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A specific inhibitor of proton pump  metabolised in the gastric parietal cells to active sulfonamide derivatives that inactivate the sulfhydryl groups. Blocks the final stage of hydrochloric acid secretion, lowering both basal and stimulated secretion, primobolan for sale irrespective of the nature of the stimulus. Inhibition of production of hydrochloric acid at a dose of 30 mg – 80-97%. No effect on the motility of the gastrointestinal tract (GIT). The inhibitory effect of increases in the first four days of admission. After discontinuation of acidity for 39 hours is less than 50% of basal level, “rebound” increase the secretion is not marked. The secretory activity is restored in 3-4 days after ingestion. In patients with Zollinger-Ellison syndrome acts more lasting.

Pharmacokinetics
Absorption – high (eating reduces the absorption and bioavailability, but the inhibitory effect on gastric secretion remains the same, regardless of the meal). Occurrence of a maximum concentration (TC max ) average after oral administration of 30 mg – 1.7 h, the maximum concentration (C max ) – 0,75-1,15 mg / l. The maximum plasma concentration and area under the curve (AUC) are approximately proportional to the dose once. Pharmacokinetics in a dosage range from 15 mg to 60 linear, i.e. concentrations are proportional to the dose, the parameters are constant, there is no accumulation. Relationship to plasma proteins – 97%. Actively metabolized at “the initial passage” through the liver. The half-life (the T 1/2 .) – 1.3-1.7 h excretion by the kidneys (in the form of active metabolites: lansoprazole sulfone and gidroksilansoprazola) – 14-23% (renal failure, the rate and magnitude of excretion is not significantly affected) and bile (2/3). In hepatic insufficiency and in the elderly is slowing down. T 1/2 (hepatic insufficiency) – 3,2-7,2 h and T 1/2 (the elderly) – 1,9-2,9 hours.

Indications

  • Treatment and prevention of relapse of gastric ulcer and duodenal ulcer;
  • Treatment and prevention of erosive and ulcerative gastric and duodenal lesions associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) (NSAID gastropathy);
  • Gastroesophageal reflux disease (GERD), including erosive and ulcerative reflux esophagitis and non-erosive reflux disease forms (NERD);
  • Eradication of Helicobacter pylori in combination with two antibiotics;
  • Zollinger-Ellison syndrome and other pathological conditions accompanied by increased secretion of acid in the stomach.

Contraindications

  • Hypersensitivity to lansoprazole or any other components of the drug;
  • Pregnancy (I term), and lactation;
  • Children under 18 years (in the absence of the use of data in children).

Precautions: hepatic failure, pregnancy (II-III trimesters), advanced age, malignant neoplasms of the gastrointestinal tract, hereditary fructose intolerance, glucose malabsorption syndrome, and / or galactose or sucrose isomaltase deficiency.

Pregnancy and lactation
Experience of lansoprazole in pregnant women is limited. During pregnancy, you can use with caution only in the event that a positive effect for the mother justifies the potential risk to the fetus and child. If necessary, the appointment during lactation should stop breastfeeding because lansoprazole passes into breast milk.

Dosing and Administration
Inside. The capsules should be swallowed whole without chewing. Preferably, single dose per day to take medication in the morning before breakfast, but perhaps also in the evening, before dinner. If necessary, double reception: designate before breakfast and dinner. If you swallow a whole capsule is not possible, the contents can be mixed with a small amount of apple juice (about 1 rounded tablespoon) and swallow immediately without chewing. As can also be introduced by gavage. The maximum daily dose – 60 mg in the case of Zollinger-Ellison Syndrome – can be higher.

In hepatic insufficiency and in elderly patients, treatment is initiated with half doses, gradually increasing them to the recommended, but not more than 30 mg / day.

Peptic ulcer of the duodenum in the acute phase of the disease: 30 mg daily for 2-4 weeks (in resistant cases up to 60 mg per day).

Gastric ulcer in the acute phase: 30 mg 1 time a day for 4-8 weeks.

Erosive-ulcerative lesions of gastric and duodenal ulcers associated with NSAID (NSAID gastropathy): 30 mg daily for 4-8 weeks.

GERD, including reflux and NERD zzofagit: 30 mg daily for 4-8 weeks. In the case of erosive esophagitis, if necessary, the duration of therapy can be increased twice.

Eradakatsiya Helicobacter pylori: 30 mg 2 times a day for 7-14 days in combination with two antibacterial agents.

Anti-treatment of gastric ulcer and 12 duodenal ulcer: 30 mg per day. The efficacy and safety of lansoprazole 12 month therapy proved.

Prevention of relapse of erosive esophagitis: 30 mg per day. The efficacy and safety of lansoprazole 12 month therapy proved.

Prevention of ulcers primobolan for sale and erosions of the stomach and duodenum, as well as dyspeptic symptoms while taking NSAIDs: 30 mg 1 time a knock.

Zollinger-Ellison syndrome: the dose is adjusted individually to achieve the level of basal secretion less than 10 mmol / h. It recommended starting dose – 60 mg once per day. If necessary, a daily dose of 120 mg is recommended to be administered in two doses. The duration of therapy is determined by the doctor.

Side Effects From hemopoiesis system: very rare: leucopenia, thrombocytopenia (with hemorrhagic manifestations), eosinophilia, pancytopenia, agranulocytosis; in some cases – anemia.

From the digestive system: common: constipation; Uncommon: abdominal pain, diarrhea, nausea, dry mouth, dyspepsia, dysgeusia, flatulence; rare: jaundice, hepatitis; very rare: Ulcerative Colitis, candidiasis gastrointestinal, increased activity of “liver” enzymes, hyperbilirubinemia.

On the part of the central and peripheral nervous system: common: headache; Uncommon: malaise, dizziness, agitation, anxiety, confusion, depression, drowsiness, anxiety.

From the senses: common: eye pain, blurred vision; very rare: tinnitus.

With the skin side and subcutaneous tissue: rare: pruritus, purpura, petechiae and loss of hair; very rare: toxic epidermal necrolysis, Stevens – Johnson and erythema multiforme.

From the musculoskeletal and connective tissue: rare: pain in joints, muscles and bones.

From the urogenital system: very rare: interstitial nephritis, renal failure, serum creatinine; very rare: urogenital disorders, impotence, breast enlargement or gynecomastia.

With the respiratory system: rarely – cough, pharyngitis, rhinitis, upper respiratory tract infection, flu-like symptoms.

Allergic reactions: rare: urticaria, angioedema, photosensitivity, skin rash; very rarely: anaphylactic reactions, erythema multiforme.

Disorders of metabolism and nutrition: Rare: anorexia, increased appetite.

Other: alopecia, weakness.

Overdose
There is one report of overdose: The patient received 600 mg of lansoprazole with no adverse effects.

Treatment: symptomatic, the patient should be under medical supervision. Hemodialysis is primobolan for sale ineffective.

Interaction with other drugs:

Lansoprazole reduces the acidity of gastric juice, which can affect the absorption of some drugs. For example, it reduces the bioavailability of ketoconazole, ampicillin esters and iron salts. digoxin bioavailability is increased by 10%, which is clinically insignificant for most patients.

Slows elimination of drugs, metabolized in the liver by microsomal oxidation (r. H. Diazepam, ibuprofen, indomethacin, clarithromycin, prednisolone, propranolol, warfarin or terfenadine, phenytoin).

Reduces by 10% clearance of theophylline, a clinically insignificant effect. Changes of pH-dependent absorption of drugs related to weak acid groups (deceleration) and bases (acceleration). Sukralfat reduces the bioavailability of lansoprazole by 30% (observe the interval between administration of these preparations 30-40 minutes) Antacids slow down and reduce the absorption of lansoprazole (they should be administered for 1 hour or 1-2 hours after receiving lansoprazole).

Cautions
Before therapy is necessary to exclude the presence of malignant process (especially gastric ulcer), t. To. The treatment of “masking” the symptoms, may delay correct diagnosis. Therefore, it is recommended before and after treatment mandatory endoscopic control.

Precautions must be taken Lanzoptol in patients with severe liver disease, and the elderly; with a maximum daily dose of 30 mg.

Changes doses to patients with kidney disease is not required. Lanzoptol contains sucrose, and the drug is not recommended for patients with hereditary fructose intolerance, glucose malabsorption syndrome, and / or galactose or sucrose isomaltase deficiency Buy musclelabsusa steroids online bodybuilding how to lose fat buy tramadols online bodybuilding shred