Kvamatel pills 20mg №28

Blocker H2-histamine receptors III generation. Suppresses the production of hydrochloric acid, both basal and stimulated by histamine, gastrin and acetylcholine. Simultaneously with a decrease in the production of hydrochloric acid and an increase in pH, the activity of pepsin decreases. Strengthens the protective mechanisms of the gastric mucosa and promotes healing associated with exposure to hydrochloric acid damage (including the cessation of Gastrointestinal bleeding and scarring stress ulcers) by increasing the formation of gastric mucus, the content of glycoproteins in it, stimulate the secretion of bicarbonate by the mucous membrane stomach, endogenous synthesis of Pg in it and the rate of regeneration. Weakly inhibits the cytochrome P450 oxidase system in the liver. After ingestion, the action begins after 1 hour, reaches a maximum within 3 hours and continues, depending on the dose, from 12 to 24 hours. Under the conditions of intravenous administration, the maximum effect develops after 30 minutes. A single dose (10 and 20 mg) suppresses secretion by 10–12 hours.

When ingestion absorption is incomplete; bioavailability - 40-45%, increases when taken with food and decreases on the background of antacids. Communication with plasma proteins - 15-20%. TCmax - 1-3 hours. Penetrates into CSF, through the placental barrier and into breast milk. T1 / 2 - 2.5-3.5 h.In patients with severe renal insufficiency (CC - below 10 ml / min), it increases to 20 hours (dose adjustment is required). 30-35% is metabolized in the liver to form S-oxide. Excreted by the kidneys by glomerular filtration and tubular secretion. 25-30% of the dose taken orally, and 65-70% of the entered IV, is found in the urine unchanged.

Peptic ulcer and duodenal ulcer, hyperacidity of the gastric juice, heartburn (associated with hyperacidity), symptomatic and stress ulcers stomach, erosive reflux esophagitis, NSAID-gastropathy, Zollinger-Ellison syndrome, systemic mastocytosis, polyendocrine adenomatosis, prevention of rebleeding postoperatively; prevention of gastric juice aspiration in patients undergoing surgery under general anesthesia (Mendelssohn's syndrome); aspiration pneumonitis (prophylaxis), dyspepsia with epigastric or chest pain appearing at night or associated with food intake.

Contraindications

Hypersensitivity, pregnancy, lactation. With caution - liver failure, cirrhosis of the liver with portosystemic encephalopathy (in history), renal failure, childhood.

Inside, during exacerbations of gastric ulcer and duodenal ulcer - at 0.04 g once a day before bedtime or at 0.02 g 2 times a day. If necessary, the daily dose can be increased to 0.08-0.16 g. The duration of treatment is 4-8 weeks.For the prevention of peptic ulcer exacerbations - by 0.02 g once a day before bedtime. With Zollinger-Ellison syndrome - in the initial dose of 0.02-0.04 g 4 times a day; if necessary, the daily dose can be increased to 0.24-0.48 g. With reflux esophagitis, the initial dose is 0.02 g 2 times / day to 6 weeks (if necessary, 20-40 mg 2 times / day to 12 weeks). To prevent aspiration of gastric contents - 0.04 g on the eve of the operation or on the morning of the operation, or 0.02 g in / in the jet, 2 hours before the operation. Patients with QC below 30 ml / min or with a serum creatinine concentration of more than 3 mg / 100 ml are recommended to reduce the daily dose to 0.02 g. Children: with gastroesophageal reflux, by mouth, 1-2 mg / kg / day for children weighing more than 10 kg in 2 divided doses, with a body weight less than 10 kg - in 3 divided doses. In / in slowly, for 2 minutes (gastric bleeding or inability to ingest) for gastric ulcer and duodenal ulcer, hypersecretory conditions of the stomach - 0.02 g every 12 hours; in the prevention of aspiration pneumonitis - in / m, 0.02 g at bedtime the day before or in the morning on the day of the surgical operation. Powder for injection diluted in 5-10 ml of 0.9% sodium chloride (ampoule solvent).

Adverse reactions

On the part of the digestive system: dry mouth, decreased appetite, nausea, vomiting, abdominal pain, increased activity of liver transaminases, hepatocellular, cholestatic or mixed hepatitis, acute pancreatitis. From the side of blood-forming organs: leukopenia, thrombocytopenia, agranulocytosis, pancytopenia, hypoplasia, bone marrow aplasia.Allergic reactions: urticaria, skin rash, itching, bronchospasm, angioedema, anaphylactic shock. On the part of the cardiovascular system: reduction of blood pressure, bradycardia, AV blockade, with parenteral administration - asystole. The nervous system: headache, dizziness, confusion, hallucinations. On the part of the senses: blurred visual perception, accommodation paresis, tinnitus. On the part of the urogenital system: with prolonged intake of large doses - hyperprolactinemia, gynecomastia, amenorrhea, decreased libido. From the musculoskeletal system: arthralgia, myalgia. Local reactions: irritation at the injection site. Other: dry skin. Overdose. Symptoms: vomiting, motor agitation, tremor, decrease in blood pressure, tachycardia, collapse. Treatment: adequate symptomatic and supportive therapy. Hemodialysis is effective.

Special notes

May mask the symptoms associated with carcinoma of the stomach, so before starting treatment it is necessary to exclude the presence of cancer-ulcers. Famotidine, like all H2-histamine blockers, is undesirable to abruptly cancel (bounce syndrome). With prolonged treatment in debilitated patients, as well as under stress, bacterial lesions of the stomach are possible, followed by the spread of infection. With caution used in patients with abnormal liver function. H2-histamine receptor blockers should be taken 2 hours after taking itraconazole or Ketoconazole in order to avoid a significant decrease in their absorption.H2-histamine receptor blockers can counteract the effects of pentagastrin and histamine on the acid-forming function of the stomach, so it is not recommended to use H2-histamine receptor blockers during the 24 hours preceding the test. H2-histamine receptor blockers can suppress the skin reaction to histamine, thus leading to false-negative results (it is recommended to stop using the H2-histamine receptor blockers before carrying out diagnostic skin tests to detect an allergic immediate-type skin reaction). During treatment, avoid eating foods, drinks and other drugs, which can cause irritation of the gastric mucosa.

Drug Interactions

Antacids, sucralfat slow down absorption. Reduces the absorption of itraconazole and ketoconazole. Drugs that inhibit bone marrow increase the risk of neutropenia. It inhibits metabolism in the liver phenazone, aminophenazone, diazepam, hexobarbital, propranolol, Lidocaine, phenytoin, aminophylline, theophylline, anticoagulants, tricyclic antidepressants, glipizide, buformin, Metoprolol, Metronidazole, caffeine, BCCI. Increases absorption of Amoxicillin and clavulanic acid. Compatible with 0.9% sodium chloride solution, 5% dextrose solution, 0.18% sodium chloride solution, 4% dextrose, 4.2% sodium bicarbonate solution.