Losek MAPS
Losek MAPS: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. In case of impaired liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Losec MUPS
ATX code: A02BC01
Active ingredient: Omeprazole (Omeprazolum)
Manufacturer: Astrazeneca (Sweden)
Description and photo update: 2018-23-10
Prices in pharmacies: from 266 rubles.
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Losek MAPS is a drug that lowers the secretion of gastric glands, a proton pump inhibitor.
Release form and composition
Dosage form Losek MAPS - film-coated tablets: biconvex, oblong, at a dosage of 10 mg - light pink with engraving "10 mG"; at a dosage of 20 mg - pink with engraving "20 mG" (dosage 10 mg - 14 pcs. in plastic bottles; dosage 20 mg - 14 or 28 pcs. in plastic bottles; in a cardboard box 1 bottle).
Composition of 1 tablet 10/20 mg:
- active substance: omeprazole magnesium - 10.3 / 20.6 mg (which corresponds to 10/20 mg of omeprazole);
- auxiliary components: microcrystalline cellulose, glycerin monostearate 40-55, hyprolose, hypromellose, crospovidone, magnesium stearate, copolymer of methacrylic and ethacryl acids, paraffin, macrogol, polysorbate 80, sodium stearyl fumarate, sucrose, talc, triethyl titanium dioxide red and yellow.
Pharmacological properties
Pharmacodynamics
Losec MAPS is an antiulcer drug. Its action is due to the inhibition of hydrogen-potassium adenosine triphosphatase (H + / K + -adenosine triphosphatase) in the parietal cells of the stomach, which leads to blocking the formation of hydrochloric acid at the last stage.
With daily use, the drug effectively inhibits basal and stimulated secretion. Its maximum efficiency is achieved within 4 days. As part of combination therapy with antibacterial drugs, Losec MAKS leads to the eradication of Helicobacter pylori, relieves the symptoms of the disease, helps to achieve stable remission, reduces the risk of bleeding from the gastrointestinal tract (GIT), heals damage to the gastric mucosa. With Losek MAPS therapy, there is no need for long-term antiulcer treatment.
A decrease in hydrochloric acid secretion leads to the growth of normal flora, which may lead to a slight increase in the risk of developing intestinal infections caused by Salmonella spp. and Campylobacter spp., as well as Clostridium difficile in patients receiving therapy in a hospital setting.
Proton pump inhibitors should be discontinued 5-14 days prior to the CgA (chromogranin A) test to avoid bias in test results.
With prolonged use of omeprazole in patients of different age groups, an increase in the number of ECL-cells (enterochromaffin-like cells) was noted, which is probably associated with an increase in the concentration of gastrin in the blood serum. This phenomenon has no clinical significance.
Pharmacokinetics
Absorption of the drug occurs in the small intestine for 3-6 hours. Its bioavailability is about 60%, and increases by almost 50% with repeated use, compared to taking a single dose. The connection with plasma proteins is 95%; volume of distribution - 0.3 l / kg. The bioavailability of omeprazole does not depend on the timing of the meal.
T 1/2 (half-life) is 30–90 minutes. Omeprazole is broken down mainly in the liver by the cytochrome system, excreted mainly, up to 80% in the form of metabolites in the urine, 20% in the feces.
A significant decrease in plasma clearance and an increase in the bioavailability of Losec MAPS were observed in patients with impaired liver function.
Indications for use
- peptic ulcer of the stomach and / or duodenum;
- pathologies of the gastrointestinal tract associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs): ulcers and erosion of the stomach and duodenum;
- eradication of Helicobacter pylori in peptic ulcer disease;
- reflux esophagitis;
- dyspepsia caused by acidity;
- symptomatic gastroesophageal reflux disease;
- Zollinger-Ellison syndrome.
Contraindications
Absolute contraindications:
- deficiency of sucrase / isomaltase, fructose intolerance, glucose-galactose malabsorption;
- increased sensitivity to the active and auxiliary components of Losec MAPS, as well as to substituted benzimidazoles.
Omeprazole therapy can mask the symptoms of a malignant neoplasm, slowing down the diagnosis. In this connection, with significant spontaneous weight loss, dysphagia, frequent vomiting, vomiting with blood, melena, as well as a diagnosed stomach ulcer (or suspicion of it), the presence of a malignant tumor should be excluded.
Instructions for use Losek MAPS: method and dosage
Losek MAPS is taken orally, once a day, in the morning. It is recommended to swallow the tablets whole with a liquid, or dissolve in a small amount of water or a slightly acidic liquid, such as fruit juice. The resulting solution should be used within 30 minutes. In order to be sure of the completeness of the dose drunk, it is recommended to pour a small amount of liquid into the used container again, shake it and drink.
Recommended dosage:
- stomach ulcer: 20 mg per day, course duration - 4 weeks, if necessary, a second course is possible. With a poor response to treatment, the dose can be increased to 40 mg per day for 1 dose, the duration of the course is 8 weeks. Further, in order to prevent relapses, it is recommended to take 20 mg per day, if necessary, the dose can be increased to 40 mg per day;
- duodenal ulcer: 20 mg per day, course duration - 2 weeks, if necessary, a second course is possible. With a poor response to treatment, the dose can be increased to 40 mg per day, for 1 dose, the duration of the course is 4 weeks. Further, in order to prevent relapses, it is recommended to take 10 mg per day, if necessary, the dose can be increased to 20-40 mg per day;
- NSAID-associated ulcers and erosion of the stomach and duodenum: 20 mg per day, course duration - 4 weeks, if necessary, a second course is possible. Further, in order to prevent relapses, it is recommended to take the drug at 20 mg per day;
- reflux esophagitis: 20 mg per day, course duration - 4 weeks, if necessary, it is possible to repeat the course, with / without increasing the dose of the drug to 40 mg per day. In case of reflux esophagitis in remission, the recommended dose is 10 mg (up to 20–40 mg if necessary) per day, in the form of long-term maintenance therapy;
- symptomatic gastroesophageal reflux disease; dyspepsia caused by acidity: 10–20 mg per day; if the symptoms of the disease do not disappear after 4 weeks of therapy, an additional examination of the patient is recommended;
- Zollinger-Ellison syndrome: 60-120 mg per day; the dose should be selected by the doctor individually, in the case when the daily dose of the drug exceeds 80 mg, it should be divided into 2 doses.
Recommended modes of eradication of Helicobacter pylori in peptic ulcer disease:
- three-component regimen: Losec MAPS 20 mg + metronidazole 400 mg (or tinidazole 500 mg) + clarithromycin 250 mg - all drugs are taken 2 times a day for a week;
- three-component scheme: Losec MAPS 40 mg once a day + amoxicillin 500 mg three times a day + metronidazole 400 mg three times a day - for a week;
- three-component regimen: Losek MAPS 20 mg + amoxicillin 1000 mg + clarithromycin 500 mg - all drugs are taken 2 times a day for a week;
- two-component scheme: Losec MAPS 40-80 mg once a day + amoxicillin 1500 mg (divided into 2 doses) is taken for 2 weeks.
After that, treatment should be continued in accordance with the recommended dosage for the treatment of gastric ulcers and duodenal ulcers.
If, after undergoing the recommended treatment, the test for Helicobacter pylori is positive, the course of therapy can be repeated.
Side effects
- central and peripheral nervous system: headache, dizziness, drowsiness, insomnia, paresthesia, impaired taste, blurred vision, confusion (reversible), depression, agitation, hallucinations (mainly in patients with severe disease);
- digestive system: constipation, diarrhea, abdominal pain, nausea, vomiting, flatulence, increased activity of hepatic transaminases, stomatitis, dry mouth, gastrointestinal candidiasis, encephalopathy (in patients with severe liver disease), jaundice, hepatitis, liver dysfunction;
- endocrine system: gynecomastia;
- hematopoietic system: leukopenia, agranulocytosis, thrombocytopenia, pancytopenia;
- musculoskeletal system: joint and muscle pain, muscle weakness;
- skin and subcutaneous fat: rash, itching, photosensitivity, alopecia, erythema multiforme;
- allergic reactions: urticaria, Quincke's edema, fever, bronchospasm, interstitial nephritis, anaphylactic shock;
- other reactions: malaise, increased sweating, peripheral edema, decreased sodium concentration in the blood.
When using Losec MAPS, undesirable effects are usually mild and transient. In most cases, the causal relationship of the listed side effects with taking the drug has not been established.
Overdose
The use of omeprazole at a dose of up to 400 mg did not cause overdose symptoms, while the rate of its elimination did not change and specific therapy was not required. After taking the drug in a dose of 560 mg by adult patients, moderate intoxication was noted.
Overdose symptoms are apathy, confusion, dizziness, headache, vascular dilatation, tachycardia, nausea, vomiting, flatulence, diarrhea. It is recommended to take activated charcoal and gastric lavage, and, if necessary, conduct symptomatic therapy.
special instructions
Patients at risk of developing osteoporosis, or fractures on its background, need to be monitored during Losec MAPS therapy, as there is evidence from observational studies that proton pump inhibitors can lead to an increased risk of fractures associated with osteoporosis (the relationship between taking omeprazole and fracture has not been identified in other studies).
With prolonged use of drugs that suppress the secretion of gastric glands, there is a risk of the formation of glandular gastric cysts of a benign nature. Such formations are the result of physiological changes as a result of inhibition of the secretion of hydrochloric acid and in the process of further therapy pass independently.
Influence on the ability to drive vehicles and complex mechanisms
During the period of therapy with Losec MAPS, side effects such as dizziness, drowsiness and blurred vision may occur, and therefore, care should be taken when driving vehicles, as well as performing other activities that require increased concentration of attention and speed of psychomotor reactions.
Application during pregnancy and lactation
According to the instructions, Losek MAPS is approved for use during pregnancy, as studies have shown that there is no undesirable effect on the fetus or pregnancy.
Omeprazole passes into breast milk, but when used in therapeutic doses, it is unlikely to affect the child.
Pediatric use
The experience of using omeprazole in children is insufficient.
With impaired renal function
Patients with impaired renal function do not need Losec MAPS dose adjustment.
If liver function is impaired
In patients with impaired liver function, the bioavailability and half-life of the drug increase, and therefore do not exceed a dose of omeprazole more than 10–20 mg per day.
Use in the elderly
Elderly patients do not need dose adjustment of Losec MAPS.
Drug interactions
Co-administration of omeprazole with atazanavir and nelfinavir is contraindicated.
Omeprazole does not affect the metabolism of cyclosporine, lidocaine, quinidine, estradiol, erythromycin, budesonide, and other drugs metabolized by the CYP3A4 isoenzyme.
Omeprazole does not interact with caffeine, theophylline, S-warfarin, piroxicam, diclofenac, naproxen, metoprolol, propranolol, ethanol.
Omeprazole interacts with the following drugs:
- digoxin: increases its absorption;
- ketoconazole, itraconazole, erlotinib: reduces their absorption;
- warfarin, diazepam, vitamin K antagonists, cilostazol: slows down the metabolism of these drugs, it is necessary to control the INR (international normalized ratio), dose reduction may be required. Co-administration of cilostazol with omeprazole (40 mg per day) leads to an increase in Cmax (peak drug concentration in the blood) and AUC (area under the concentration-time pharmacokinetic curve) of cilostazol by 18% and 26%, respectively, and for one of the active metabolites of cilostazol the increase was 29% and 69%, respectively;
- clopidogrel (loading dose 300 mg and maintenance dose 75 mg / day): when used with omeprazole 80 mg / day, there is a decrease in exposure to the active metabolite of clopidogrel, on average, by 46% and a decrease in the maximum inhibition of ADP-induced platelet aggregation, on average, by 16%. The clinical significance of this effect is not clear. There is no evidence of an increased risk of cardiovascular complications. It is not known whether the risk of thromboembolic cardiovascular complications is increased;
- tacrolimus: its concentration in blood serum increases;
- methotrexate: sometimes there is an increase in its concentration, which may require the cancellation of omeprazole during the period of methotrexate therapy.
The effect of drugs on the pharmacokinetics of omeprazole:
- inhibitors of isoenzymes CYP2C19 and CYP3A4, such as clarithromycin and voriconazole: can slow down the metabolism of omeprazole, causing an increase in its concentration in blood plasma. When taking voriconazole and omeprazole, the AUC of the latter increases more than 2 times. Correction of the dosage of omeprazole is not required, since it is well tolerated in high doses;
- inducers of isoenzymes CYP2C19 and CYP3A4, such as rifampicin and St. John's wort preparations: accelerate the metabolism of omeprazole, leading to a decrease in its concentration in blood plasma.
Analogs
Analogs of Losek MAPS are Gastrozol, Zhelkizol, Omal, Omez, Omeprazole, Omizak, Ortanol, Pleom-20, Promez, Romesek, Ulkozol, Ultop, Helicid, Tsisagast, etc.
Terms and conditions of storage
Store at a temperature not exceeding 25 ° C. Keep out of the reach of children.
Shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Losek MAPS
Reviews about Losek MAPS are mostly positive. Patients talk about the high efficiency of the drug when used for the treatment of ulcerative lesions of the stomach and esophagus, reflux disease, as well as for lowering the acidity of gastric juice. It is noted that the symptoms of these diseases (heartburn, feeling of heaviness in the intestines, belching) pass already at an early stage of therapy.
Of the minuses, some patients cite the high cost of the drug and the presence in rare cases of side effects, such as nausea at the beginning of treatment.
Price for Losek MAPS in pharmacies
The approximate price for Losek MAPS (in a dosage of 20 mg) for a package containing 14 tablets is 316 rubles, for 28 tablets - 508 rubles.
Losek MAPS: prices in online pharmacies
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Drug name Price Pharmacy |
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Losek MAPS 20 mg film-coated tablets 14 pcs. 266 r Buy |
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Losek Maps tablets p.p. 20mg 14 pcs. 283 r Buy |
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Losek Maps 20 mg film-coated tablets 28 pcs. RUB 516 Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
