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► Agastin (omeprazole) - Practical Medicine

Agastin (omeprazole) - hard gastro-resistant capsules

The name of the preparation Character; dose; package Manufacturer Price 100% Price after refund In which pharmacy?
Agastin hard gastro-resistant capsules; 20 mg; 28 caps. Exeltis Poland 11.60 5.80
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Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.

The preparation contains the substance:omeprazole

The drug is available on prescription

What is Agastin?

A drug that inhibits the secretion of hydrochloric acid in the stomach, containing a proton pump inhibitor.

What does Agastin contain and how does it work?

The active substance of the preparation is Omeprazole , a drug from the group of proton pump inhibitors (this group of drugs is sometimes indicated by the abbreviation IPP). This substance blocks the enzyme - a proton pump (ATP-aza K + / H +) in the Pariet al cells of the gastric mucosa, thereby inhibiting the secretion of hydrochloric acid by these cells. In this way, the acidity (pH increases) of the gastric juice decreases. The degree of inhibition depends on the dose and applies to both basal and stimulated secretion of hydrochloric acid.
Omeprazole is sensitive to acid in the stomach juice and is therefore used orally in enteric forms. After oral administration, it is rapidly absorbed from the small intestine, the maximum concentration in the blood is obtained after about 1-3 hours. Food does not affect the bioavailability of omeprazole. After a single dose, the reduction of gastric acid secretion is maintained around the clock. Omeprazole is metabolised in the liver with the cytochrome P450 enzyme system, most metabolites excreted in the urine, partly also in the bile.

When should I use Agastin?

The preparation is indicated:
· In the treatment of duodenal ulcer
· In the treatment of gastric ulcer
· In the treatment of reflux oesophagitis
· In the maintenance treatment of reflux oesophagitis, to prevent relapse
· To treat symptomatic gastroesophageal reflux disease
· In the treatment of Zollinger-Ellison syndrome
· Treatment of gastric and duodenal ulcer associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs)
· In supportive treatment and to prevent recurrence of gastric and duodenal ulcers associated with use (NSAIDs)
· For eradicationHelicobacter pylori(H. pylori) in combination with appropriate antibiotics in people with peptic ulcer of the stomach and duodenum.

When not to use this preparation?

Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the product if you are allergic (you are hypersensitive) to any of the other ingredients or other benzimidazole-based medicines.
The preparation is contraindicated if atazanavir (an antiviral medicine) is used in parallel.
In patients with impaired liver function, omeprazole with Clarithromycin should not be used in parallel.

Take special care with Agastin?

Certain diseases and other circumstances may constitute a contraindication to use or indication to change the dosage of the preparation. In some situations it may be necessary to carry out specific check-ups.
Before starting treatment, the cancerous nature of the disease should be ruled out. The use of the preparation may mask the symptoms of cancer, including stomach cancer and delay the proper diagnosis.You should consult your doctor immediately if you have changed the nature of the symptoms or if you have worrying symptoms such as significant weight loss, recurrent vomiting, swallowing disorders, bloody vomiting, anemia, tarry stools and if stomach ulceration is suspected or suspected.
If the symptoms persist despite the use of the preparation, a doctor should be consulted who may recommend further diagnostic tests.
Before starting treatment, your doctor may recommend additional diagnostic tests to exclude or confirm the infectionH. pylori and to confirm the diagnosis.
The use of proton pump inhibitors may be associated with an increase in the number of bacteria naturally present in the gastrointestinal tract, as well as a slight increase in the risk of gastrointestinal infections by bacteria, such asSalmonellaandCampylobacter.
In patients with severe hepatic impairment, periodic monitoring of liver enzymes is recommended.
Caution should be used if the preparation is used in combination with other medicines in the elderly or in people with impaired renal and / or liver function. In the case of combination therapy, one should also remember about the possibility of interaction between the drugs used.
In order to increase the effectiveness of NSAID ulcer treatment, your doctor will consider stopping or temporarily stopping NSAIDs .
The use of the preparation in the prevention of recurrence of ulcers associated with the use of NSAIDs is limited to patients with an increased risk of their occurrence. This risk will be assessed by the doctor in each case individually, taking into account, among others old age (above 65), gastric or duodenal ulceration and previous Gastrointestinal bleeding .
If the treatment is long-lasting, especially if it lasts for more than a year, you should be under careful medical supervision.
Do not use the product in infants or children up to 2 years of age.
For seriously ill people it is recommended to periodically check vision and hearing.
Additional information about the other ingredients of the preparation:
· The product contains sucrose; people with inherited disorders associated with fructose intolerance, Glucose -galactose malabsorption or sucrase-isomaltase deficiency should not use the preparation.

Does this preparation affect the ability to drive vehicles?
In some people, the preparation may cause side effects such as dizziness, blurred vision, drowsiness and other symptoms that may impair psychophysical fitness. If these side effects occur, do not drive or operate machines or equipment.

Dosage of Agastin

The preparation is in the form of gastro-resistant capsules. It is intended for oral use. Use the product as directed by your doctor. Do not exceed the recommended doses because it will not increase the effectiveness of the drug and may harm your health and life. If you have any doubts regarding the use of the preparation, consult a physician.
Treatment of duodenal ulcer: 20 mg once daily for 2-4 weeks. If necessary, your doctor may increase the dose to 40 mg once a day.
Prevention of duodenal ulcer recurrence: usually 20 mg once daily; some patients have a dose of 10 mg 1 once a day.
Treatment of peptic ulcer: 20 mg once daily for 4-8 weeks. If necessary, your doctor may increase the dose to 40 mg once a day.
Treatment of reflux oesophagitis in adults: 20 mg once daily for 4-8 weeks. If necessary, your doctor may increase the dose to 40 mg once a day.
Treatment of severe reflux oesophagitis in children after two years of age and adolescents when other treatments are ineffective: treatment should be started in a hospital under the supervision of a pediatrician; In children with a body weight of 10-20 kg, 10 mg is used daily and 20 mg per day is used in children who weigh more than 20 kg. The duration of treatment is usually 4-8 weeks; do not use for more than 12 weeks. Do not use in children under 2 years of age or in children weighing up to 10 kg.
Long-term maintenance treatment to prevent the recurrence of reflux oesophagitis: 10-20 mg per day.
Zollinger and Ellison syndrome: initially 60 mg per day, then the doctor will adjust the dosage in each case individually. If doses are higher than 80 mg daily, they should be taken in two divided doses. Treatment should be carried out under close medical supervision. The doctor will determine the duration of treatment.
Treatment of gastric and duodenal ulcer caused by NSAIDs: 20 mg once daily for 4-8 weeks.
Maintenance treatment to prevent recurrent gastric and duodenal ulcer caused by NSAIDs: 20 mg once daily.
For the symptomatic treatment of gastroesophageal reflux disease: 10-20 mg 1 once a day, according to individual doctor's recommendations, for 2-4 weeks. If after 2 weeks of using the preparation there is no improvement, please consult your doctor for further diagnosis.
eradicationH. pylori in patients with peptic ulcer: 20 mg twice daily in combination with the recommended antibiotics (depending on the treatment schedule) for 7 days, sometimes for 14 days. The recommended treatment time should not be shortened.
There is no need to modify the dose in the elderly or with impaired renal function. People with hepatic impairment should consult a doctor before using the product, as dosage adjustments may be necessary; in this group of patients a dose of more than 20 mg per day should not be used.
Application method:
The preparation in the form of capsules is intended for oral use. It is recommended to take the capsules before meals. Capsules should be swallowed whole (do not chew, chew or crumble) with, for example, a glass of water. In order to facilitate swallowing, you can also open the capsule and swallow its contents after mixing it with a small amount of yogurt or fruit juice; the suspension should be prepared immediately before the reception.

Can Agastin be used during pregnancy and breastfeeding?

During pregnancy, do not use any medicine without consulting your doctor!
It is very important that before using any medicine during pregnancy or breastfeeding, consult a physician and explain beyond any doubt the potential risks and benefits associated with the use of the drug. If you are pregnant or plan to become pregnant, please inform the doctor prescribing the prescription for this medicine.
The use of the preparation during pregnancy and breastfeeding is allowed only if the doctor deems it absolutely necessary and if in the physician's opinion the expected benefits clearly outweigh the possible risks. Only a doctor can assess the benefit / risk ratio in your case!

Can I use other preparations in parallel?

Tell your doctor about all medicines you have recently taken, including those that are over the counter.
The preparation is contraindicated if atazanavir (an antiviral medicine) is used in parallel.
Omeprazole reduces the secretion of hydrochloric acid in the stomach and thus reduces the acidity (increases the pH) of gastric juice. Therefore, omeprazole may reduce the absorption of certain drugs, such as, for example, antifungal azole (ketoconazole, posaconazole, Itraconazole ) and reduce the effectiveness of their action. Such combination therapy should be avoided.
Caution should be exercised because omeprazole may increase the concentration of certain concurrently used drugs and increase the systemic exposure to these drugs; this applies to medicines such as:
· Digoxin ; caution is especially required in the elderly and / or when omeprazole is used in high doses; it may be necessary to adjust the doctor's dosage of digoxin
· Warfarin ; it is recommended to check the parameters of blood coagulation; warfarin dosage may need to be adjusted
· Diazepam and other benzodiazepines (e.g., triazolam, flurazepate); observation of the patient is recommended; dosage adjustments may be necessary
· Phenytoin; it may be necessary to reduce the dose of phenytoin; monitoring of phenytoin plasma levels is recommended (especially at the beginning and after completion of omeprazole treatment)
· cilostazol
· Cyclosporin; you should monitor the concentration of cyclosporin in the blood
· Tacrolimus; the concentration of tacrolimus and renal function (creatinine clearance) should be monitored; it may be necessary to reduce the dose of tacrolimus
· saquinavir
· clarithromycin
· Disulfiram; Muscle stiffness may occur.
Interactions of omeprazole with barbiturates (hexabarbital), citalopram , imipramine and clomipramine are possible.
Co-administration of omeprazole with Clopidogrel is not recommended (omeprazole may reduce the effectiveness of clopidogrel).
Omeprazole, like other drugs that reduce the secretion of hydrochloric acid, especially when used for a long time, may reduce the absorption of vitamin B12 (cyanocobalamin) and lead to clinical symptoms of its deficiency.
Omeprazole is metabolised in the liver with the cytochrome P450 enzyme system. The interaction of omeprazole with other drugs metabolised by this enzyme system is possible. Drugs that inhibit 2C19 activity (e.g. fluvoxamine) or 3A4 isoenzyme (eg, ketoconazole, voriconazole, protease inhibitors, clarithromycin) may cause an increase in omeprazole in the blood; in patients with severe hepatic impairment or requiring long-term use of the preparation dosage may need to be adjusted. Drugs that increase the activity of the 2C19 or 3A4 isoenzyme (eg rifampicin, St. John's wort) can cause a significant reduction in the concentration of omeprazole in the blood. St John's wort should not be used during treatment.

What side effects can occur?

Like all medicines, Agastin can cause side effects, although they will not occur in all patients who use this medicine. Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects.
Common or uncommon: nausea, vomiting, diarrhea, constipation, flatulence, indigestion, abdominal pain, increased activity of liver enzymes, headache and dizziness, drowsiness, insomnia, blurred vision (blurred vision, visual field limitation), hearing impairment (tinnitus ), taste disorders, allergic reactions (pruritus, rash, urticaria), alopecia, erythema multiforme, hypersensitivity to light, profuse sweating, peripheral edema. Rare or very rare: dry mouth, oral mucositis, gastrointestinal candidiasis, pancreatitis, hepatitis, jaundice, hepatic failure, encephalopathy in people with previous liver disease, interstitial nephritis, haematological disorders (pancytopenia, agranulocytosis) , leukopenia, thrombocytopenia, anemia), muscle and joint pain, muscle weakness, paresthesia, dizziness / balance disorders, hallucinations, confusion, agitation, depression, aggression, decrease in sodium and / or Magnesium in the blood, gynecomastia, hypersensitivity and Anaphylactic reactions (including angioneurotic edema , for example on the face, larynx, tongue, throat that may interfere with breathing, anaphylactic shock), bronchospasm, fever, severe skin reactions, including Stevens and Johnson syndrome and toxic epidermal necrolysis.

Other preparations on the Polish market containing omeprazole

Bioprazole (hard capsules)
Bioprazole (hard gastro-resistant capsules)
Bioprazol Bio (hard capsules)
Bioprazol Bio Control (hard gastro-resistant capsules)
Bioprazol Bio Max (hard gastro-resistant capsules)
Gasec-20 Gastrocaps (capsules)
Gasec-20 Gastrocaps (hard gastro-resistant capsules)
Goprazole (hard gastro-resistant capsules)
Goprazol Max (hard gastro-resistant capsules)
Helicid 20 (hard gastro-resistant capsules)
Helicid 40 (powder for solution for infusion)
Helicid Control (hard gastro-resistant capsules)
Helicid Forte (hard gastro-resistant capsules)
Heligen (hard gastro-resistant capsules)
Heligen Neo (hard gastro-resistant capsules)
Losec (capsules)
Loseprazol 20 (hard gastro-resistant capsules)
Nozer (hard gastro-resistant capsules)
Nozer Med (hard gastro-resistant capsules)
Omeprazole Aurobindo (hard gastro-resistant capsules)
Omeprazole Farmax (hard gastro-resistant capsules)
Omeprazole Mylan (powder for solution for infusion)
Omeprazole Genoptim (capsules)
Omeprazole Genoptim (hard gastro-resistant capsules)
Omeprazole Genoptim SPH (hard gastro-resistant capsules)
Omeprazolum 123ratio (hard gastro-resistant capsules)
Ortanol 20 Plus (capsules)
Ortanol 40 Plus (capsules)
Ortanol Max (enteric capsules)
Piastprazole (hard gastro-resistant capsules)
Polprazole (hard gastro-resistant capsules)
Polprazol (powder for solution for infusion)
Polprazol Acidcontrol (hard gastro-resistant capsules)
Polprazol Max (hard gastro-resistant capsules)
Polprazol PPH (hard gastro-resistant capsules)
Prazol (capsules)
Prazol (hard gastro-resistant capsules)
Prenome (hard gastro-resistant capsules)
Progastim (enteric capsules)
Ultop (hard gastro-resistant capsules)
Ventazol (hard gastro-resistant capsules)