Nolpase (pantoprazole) is an anti-ulcer drug of the proton pump inhibitor group (IPP). Used to treat diseases associated with the aggressive effects of hydrochloric acid on the mucous membranes of various parts of the digestive tract.
The active ingredient reduces the basal and stimulated synthesis of hydrochloric acid by inhibiting the proton pump of the parietal cells of the gastric mucosa. The acidic environment of the gastric contents activates the drug.
As a result, the acidity of gastric juice decreases. Pantoprazole causes an increase in gastrin concentration in the gastric contents.
Clinical and pharmacological group
Inhibitor H + -K + -ATP-ase. Anti-ulcer drug.
Pharmacy sales terms
It is released on prescription.
How much does Nolpaz in pharmacies? The average price is at 150 rubles.
Release form and composition
The drug is produced in the form of oval yellow-brown tablets, enteric-coated.
- The composition of one tablet Nolpaz 20 includes 20 mg of pantoprazole sodium (in terms of pantoprazole), as well as sorbitol, mannitol, crospovidone, calcium stearate, anhydrous sodium carbonate as auxiliary substances.
- The composition of one tablet Nolpaz 40 includes 40 mg of pantoprazole sodium (in terms of pantoprazole), and similar excipients.
They are realized in blister packs of 14 pieces each, sold in cardboard boxes of 1, 2 or 4 packs in each.
Pantoprazole is characterized by the ability to block the enzyme H + -K + -ATP-azu, which is responsible for the transfer of hydrogen protons to the covering cells of the fundic glands of the gastric wall, due to which the process of HCl biosynthesis stops at the final stage. Acid production is reduced regardless of the nature of the stimulating factor.
The active ingredient is released and absorbed in the small intestine. After taking 20 mg of the drug, the effect reaches its maximum after 2-2.5 hours. The motility of the digestive tract (in particular - the speed of evacuation of the contents of the stomach), the drug does not affect. After completing the course, HCl production returns to normal levels only after 3-4 days. The level of bioavailability averages 77%, and does not decrease after a meal. With blood proteins conjugated to 98% of the active substance. The process of pantoprazole biotransformation takes place in the liver, and metabolic products are excreted mainly in the urine (more than 80%).
The half-life of the major metabolite is 1 hour; it increases significantly in patients with cirrhosis of the liver.
Indications for use
What helps? Nolpase is prescribed for hyperacid states - an increase in gastric acidity, including with erosive and ulcerative lesions of the mucous membrane.
- Reflux esophagitis.
- Zollinger-Ellison syndrome.
- Gastroesophageal reflux disease (GERD).
- A peptic ulcer localized in the stomach and duodenum.
- Pathological conditions accompanied by increased secretion of hydrochloric acid and hyperacidity.
Nolpazu is used to treat diseases of the gastrointestinal tract associated with Helicobacter pylori infection (Helicobacter pylori) during antimicrobial therapy.
Contraindications for taking Nolpazy following:
- High sensitivity to the components of the drug (fructose intolerance, etc.).
- You can not take the drug for people with neurotic dyspepsia.
- Nolpase 40mg is not used together with antimicrobial agents for the treatment of patients with severe kidney and / or liver diseases.
The drug is prescribed with caution:
- Those who have a high risk of developing ulcers, intestinal, stomach bleeding.
- Patients at high risk of developing hypovitaminosis B12.
- People suffering from liver disease. If the treatment is carried out for a long time, the level of hepatic enzymes must be monitored in patients.
Use during pregnancy and lactation
If necessary, use Nolpaza during pregnancy, it is necessary to assess the intended benefits to the mother and the potential risk to the fetus.
If necessary, use during lactation should decide on the termination of breastfeeding.
Dosage and method of use
The instructions for use indicate that Nolpaz is taken orally. The tablet should be swallowed whole, not chewed or cracked, washed down with a small amount of liquid, before eating, usually before breakfast. When taking a second dose of the drug is recommended to take before dinner.
- For eradication of Helicobacter pylori (in combination with antibiotics) the recommended dose is 40 mg 2 times a day in combination with two antibiotics, usually the course of anti-helicobacter therapy is 7-14 days.
- With GERD, incl. erosive-ulcerative reflux esophagitis and associated symptoms (heartburn, acid regurgitation, pain when swallowing) mild, recommended dose - 20 mg / day, moderate and severe - 40-80 mg / day. Symptom relief usually occurs within 2–4 weeks. The course of therapy is 4-8 weeks.
- For prophylaxis, as well as supporting long-term therapy, 20 mg / day is prescribed, if necessary, the dose is increased to 40-80 mg / day. It is possible to take the drug “on demand” when symptoms occur.
- When erosive and ulcerative lesions of the stomach and duodenum, associated with the intake of NSAIDs, the recommended dose - 40-80 mg / day. The course of therapy is 4-8 weeks.
- For the prevention of erosive lesions on the background of long-term use of NSAIDs - 20 mg.
- For the treatment and prevention of gastric ulcer and duodenal ulcer appoint 40-80 mg / day. The course of treatment for acute exacerbation of duodenal ulcer is usually 2 weeks, and gastric ulcer is 4-8 weeks. If necessary, the duration of therapy is increased.
- With Zollinger-Ellison syndrome and other pathological conditions associated with increased gastric secretion, the recommended starting dose of long-term therapy with pantoprazole is 80 mg / day, divided into 2 doses. 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 in order to adequately control 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 with Helicobacter pylori, the duration of therapy usually does not exceed 7 days.
In patients with severely impaired liver function, the dose of pantoprazole should not exceed 40 mg / day and it is recommended to regularly monitor the activity of hepatic enzymes, especially with prolonged treatment with pantoprazole. With increasing activity of liver enzymes, it is recommended to cancel the drug.
Very rarely, with prolonged treatment with Nolpaza, there have been cases of development of renal failure, destructive lesions of the liver tissue, including jaundice.
Sometimes patients complain about the occurrence of such side effects Nolpazy:
- neurogenic neurogenic origin;
- breast pains;
- excessive gas, bloating, bouts of vomiting;
- peristalsis disorder;
- pains in muscles and joints;
- allergic reactions: urticaria, pruritus, redness and rash on the upper layer of the epidermis under the action of sunlight, erythema;
- swelling of different localization.
The nervous system can also manifest side effects: sleep disturbance, lethargy, apathy, emotional lability, dizziness.
Overdose Nolpazoy theoretically possible, but its symptoms in humans are unknown. Therefore, when there are signs of intoxication (headache, nausea, general weakness, fatigue, etc.) after taking a high dose of Nolpaz, they should be considered as symptoms of overdose and detoxification measures should be taken (excessive drinking, diuretic and sorbents, administration plasma solutions, glucose, sodium thiosulfate or intravenous unithiol).
Before you start using the drug, read the specific instructions:
- If after 4 weeks of treatment with pantoprazole, the patient does not have the desired therapeutic effect, he should be re-examined.
- Conducting long-term therapy, especially for more than 1 year, requires regular monitoring of the patient.
- Like other proton pump inhibitors, pantoprazole may reduce the absorption of cyanocobalamin (vitamin B12) on the background of hypo- and achlorhydria. This should especially be considered with long-term treatment and in patients with risk factors for vitamin B12 deficiency.
- Before starting therapy, it is necessary to exclude the presence of a malignant neoplasm (endoscopic control, if necessary with a biopsy - especially for a stomach ulcer), since treatment, masking the symptoms, may delay the correct diagnosis.
The drug does not affect the ability to drive a car or other technical means.
When using the drug, you must consider the interaction with other drugs:
- While taking pantoprazole with antacids, no drug interaction has been registered.
- Nolpase reduces the absorption of drugs, the bioavailability of which depends on the pH of the stomach and absorbed at acidic pH values (for example, ketoconazole).
- Although with simultaneous use with warfarin in clinical pharmacokinetic studies, no significant interaction was found, several separate reports of a change in MHO were noted. In patients receiving coumarin anticoagulants, simultaneously with pantoprazole, it is recommended to regularly monitor the prothrombin time or MHO.
- Pantoprazole is metabolized in the liver through the enzyme system of cytochrome P450. Pantoprazole interactions with drugs that are metabolized by the same system cannot be ruled out. However, in clinical studies, no significant interaction with digoxin, diazepam, diclofenac, ethanol, phenytoin, glibenclamide, carbamazepine, caffeine, metoprolol, naproxen, nifedipine, piroxicam, theophylline, and oral contraceptives was found.
We picked up some reviews of people using the Nolpaz drug:
- Olga I have been suffering from GERD with high acidity for several years. And every year I just need to undergo prevention from exacerbation of the disease. Initially, she took omeprazole, but for the last 2 years, the doctor prescribes nolpase to drink. 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 the gastric juice. And the disease does not worsen after a course of taking nolpase longer compared with similar drugs. For the whole course you need several packages, since you need to take it a month. It is not so cheap, but the result is worth it!
- Lily Peptic ulcer, pancreatitis, I took a long omez, an ultrop, I take Nolpaz from November, I tried 10 mg from a 20-ka switch, it does not work. Today I tried not to take it until 11.30, it began, the whole digestive tract was doused with acid. Afraid of pancreatitis attack, again took.
- Lyudmila. Stomach problems have arisen due to an irresponsible attitude to health and nutrition. Doctors in a private clinic diagnosed gastritis. Discharged several drugs, among which was nolpaz. It is, of course, not cheap, but it was necessary to drink the course. Stomach pain gone. But there was a terrible bitterness in the mouth. After reading numerous reviews on the use of this drug, I noticed that there were a lot of complaints about the appearance of bitterness. We treat one thing - the other is crippled - this is a pattern when using strong drugs. The recommendations of the doctors in this case are the following - along with this medicine, it is necessary to drink hepatoprotectors. And no bitterness will bother you.
In the pharmacy network, you can always find drugs containing the same active ingredient, or with similar therapeutic effects. The following drugs are referred to as structural analogs of Nolpazy according to the active substance:
- Zipantola tablets;
- Kontrolok tablets and powder for solution for injection;
- Crocicide tablets;
- Pantasis tablets;
- Panum pills;
- Peptazole tablets;
- Pigenum-sanovel tablets;
- Sanpraz tablets and lyophilisate for solution for injection;
- Ultra pills;
- Pantoprazole Canon Tablets;
- Puloref tablets.
Among the drugs that have a similar therapeutic effect, use:
Before using analogues consult your doctor.
Storage conditions and shelf life
Store the drug should be in a dry place, protect from light. Storage temperature should be between 15 and 30 degrees.
The shelf life of the drug for 2 years.