешательство, на фоне тяжелого заболевания печени – энцефалопатия."}},{"type":"paragraph","data":{"text":"Нарушения со стороны нервной системы:"}},{"type":"paragraph","data":{"text":"часто: головная боль;"}},{"type":"paragraph","data":{"text":"нечасто: головокружение, парестезия, сонливость."}},{"type":"paragraph","data":{"text":"Нарушения со стороны кожи и подкожных тканей:"}},{"type":"paragraph","data":{"text":"нечасто: дерматит;"}},{"type":"paragraph","data":{"text":"редко: фотосенсибилизация (покраснение кожи), алопеция;"}},{"type":"paragraph","data":{"text":"очень редко: мультиформная экссудативная эритема, синдром Стивенса-Джонсона (тяжелая мультиформная эритема, характеризующаяся появлением пятен и пузырей на коже и слизистых оболочках на фоне высокой температуры и боли в суставах), токсический эпидермальный некролиз;"}},{"type":"paragraph","data":{"text":"частота неизвестна: подострая кожная красная волчанка (ПККВ)."}},{"type":"paragraph","data":{"text":"Нарушения со стороны органа зрения:"}},{"type":"paragraph","data":{"text":"нечасто: зрительные нарушения, в том числе уменьшение полей зрения, снижение остроты и четкости зрительного восприятия (обычно проходят после прекращения терапии)."}},{"type":"paragraph","data":{"text":"Нарушения со стороны органа слуха и лабиринтные нарушения:"}},{"type":"paragraph","data":{"text":"нечасто: нарушения слухового восприятия, в том числе «звон в ушах» (обычно проходят после прекращения терапии), вертиго."}},{"type":"paragraph","data":{"text":"Нарушения со стороны скелетно-мышечной и соединительной ткани:"}},{"type":"paragraph","data":{"text":"нечасто: переломы позвонков, костей запястья, головки бедренной кости (см. раздел «Особые указания»);"}},{"type":"paragraph","data":{"text":"редко: миалгия (боль в мышцах), артралгия (боль в суставах), мышечная слабость."}},{"type":"paragraph","data":{"text":"Нарушения со стороны дыхательной системы, органов грудной клетки и средостения:"}},{"type":"paragraph","data":{"text":"редко: бронхоспазм."}},{"type":"paragraph","data":{"text":"Нарушения со стороны почек и мочевыводящих путей:"}},{"type":"paragraph","data":{"text":"редко: интерстициальный нефрит."}},{"type":"paragraph","data":{"text":"Нарушения со стороны половых органов и молочной железы:"}},{"type":"paragraph","data":{"text":"очень редко: гинекомастия."}},{"type":"paragraph","data":{"text":"Общие расстройства и нарушения в месте введения:"}},{"type":"paragraph","data":{"text":"нечасто: периферические отеки, недомогание;"}},{"type":"paragraph","data":{"text":"редко: усиление потоотделения."}},{"type":"paragraph","data":{"text":"Сообщалось о случаях образования железистых полипов дна желудка у пациентов, принимающих лекарственные препараты, понижающие секрецию желез желудка в течение длительного промежутка времени; полипы доброкачественные, проходят самостоятельно на фоне продолжения терапии."}},{"type":"paragraph","data":{"text":"В случае появления побочных эффектов, не указанных в данной инструкции, необходимо немедленно обратиться к врачу."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Необходимо проконсультироваться с врачом перед приемом препарата Ультоп®, если Вы получаете лечение одним или несколькими из указанных в данном разделе препаратов."}},{"type":"paragraph","data":{"text":"Влияние омепразола на фармакокинетику других лекарственных препаратов"}},{"type":"paragraph","data":{"text":"Снижение секреции соляной кислоты в желудке при лечении омепразолом и другими ингибиторами протонного насоса может привести к снижению или повышению абсорбции других препаратов, всасывание которых зависит от кислотности среды."}},{"type":"paragraph","data":{"text":"Подобно другим препаратам, снижающим кислотность желудочного сока, лечение омепразолом может привести к снижению всасывания кетоконазола, итраконазола, позаконазола и эрлотиниба, препаратов железа и цианокобаламина. Следует избегать их одновременного применения с омепразолом."}},{"type":"paragraph","data":{"text":"Биодоступность дигоксина при одновременном применении с омепразолом повышается на 10 % (может потребоваться коррекция режима дозирования дигоксина). Следует соблюдать осторожность при одновременном применении этих препаратов у пациентов пожилого возраста."}},{"type":"paragraph","data":{"text":"Было показано, что омепразол взаимодействует с некоторыми антиретровирусными препаратами. Механизмы и клиническое значение этих взаимодействий не всегда известны. Увеличение значения pH на фоне терапии омепразолом может влиять на всасывание антиретровирусных препаратов. Также возможно взаимодействие на уровне изофермента CYP2C19. При одновременном применении омепразола и некоторых антиретровирусных препаратов, таких как атазанавир и нелфинавир, на фоне терапии омепразолом отмечается снижение их концентрации в сыворотке крови. При одновременном применении с омепразолом на 75 % уменьшается площадь под кривой «концентрация-время» атазанавира. В связи с этим одновременное применение омепразола с антиретровирусными препаратами, такими как атазанавир и нелфинавир, противопоказано."}},{"type":"paragraph","data":{"text":"При одновременном применении омепразола и саквинавира было отмечено повышение плазменной концентрации саквинавира/ритонавира до 70 %, при этом переносимость лечения пациентами с ВИЧ-инфекцией не ухудшается."}},{"type":"paragraph","data":{"text":"При одновременном применении омепразола с клопидогрелом наблюдается уменьшение антиагрегантного эффекта последнего."}},{"type":"paragraph","data":{"text":"При одновременном применении с омепразолом возможно повышение плазменной концентрации и удлинение Т(1/2) варфарина, диазепама, фенитоина, цилостазола, имипрамина, кломипрамина, циталопрама, гексобарбитала, дисульфирама, а также других препаратов, метаболизирующихся в печени с участием изофермента CYP2C19 (может потребоваться снижение доз этих препаратов)."}},{"type":"paragraph","data":{"text":"При одновременном применении омепразола и такролимуса было отмечено повышение концентрации такролимуса в сыворотке крови, что может потребовать коррекции его дозы."}},{"type":"paragraph","data":{"text":"У некоторых пациентов отмечали незначительное повышение концентрации метотрексата на фоне одновременного применения с ингибиторами протонного насоса. При назначении высоких доз метотрексата следует рассмотреть возможность временного прекращения приема омепразола."}},{"type":"paragraph","data":{"text":"Влияние лекарственных препаратов на фармакокинетику омепразола"}},{"type":"paragraph","data":{"text":"Одновременное применение с ингибиторами изоферментов CYP2C19 и CYP3A4 (такими как кларитромицин и вориконазол) может привести к увеличению плазменной концентрации омепразола, что может потребовать коррекции дозы омепразола у пациентов с тяжелой степенью тяжести печеночной недостаточности в случае его длительного применения."}},{"type":"paragraph","data":{"text":"Индукторы изоферментов CYP2C19 и CYP3A4 (например, рифампицин, препараты Зверобоя продырявленного [Hypericum perforatum]) при одновременном применении с омепразолом могут ускорять его метаболизм, снижая тем самым концентрацию омепразола в плазме крови."}},{"type":"paragraph","data":{"text":"Не установлено клинически значимого взаимодействия омепразола с антацидными препаратами, кофеином, пропранололом, теофиллином, метопрололом, лидокаином, хинидином, эритромицином, фенацетином, эстрадиолом, амоксициллином, будесонидом, диклофенаком, метронидазолом, напроксеном, пироксикамом."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eКапсулы кишечнорастворимые 10 мг, 20 мг и 40 мг.\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eПри производстве на АО «КРКА, д.д., Ново место», Словения.\u003c/i\u003e По 14 или 28 капс. помещают в ПЭ пенал с полипропиленовой завинчивающейся крышкой с контролем первого вскрытия и капсулой гидросорбента. В ПЭ пенал с 28 капс. по 40 мг помещают дополнительную капсулу гидросорбента."}},{"type":"paragraph","data":{"text":"1 пенал помещают в пачку картонную."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПри производстве на ООО «КРКА-РУС», Россия.\u003c/i\u003e По 7 капс. в контурной ячейковой упаковке (бл.) из комбинированного материала ПВХ/ПЭ/ПВДХ/ПЭ/ПВХ и фольги алюминиевой или из комбинированного материала ОПА/Ал/ПВХ и фольги алюминиевой."}},{"type":"paragraph","data":{"text":"По 2 или 4 контурные ячейковые упаковки (бл.) помещают в пачку из картона."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"При температуре не выше 25 °C, в оригинальной упаковке."}},{"type":"paragraph","data":{"text":"\u003ci\u003eХранить в недоступном для детей месте.\u003c/i\u003e"}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"Не применять по истечении срока годности, указанного на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Ультоп\u003csup\u003e®\u003c/sup\u003e 10 мг — без рецепта."}},{"type":"paragraph","data":{"text":"Ультоп\u003csup\u003e®\u003c/sup\u003e 20 и 40 мг — по рецепту."}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"KRKA, d.d., Novo mesto (Словения), ООО «КРКА-Рус» (Россия)."}},{"type":"paragraph","data":{"text":"Представительство АО «КРКА, д.д., Ново место» в РФ/организация, принимающая претензии потребителей: 125212, Москва, Головинское ш., 5, корп. 1, эт. 22."}},{"type":"paragraph","data":{"text":"Тел.: (495) 981-10-95; факс (495) 981-10-91."}}]}],"source":null},"description_toggle":false,"short_description":"желез желудка секрецию понижающее средство – протонного насоса ингибитор Всасывание и распределение Омепразол абсорбируется в тонкой кишке обычно в течение 3-6 часов. Биодоступность после приема внутрь составляет приблизительно 60 %. Прием пищи не влияет на биодоступность омепразола. Связь с белками плазмы крови составляет около 95 %, объем распределения составляет 0,3 л/кг. Метаболизм Омепразол полностью метаболизируется в печени. Основные ферменты, участвующие в процессе метаболизма, – изоферменты CYP2C19 и CYP3A4. Образующиеся метаболиты – сульфон, сульфид и гидрокси-омепразол не оказывают значительного влияния на секрецию соляной кислоты. Общий плазменный клиренс составляет 0,3-0,6 л/мин. Биодоступность омепразола увеличивается приблизительно на 50 % при повторном приеме по сравнению с приемом разовой дозы. Экскреция Период полувыведения (Т(1/2)) составляет около 40 мин (30-90 мин). Около 80 % выводится в виде метаболитов почками, а остальная часть – через кишечник. Особые группы пациентов Не отмечено значительных изменений биодоступности омепразола у пациентов пожилого возраста или у пациентов с нарушением функции почек. У пациентов с нарушением функции печени отмечается увеличение биодоступности омепразола и значительное уменьшение плазменного клиренса. Омепразол ингибирует фермент Н(+)/К(+)-АТФ-азу («протонный насос») в париетальных клетках желудка, блокируя тем самым заключительную стадию секреции соляной кислоты. Это приводит к снижению уровня базальной и стимулированной секреции кислоты независимо от природы раздражителя. После однократного приема препарата внутрь действие омепразола наступает в течение первого часа и продолжается в течение 24 часов. Максимум эффекта достигается через 2 часа. 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