"Nolpaza" is an antiulcer drug. This agent inhibits the enzyme H + / K + -ATPase in gastric parietal cells and thereby blocks the final period of hydrochloric acid synthesis. As a result, the level of stimulated and basal secretion of hydrochloric acid decreases, regardless of the nature of the stimulus. After the drug is once taken orally at a dosage of twenty milligrams, the effect of pantoprazole is activated within the first hour, and the maximum effect will be achieved in two or two and a half hours. The drug does not affect the motility of the digestive tract. As soon as the drug is stopped, its secretory activity is restored in full after three to four days. We will consider Russian analogues of Nolpaza in this article.
Release form, packaging and composition
The drug consists of tablets coated with an intestine-soluble shell, the color is light brownish-yellowish, the shape is oval, slightly biconvex, a mass is observed at its fracture, which can be white or correspond to the shade of the tablets, the surface is rough.
One tablet contains 22.55 milligrams of pantoprazole sodium sesquihydrate, which corresponds to twenty milligrams of pantoprazole. The auxiliary components are: calcium stearate, mannitol, sorbitol, sodium carbonate anhydrous, crospovidone.
The shell contains the following elements: povidone, macrogol 6000, hypromellose, talc, polysorbate-80, sodium lauryl sulfate, dye propylene glycol, iron oxide yellow (E172), water, titanium dioxide (E171), dispersion Eudragit L30D (copolymer of ethyl acrylate and methacrylic acid in a proportion of one to one, thirty percent dispersion).
In a cardboard pack are either one or two blisters, each of which contains fourteen tablets. Russian analogues of Nolpaza can be purchased at any pharmacy.
Pharmacokinetics
Nolpaza has the following characteristics.
1) In terms of absorption.
The active substance pantoprazole is rapidly absorbed from the gastrointestinal tract, reaches its maximum concentration in about two or two and a half hours after use and has indicators of 1.0-1.5 micrograms per milliliter, while the value of the highest concentration will be constant even under repeated use. The bioavailability of the drug is seventy-seven percent. Concomitant use with food does not have any effect on bioavailability, AUC and maximum concentration. There is only a change in the time when the drug begins to act. This confirms the instructions for use for Nolpase. According to reviews, analogues work no worse.
2) In terms of distribution.
The drug binds to plasma proteins at ninety-eight percent.
3) In terms of metabolism.
The active substance pantoprazole is almost completely metabolized in the liver. It is a CYP2C19 isoenzyme inhibitor.
4) Withdrawal.
The half-life is one hour. Due to the specific nature of the binding of the proton pump of parietal cells and pantoprazole, the half-life does not correlate with the duration of the therapeutic effect. Metabolites are excreted mainly through the kidneys (eighty percent), the rest - along with bile. The main metabolite, which is determined in urine and in blood serum, is desmethyl pantoprazole. It conjugates with sulfate. The half-life of desmethyl pantoprazole is about one and a half hours, that is, more than that of pantoprazole. The Russian analogues for Nolpase should be selected by a doctor.
Pharmacokinetics in specific clinical cases
If the patient has chronic kidney failure (including those on hemodialysis), no change in dosage is required. The half-life is short, as for people with good health. With dialysis, the excretion of pantoprazole can be carried out in a very small volume.
In patients diagnosed with cirrhosis, while taking pantoprazole twenty milligrams per day, the elimination half-life increases to three to six hours, the AUC increases by three to five times, and the highest concentration increases by 1.3 compared to healthy individuals.
A slight increase in maximum concentration as well as AUC in elderly patients are not clinically significant compared with the same data in younger patients.
What else does the instruction for use report to the Nolpaza preparation. We will consider Russian analogues below.
When is the drug used?
"Nelpaza" is recommended for use:
- with gastroesophageal reflux disease (GERD), including also the symptoms associated with GERD (acid regurgitation, heartburn, pain during swallowing), and erosive-ulcerative reflux esophagitis;
- with ulcerative and erosive defects of the duodenum and stomach, which are caused by the use of NSAIDs;
- with the eradication of Helicobacter pylori, in combination with two antibiotics;
- peptic ulcer of the duodenum and stomach, prevention and therapy;
- with Zollinger-Ellison syndrome and other pathological conditions that are associated with increased gastric secretion.
In all these cases, doctors prescribe Nolpazu. Instructions for use with Russian counterparts contain the same indications.
Who is contraindicated in?
Contraindications to the use of "Nolpazy" are:
- dyspepsia of neurotic origin;
- age up to eighteen years, since the effectiveness and safety of use have not been studied;
- high sensitivity to the main component of pantoprazole or other components of the drug.
Nolpase contains sorbitol, which is why this drug is not recommended for patients with rare hereditary fructose intolerance.
Caution should be used in pregnant women and nursing mothers, with liver failure, the risk of a lack of cyanocobalamin (especially with achlo and hypohydria).
It is quite easy to find Russian analogues cheaper than Nolpazy.
Features of the dosage of the drug
The drug is used orally. The entire tablet is swallowed; it is not necessary to break or chew it. Drink a small amount of liquid. Eat before meals, most often before breakfast. If taking twice, then the second dose is recommended to drink before dinner.
If the patient has GERD, which includes mild associated symptoms and erosive-ulcerative reflux esophagitis, it is recommended to take twenty milligrams per day, with moderate or severe degree - from forty to eighty milligrams per day. Relief of symptoms occurs most often in the period from two to four weeks. The therapeutic course is from four to eight weeks.
Preventive method
For preventive purposes, as well as long-term maintenance therapy, Nolpaz should be drunk twenty milligrams per day, if there is such a need, the dose should be increased to a maximum of eighty milligrams per day. The drug can also be taken "on demand" if symptoms occur.
For therapy and as prophylaxis for peptic ulcer of the duodenum and stomach, from forty to eighty milligrams per day are prescribed. The treatment course against the background of exacerbation of a duodenal ulcer is mainly two weeks, with a stomach ulcer - from four to eight weeks. If there is such a need, then the duration of therapy is increased. This describes the instructions for the drug "Nolpaza". The price of analogues depends on the region and the pharmacy chain.
To eradicate Helicobacter pylori in combination with antibiotics, it is recommended to take Nolpase at a dose of forty milligrams twice a day, combined with other drugs. Most often, the course of anti-Helicobacter pylori treatment is from seven to fourteen days.
If the patient has Zollinger-Ellison syndrome and other pathological conditions caused by increased secretion of the stomach, the starting dose during prolonged therapy is eighty milligrams per day. It is divided into two methods. After this, the daily dose can be titrated, which is determined by the initial level of gastric secretion. The daily dose can be temporarily increased to one hundred and sixty milligrams, if there is a task to adequately control gastric secretion. The duration of therapy is considered individually.
For patients with serious liver dysfunction, the dose should not be more than forty milligrams per day, it is also recommended to constantly monitor the activity of liver enzymes, especially with prolonged therapy with pantoprazole. If the activity of liver enzymes increases, then the drug is better not to use.
Elderly patients and those with kidney disease can take the drug at a maximum dose of forty milligrams.
Elderly people who receive Helicobacter pylori eradication treatment are usually advised to have no more than seven days of using Nolpase. Analogs are often assigned in the same way.
Side effect
Side effects from taking "Nolpaza" are as follows.
- Hematopoietic organs: in rare cases, thrombocytopenia, leukopenia.
- Digestive system: often - abdominal pain, constipation, flatulence, diarrhea; infrequently - vomiting and nausea; rarely - a feeling of dryness in the oral cavity; very rarely - increased activity of transaminases and GGT of the liver, serious lesions of this organ that lead to jaundice with liver failure or without it.
- Immune system: in very rare cases, anaphylactic reactions, including anaphylactic shock.
- Musculoskeletal system: in rare cases - arthralgia; myalgia is very rare.
- The central nervous system and peripheral nervous system: often - headaches; infrequently - visual impairment (its vagueness), dizziness; in very rare cases, depression.
- Genitourinary system: in exceptional cases - interstitial nephritis.
- Allergic reactions: rarely - rash and itching; very rarely - urticaria, Stevens-Johnson syndrome, photosensitivity, erythema multiforme or Lyell's syndrome, angioedema.
- Other: in very rare cases - weakness, peripheral edema, painful tension in the mammary gland, hyperthermia, increased triglyceride level.
If serious negative effects develop, then treatment with the drug should be stopped immediately.
The drug costs about 180-200 rubles per pack. It depends on the region and the pharmacy network.
Russian analogues of Nolpaz
According to the active substance, the structural analogues of Nolpaza are:
- "Zipantola";
- "Krosatsid";
- "Panum";
- "Control";
- Pantaz
- Pizhenum Sanovel;
- "Peptazole";
- Sanpraz;
- Puloref;
- Ultra.
"Bereta"
The cost of the drug is 380-400 rubles. It is a high-quality analogue of Nolpaza tablets. The predominant compound rabeprazole is characterized by a pronounced anti-ulcer antisecretory effect. It can be prescribed for the treatment of gastrointestinal pathologies of a ulcerative nature. It is forbidden to take during pregnancy, breastfeeding, allergies.
Gastrozole
It costs 130-140 rubles. This is a cheap Russian analogue of Nolpaza. Available in oblong capsules. The main component of omeprazole has an antiulcer effect. Assign for the prevention and treatment of stomach ulcers. The restrictions on admission are the same.
Ontime
Pretty expensive - 800-850 rubles.
But it is considered the best prototype of the original of Russian manufacturers. Effective for ulcers and gastritis. Strongly not recommended for pregnancy, breast-feeding, for children.
We examined the main analogues of Nolpaza.
Reviews
Patients respond to the use of "Nolpaza" and analogues both positively and negatively.
Among the advantages of the drugs are: speed and effectiveness, elimination of pain in the stomach, help in correcting the consequences of diet errors, ease of use (only one tablet per day). Thanks to the use of Nolpaza, many patients did not require complex treatment.
Among the shortcomings, patients make a special emphasis on a large number of side effects. In addition, it is noted that the drug is not affordable for everyone. However, in this case, the drug should be selected individually so that it is suitable not only for the price, but also suits the body and does not cause negative reactions.
We examined in an article for the Nolpaza facility instructions, reviews, and analogues.