Treatment of ulcerative lesions of the mucous membrane of the stomach or digestive tract as a whole is a complex and lengthy process. This is due not only to the fact that hydrochloric acid, which is part of the gastric juice, slowly increases the mucosal defect, digesting its own tissues, but also the association of the disease with the presence of the microorganism Helicobacter pylori. In order to prevent the expansion of the defect and contribute to the speedy recovery of the patient, doctors prescribe Omeprazole or Ultop. Which is better, we will analyze in this article.
Mechanism of action
Despite the fact that the drugs have different names, the active ingredient in them is the same - omeprazole. What does this medicine treat and represent?
According to the chemical characteristics, this substance is practicallyinsoluble in water, but very soluble in ethyl alcohol or methanol.
In clinical practice, omeprazole is used as part of various drugs, including combined ones, as a means for the treatment of ulcerative defects. "Omeprazole" or "Ultop" - which is better? Very often patients and doctors ask themselves this question.
The mechanism of action is based on the inhibition of the so-called proton pump - a specific transport protein located in the cell membrane of the secretory cells of the stomach. By reducing the flow of hydrogen ions into the cytoplasm of such a secretory cell, the amount of hydrochloric acid produced by it decreases, and the acidity of gastric juice decreases, which leads to a decrease in tissue destruction and favors accelerated healing of the ulcer.
Pharmacokinetics
Omeprazole effectively inhibits both stimulated and basal hydrochloric acid production with a dose-dependent effect. With a single oral dose of 20 mg of "Omeprazole" or taking a dose of the drug "Ultop" - 20 mg, a decrease in acidity is observed already within the first hour, since the drug is quickly and well absorbed in the intestinal lumen and enters the systemic circulation.
Despite the fact that the half-life of the active substance of the drugs is about two hours, inhibition of hydrochloric acid production is observed within a day after a single dose.
Omeprazole Tropene, distributed through the mucosamembranes of the stomach, liver and biliary tract, practically does not penetrate the blood-brain barrier and is completely associated with plasma proteins. The degree of binding with the latter can reach up to 90-95%.
Omeprazole is excreted primarily in the urine, with about 60-77% excreted as metabolites such as hydroxyomeprazole and carboxylic acid. Most of the resulting conjugates show practically no antisecretory activity, with the exception of sulfonomeprazole. The part of the medicinal substance remaining in the body is excreted through the gastrointestinal tract with bile and fecal matter.
Particular attention should be paid to the pharmacokinetics of omeprazole in patients with hepatic insufficiency. By reducing the metabolism of the drug, its bioavailability reaches a maximum, and the half-life is extended to three hours. In patients with chronic renal insufficiency, the excretion of omeprazole metabolites is slowed down in accordance with the clearance of blood plasma from creatinine.
Indications for use
Drugs "Omeprazole" and "Ultop" are indicated for use in the treatment of peptic ulcers of the digestive tract, hyperacid conditions (including gastritis), Zollinger-Ellison syndrome, postoperative conditions, reflux disease. These drugs can be recommended for the treatment of non-ulcerative dyspepsia, in the treatment of complications caused by therapy with non-steroidal anti-inflammatory drugs (analgesics, antipyretics), as well as for the treatmentuncomplicated heartburn that occurs no more than 2 times a week.
Despite the indications for the use of the drug "Omeprazole" in the instructions, what this drug treats is well known only to a qualified specialist. Therefore, if you feel worse in the gastrointestinal tract, you should contact the clinic and not self-medicate.
Contraindications
All forms of the drug, including Omeprazole tablets, are contraindicated in patients with hypersensitivity to the drug, as well as in children. A decrease in the secretory function of the stomach in hypoacid conditions and atrophic gastritis are also a contraindication to the appointment of omeprazole.
Side effects
About the drugs "Omeprazole" and "Ultop" reviews say that, due to a decrease in the acid-forming function of the stomach, constipation, flatulence, constipation, vomiting and pain in the epigastric region are likely to occur in the gastrointestinal tract. Candidiasis, dry mouth, development of atrophic or hypoacid gastritis, intestinal polyposis are less common.
On the part of the nervous system (afferent impulses), headaches, feelings of malaise, feelings of anxiety and anxiety, depression and mental disorders may occur. It is not excluded the appearance of disorders of visual function, which may become permanent.
Allergic reactions to omeprazole are rare. The occurrence of urticaria is situationally possible,skin itching. With a low frequency, there is a spasm of the smooth muscle cells of the bronchi, the development of Quincke's edema with further progression by the type of anaphylactic reaction and the development of a shock state. The development of gynecomastia, the appearance of pain in the chest were casuistically noted.
How to use
Omeprazole is taken on an empty stomach with water. In a special category of patients, it may be difficult to swallow the capsules of the drug. In this case, it is recommended to open the capsule, and prepare a water-based suspension from its contents. This suspension should be taken no later than half an hour after preparation. The attending physician prescribes the daily dosage, a single dose, as well as the course of drug therapy.
Features of use during pregnancy and breastfeeding
There are no data on the safety of omeprazole in pregnant women. The medicinal substance can be indicated for he alth reasons. The category of effect on the fetus is not defined.
If it becomes necessary to prescribe omeprazole during breastfeeding, then the latter should be abandoned during treatment, since the drug is able to penetrate into breast milk.
Drug Interactions
Both "Omeprazole" and "Ultop" reduce the bioavailability of all drugs, the absorption of which depends on the acidity of gastric juice. It also slows down the release of drugs metabolized in the liver. Prepared sterile injection solution of omeprazole can be used inwithin 12 hours, provided that physiological sodium chloride solution is used as a solvent, and for several hours after preparation, provided that a dextrose solution is used as a solvent. Omeprazole is not compatible with other solutions.
With concomitant treatment with Warfarin, the level of anticoagulant in the blood plasma should be monitored daily or the prothrombin time should be monitored in a timely manner.
Treatment of poisoning and overdose
Omeprazole overdose symptoms include dry mouth, dizziness, headache and visual disturbances. In case of poisoning, confusion, the appearance of drowsiness, palpitations, sensations of flushes to the face are possible.
Treatment of poisoning is symptomatic, aimed at removing the drug from the body as quickly as possible. The specific antidote is unknown. Due to the high degree of binding to blood plasma proteins, the use of dialysis methods of detoxification is irrational.
Special Instructions
Since drugs are used to treat ulcers of the stomach and duodenum, the etiological factor of which is Helicobacter pylori infection, the concomitant administration of antibacterial drugs is recommended for the eradication of microorganisms.
Before starting the use of the drug in a patient, it is necessary to refute malignant tumor diseases of the gastrointestinal tract, since the appointment of "Omeprazole" maymask the symptoms of these diseases and make early diagnosis difficult. It is necessary to exclude infectious parasitic diseases, as well as to evaluate the functional capacity of the liver and kidneys.
"Omeprazole" or "Ultop" - which is better?
It is difficult to answer this question unambiguously, because the active ingredient in both cases is omeprazole. Let's look at the release forms of the drug "Ultop". Capsules are available in dosages of 10, 20 and 40 mg, as well as in the form of a lyophilized powder (40 mg in one vial) for the preparation of an injection solution.
"Omeprazole" is presented on the pharmaceutical market in the form of capsules of 10, 20 and 40 mg of omeprazole in one capsule, as well as in the form of a lyophilized powder (40 mg in one vial) for the preparation of injection solutions. A lyophilized powder with a solvent is also available in one package. In addition, the drug can be purchased in the form of sachets (powder sachets) for the preparation of an oral suspension. It is rare to find Omeprazole tablets (pellets) with a similar drug content.
As for the reviews of these drugs, they are positive, since omeprazole is an effective drug that reduces the secretory activity of the stomach. The drug is so effective that even doctors are wondering: "What is better than omeprazole?" However, opinions vary among patients. Quite often, the reviews left about the Ultop preparation indicate the occurrence of constipation after administration, headache and nausea.
Cost of drugs
Of course, the cost of medicines will depend not only on the pharmacy chain in which they are sold, but also on the distance of the pharmacy from the medical institution and, of course, on the manufacturer of the medicine itself. For the drug "Ultop" the price ranges from 212 to 360 rubles per pack. The final cost depends on the dose and the number of capsules in the package. For the drug "Omeprazole" the average price is from 80 to 140 rubles. The price also depends on the dose and the number of capsules in the package.
Conclusion
Only the attending physician should prescribe "Omeprazole" or "Ultop". What is the best of these medicines, the competent specialist knows, and his decision should be based on the indications for the appointment and the patient's condition. It should be borne in mind that often the decisive moment in choosing a drug is its cost.
Patients need to pay attention to "Omeprazole", the price of which is much lower than the analogue of "Ultop". Those who are willing to pay more can look at the analogues of this drug. Despite the somewhat high cost of Ultop, the price can justify the degree of purification of the drug, as well as possible additional modulating additives in the drug itself.
Be that as it may, you should always remember the golden rule: do not self-medicate. Early diagnosis is the key to successful treatment!
