Nolpaz

Nolpase (pantoprazole) is an antiulcer drug of the proton pump inhibitor group (PPI). Used to treat diseases associated with the aggressive action of hydrochloric acid on the mucous membranes of various parts of the digestive tract.

The active substance reduces the basal and stimulated synthesis of hydrochloric acid by inhibiting the proton pump of the parietal cells of the gastric mucosa. Acidic medium of gastric contents activates the drug.

As a result, the acidity of the gastric juice decreases. Pantoprazole causes an increase in the concentration of gastrin in the gastric contents.

Clinical and pharmacological group

H + -K + -ATPase inhibitor. Antiulcer drug.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much is Nolpaz in pharmacies? The average price is at the level of150 rubles.

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Form of issue and composition

The drug is released in the form of oval yellow-brown color tablets, covered with enteric-coated shell.

1. The composition of one tablet of Nolpase 20 includes 20 mg of pantoprazole sodium (recalculated to pantoprazole), and sorbitol, mannitol, crospovidone, calcium stearate, sodium carbonate anhydrous as auxiliary substances.
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2. The composition of one pill Nolpaz 40 includes 40 mg of Pantoprazole sodium (recalculation on pantoprazole), and similar auxiliary substances.

They are sold in contour acheikova packing of 14 pieces, realized in cardboard boxes of 1, 2 or 4 packs in each.

Pharmacological effect

Pantoprazole is characterized by the ability to block the enzyme H + -K + -ATPase, which is responsible for the transport of hydrogen protons in lining cells of the fundal glands of the gastric wall, due to which the process of HCl biosynthesis is suspended at the final stage. The production of acid decreases regardless of the nature of the stimulating factor.

The active component is released and absorbed into the small intestine. After taking 20 mg of the drug, the effect reaches its maximum after 2 hours. On the motility of the organs of the digestive tract (in particular - the speed of evacuation of the contents of the stomach) the drug does not affect. After the completion of the course, the production of HCl returns to normal indicators only after 3-4 days. The bioavailability level averages 77%, and does not decrease after ingestion. With the proteins of the blood, up to 98% of the active substance is conjugated. The process of biotransformation of pantoprazole takes place in the liver, and excreted metabolic products predominantly in the urine (over 80%).

The half-life of the main metabolite is 1 hour; it significantly increases in patients suffering from cirrhosis of the liver.

Indications for use

What helps? Nolpaz is prescribed for hyperacid conditions - increased acidity of gastric juice, including erosive and ulcerative lesions of the mucous membrane.

1. Reflux esophagitis.
2. Zollinger-Ellison syndrome.
3. Gastroesophageal reflux disease (GERD).
4. Peptic ulcer localized in the stomach and duodenum.
5. Pathological conditions, accompanied by increased secretion of hydrochloric acid and hyperacidity.

Nolpazu is used to treat diseases of the gastrointestinal tract, associated with infection Helicobacter pylori (Helicobacter pylori), against the background of antimicrobial therapy.

Contraindications

Contraindications for taking Nolpazy are as follows:

1. High sensitivity to the components of the drug (intolerance to fructose, etc.).
2. Do not take the drug to people with neurotic dyspepsia.
3. Nolpase 40 mg is not used together with antimicrobial agents to treat patients with severe kidney and / or liver disease.

The drug is administered with caution:

1. Those who have a high risk of ulcers, intestinal, gastric bleeding.
2. Patients with a high risk of developing hypovitaminosis B12.
3. People suffering from liver disease. If treatment is carried out for a long time, it is necessary to monitor the level of hepatic enzymes in patients.

Use in pregnancy and lactation

If Nolpaz is needed during pregnancy, it is necessary to evaluate the estimated benefit to the mother and the potential risk to the fetus.

If it is necessary to use during lactation, the question of stopping breastfeeding should be resolved.

Dosage and route of administration

The instructions for use indicate that the Nolpaz is taken internally. 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.

1. For the eradication of Helicobacter pylori (in combination with antibiotics), the recommended dose is 40 mg 2 times in day in combination with two antibiotics, usually the course of anti-Helicobacter therapy is 7-14 days.
2. With GERD, incl. erosive-ulcerative reflux-esophagitis and associated symptoms (heartburn, regurgitation sour, pain when swallowing) mild, recommended dose - 20 mg / day, medium and severe - 40-80 mg / day. Relief of symptoms usually occurs within 2-4 weeks. The course of therapy is 4-8 weeks.
3. For prophylaxis, as well as as a supportive long-term therapy, appoint 20 mg / day, if necessary, increase the dose to 40-80 mg / day. It is possible to take the drug "on demand" when symptoms occur.
4. With erosive and ulcerative lesions of the stomach and duodenum associated with the administration of NSAIDs, the recommended dose is 40-80 mg / day. The course of therapy is 4-8 weeks.
5. For the prevention of erosive lesions against the background of prolonged use of NSAIDs - 20 mg each.
6. For treatment and prevention of peptic ulcer of the stomach and duodenum appoint 40-80 mg / 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.
7. 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 / day, divided by 2 reception. 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.

In elderly patients and patients with kidney disease, the maximum daily dose of pantoprazole is 40 mg.

In elderly patients receiving eradication therapy Helicobacter pylori, the duration of therapy usually does not exceed 7 days.

In patients with severe impairment of liver function, the dose of pantoprazole should not exceed 40 mg / day and It is recommended to regularly monitor the activity of liver enzymes, especially with prolonged treatment pantoprazole. When increasing the activity of liver enzymes, it is recommended to cancel the drug.

Side effects

It is extremely rare for long-term treatment with Nolpas, there have been cases of the development of renal insufficiency, destructive lesions of liver tissues, including jaundice.

Sometimes patients complain of the occurrence of such side effects of Nolpaz:

• nephritis of neurogenic origin;
• pain in the mammary glands;
• hyperthermia;
• excessive gassing, bloating, attacks of vomiting;
• peristalsis disorder;
• pain in muscles and joints;
• allergic reactions: urticaria, skin itch, redness and eruptions on the upper layer of the epidermis under the influence of sunlight, erythema;
• edema of different localization.

From the nervous system side effects can also be manifested: sleep disorder, lethargy, apathy, emotional lability, dizziness.

Overdose

An overdose of Nolpez is theoretically possible, but its symptoms are not known in man. Therefore, when there are signs of intoxication (headache, nausea, general weakness, fatigue, etc.) after taking a high dose of Nolpaz, you should consider them as symptoms overdose and carry out detoxication (abundant drinking, taking diuretics and sorbents, introducing plasma-substituting solutions, glucose, sodium thiosulfate or unithiol intravenously).

special instructions

Before you start using the drug, read the special instructions:

1. If, after 4 weeks of pantoprazole therapy, the patient does not have the desired curative effect, he should undergo a second examination.
2. Long-term therapy, especially for longer than 1 year, requires regular monitoring of the patient.
3. Like other proton pump inhibitors, pantoprazole 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.
4. Before the start of therapy, it is necessary to exclude the presence of malignant neoplasm (endoscopic control, necessity with a biopsy - especially with a stomach ulcer), tk. treatment, masking the symptoms, can delay setting correct diagnosis.

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

Drug Interactions

When using the drug, it is necessary to take into account the interaction with other drugs:

1. At simultaneous reception of pantoprazole with antacids of any drug interaction is not registered.
2. Nolpase reduces the absorption of drugs whose bioavailability depends on the pH of the stomach and is absorbed at acidic pH values ​​(eg, ketoconazole).
3. Although no significant interaction was observed in clinical pharmacokinetic studies with simultaneous use with warfarin, several separate reports on changes in MHO were noted. In patients receiving coumarin anticoagulants, concurrent with pantoprazole, it is recommended to monitor prothrombin time or MHO regularly.
4. Pantoprazole 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, in clinical trials, there was no significant interaction with digoxin, diazepam, diclofenac, ethanol, phenytoin, glibenclamide, carbamazepine, caffeine, metoprolol, naproxen, nifedipine, piroxicam, theophylline, and oral contraceptives.

Reviews

We picked up some reviews of people who used Nolpaz's drug:

1. Olga. I suffer from GERD with high acidity for several years. And every year I just need to take preventive measures against the exacerbation of the disease. Initially, I took omeprazole, but for the last 2 years the doctor has prescribed to drink nolpaz. Effective medicine for the treatment and prevention of reflux-esophagitis, helps the healing of the gastric mucosa. For a long time lowers the acid of gastric juice. And the disease is not exacerbated after the course of taking nolpase longer in comparison with similar drugs. For the whole course you need a few packages, since you need to take his month. It does not come out so cheap, but the result is worth it!
2. Lilya. Peptic ulcer, pancreatitis, took a long omez, ultop, take Nolpazu from November, tried to 10 mg from 20-ki go, it does not work. Today I tried to not take it at 11.30, it started, the whole stomach was acidified. Scared of an attack of pancreatitis, again took.
3. Lyudmila. Problems with the stomach appeared in connection with irresponsible attitude to health and nutrition. Doctors in a private clinic diagnosed gastritis. Several drugs were prescribed, among which was the nolpaz. Worth it, of course, not cheap, but it was necessary to drink a course. The pains in the stomach have passed. But there was a terrible bitterness in his mouth. After reading the numerous reviews on the use of this drug, I drew attention to the fact that there were very many complaints about the occurrence of bitterness. One cure - the other is crippled - this is a pattern when using strong drugs. The recommendations of doctors for this case are the following - in parallel with this medicine you need to drink hepatoprotectors. And no bitterness will bother you.

Analogues

In the pharmacy network, you can always find drugs that contain the same active substance, or have a similar therapeutic effect. To the structural analogs of Nolpaz, the following preparations are used according to the active substance:

• Zipantola tablets;
• Tablet controllers and powder for solution for injection;
• Crosatide tablets;
• Pantaz tablet;
• Panum tablets;
• Pepsatol tablets;
• Pienenum-sanovel tablets;
• Sunpras tablets and lyophilizate for the preparation of solution for injection;
• Ulter tablets;
• Pantoprazole canon tablets;
• PULOLEPH tablets.

Among drugs that have a similar therapeutic effect, apply:

• Gastrozole;
• Zolispan;
• Losek;
• Omez;
• Omeprazole;
• Pomez;
• Ultop;
• Helicyl;
• Esomeprazole.

Before using analogues, consult your doctor.

Storage conditions and shelf life

Store the medicine in a dry place, protect from light. The storage temperature should be between 15 and 30 degrees.

Shelf life of the drug is 2 years.

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