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 by digesting its own tissues, but also to the association of the disease with the presence of the Helicobacter pylori microorganism. 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 drugs have a different name, the active substance in them is the same - omeprazole. What cures and constitutes this medicine?
According to its chemical characteristics, this substance is practically insoluble in water, but it is very soluble in ethanol or methanol.
In clinical practice, omeprazole is used as part of various medications, including combination 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 the gastric juice decreases, which leads to a decrease in tissue destruction and favors the accelerated healing of ulcers.
Pharmacokinetics
Omeprazole effectively inhibits both stimulated and basal production of hydrochloric acid, while providing a dose-dependent effect. With a single oral administration of 20 mg of Omeprazole or a dose of Ultop, 20 mg, a decrease in acidity is observed within the first hour, since the drug is rapidly 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 preparations is about two hours, inhibition of hydrochloric acid production is observed within a day after a single dose.
Omeprazole tropin, distributed through the mucous membrane of the stomach, liver and biliary tract, practically does not penetrate the blood-brain barrier and is completely bound to plasma proteins. The degree of binding to the latter can reach up to 90-95%.
Excretion of omeprazole is carried out mainly with urine, while about 60-77% is excreted in the form of metabolites, such as hydroxyomeprazole and carboxylic acid. Most of the formed conjugates show almost no antisecretory activity, with the exception of sulfonemeprazole. The remaining part of the drug substance in the body is excreted through the gastrointestinal tract with bile and fecal matter.
Of particular note is the pharmacokinetics of omeprazole in patients with liver failure. Due to a decrease in the metabolism of a drug substance, its bioavailability reaches a maximum, and the half-life is extended to three hours. In patients with chronic renal failure, the elimination of omeprazole metabolites is slowed in accordance with the purification of blood plasma from creatinine.
Indications for use
Omeprazole and Ultop medicines are indicated for use in the treatment of peptic ulcers of the digestive tract, hyperacid conditions (including gastritis), Zollinger-Ellison syndrome, postoperative conditions, and reflux disease. These drugs can be recommended for the treatment of dyspepsia of non-ulcer genesis, in the treatment of complications caused by therapy with non-steroidal anti-inflammatory drugs (analgesics, antipyretics), as well as for the treatment of uncomplicated heartburn, which occurs no more than 2 times a week.
Despite the indications for use of the Omeprazole medication that are contained in the instructions, which treats this drug, only a qualified specialist knows well. Therefore, in case of deterioration of well-being from the gastrointestinal tract, it is necessary to 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 children. Decreased gastric secretion in hypoacid conditions and atrophic gastritis are also a contraindication to the appointment of omeprazole.
Side effects
About 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 from the gastrointestinal tract. Less commonly observed candidiasis, dry mouth, the development of atrophic or hypoacid gastritis, intestinal polyposis.
On the part of the nervous system (afferent impulse), headaches, feelings of malaise, feelings of anxiety and anxiety, depression and mental disorders can occur. It is not excluded the appearance of visual function disorders that can become permanent.
Allergic reactions to taking omeprazole are rare. Situations may cause hives, itchy skin. Spasm of smooth muscle cells of the bronchi, the development of Quincke's edema with further progression as an anaphylactic reaction and the development of shock condition are noted with a low frequency. The development of gynecomastia and the appearance of pain in the chest are casuistic.
Mode of application
Omeprazole is taken on an empty stomach, washed down with water. In a special category of patients, difficulty may occur when swallowing capsules of the drug. In this case, it is recommended to open the capsule, and prepare a water-based suspension from its contents. Take this suspension should be no later than half an hour after preparation. The daily dosage, a single dose, as well as the course of drug therapy are prescribed by the attending physician.
Features of use during pregnancy and breastfeeding
There are no data on the safety of omeprazole in pregnant women. The drug substance can be indicated for health reasons. The category of influence on the fetus is not defined.
If there is a need to prescribe omeprazole during breastfeeding, then at the time of treatment, the latter should be discarded, 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 the gastric juice. The release of drugs whose metabolism is carried out in the liver also slows down.
The prepared sterile injection solution of omeprazole can be used within 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 the drug "Warfarin", the level of anticoagulant in the blood plasma should be monitored daily or prothrombin time should be monitored in a timely manner .
Treatment of poisoning and overdose
Symptoms of an overdose of omeprazole are manifested in the form of dry mouth, dizziness, headache, and visual impairment. In case of poisoning, confusion, the appearance of drowsiness, palpitations, sensations of hot flashes to the face are possible.
Symptomatic treatment of poisoning, 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 the drugs are used to treat ulcerative lesions of the stomach and duodenum, the etiological factor of which is Helicobacter pylori infection, 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 can mask the symptoms of these diseases and complicate early diagnosis. It is necessary to exclude infectious parasitic diseases, as well as evaluate the functional ability of the liver and kidneys.
Omeprazole or Ultop - which is better?
It is difficult to unequivocally answer this question, because the active substance in both cases is omeprazole. Let's look at the release form of the Ultop drug. Capsules are available in a dosage of 10, 20 and 40 mg, as well as in the form of lyophilized powder (40 mg in one bottle) 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 lyophilized powder (40 mg in one bottle) for the preparation of injection solutions. Freeze-dried powder with solvent in one package is also available. In addition, the drug can be purchased in the form of a sachet (sachets of powder) for the preparation of an oral suspension. It is rare to find Omeprazole tablets (pellets) with a similar drug content.
As for the reviews about 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 ask themselves: “What is better than omeprazole?” However, opinions differ among patients. Quite often, the reviews left about the Ultop drug indicate the occurrence of constipation after ingestion, headache and nausea.
Cost of drugs
Of course, the cost of medicines will depend not only on the pharmacy network in which they are sold, but also on the remoteness of the pharmacy from the medical institution and, of course, on the manufacturer of the medicine. For the Ultop drug, the price ranges from 212 to 360 rubles per package. The final cost depends on the dose and number of capsules in the package. On the drug "Omeprazole" the average price is from 80 to 140 rubles. The price also depends on the dose and number of capsules in the package.
Conclusion
Only the attending physician should prescribe Omeprazole or Ultop. The best of these medicines is known to a competent specialist, and his decision should be based on the indications for the purpose and condition of the patient. It should be borne in mind that often the decisive factor 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 Ultopa. Those who are willing to pay more can look at the analogues of this drug. Despite the somewhat high cost of the Ultop drug, the price may justify the degree of purification of the drug, as well as possible additional modulating additives to the drug itself.
Anyway, it is always worth remembering the golden rule: do not self-medicate. Early diagnosis is the key to successful treatment!