Nolpase: analogues and substitutes, composition, instructions for the use of antiulcer drug

Proton pump inhibitors (PPIs), which include Nolpaza, analogues and generics for about half a century remain drugs for the treatment of pathologies accompanied by increased acidity of the stomach. The first drug in this group - Omeprazole, was approved and introduced into clinical practice in the 70s of the twentieth century. Nolpaza is a new generation drug that has received not only the EU certificate of conformity, but also numerous awards. The medicine has only been on the pharmaceutical market for several years, but, according to statistics, it has become a leader among the most commonly prescribed PPIs in Central Europe.

Composition, active substance Nolpaza

The main active ingredient in Nolpaz tablets is pantoprazole. The complex also includes components that are used in the production of solid forms as fillers, stabilizers and emulsifiers. The tablets have a coating resistant to the action of stomach acids. It dissolves in the intestine, which allows you to protect the drug from an acidic environment and release it only in the right place in the digestive tract.

The medicine is produced in the form of tablets containing pantoprazole 20 and 40 mg in one piece. The package may contain 14 and 28 tablets. Produces the drug JSC “Krka, dd, Novo mesto” (Slovenia).

For Nolpase, Krka does not acquire imported components, but synthesizes pantoprazole in its own factory. The technology by which the active substance is released has no analogues and is the know-how of the company.

Despite the fact that the production technology differs from the original, the obtained pantoprazole meets international standards. And as laboratory, clinical studies have shown, does not differ in characteristics from the original. Nolpase 40 mg and 20 mg exactly corresponds to Pantoprazole 40 mg and 20 mg.

Nolpase belongs to the group of antisecretory drugs. The active substance blocks potassium hydrogen adenosine triphosphatase (H + / K + ATPase) - an enzyme of the membranes of the parietal cells of the stomach, or the so-called proton pump. Pantoprazole prevents the transport of hydrogen ions (H +) into glandular cells, which reduces the production of hydrochloric acid.

The mechanism of action of the drug determines its use in the treatment of a large number of acid-dependent gastrointestinal pathologies:

• reflux esophagitis or GERD;
• gastritis;
• duodenitis;
• ulcers of the stomach and duodenum;
• erosive lesions of the digestive system of iatrogenic nature;
• pancreatitis and other diseases.

Diseases are found in all age groups and are often combined with Helicobacter pylori lesions.

All IPPs are derivatives of the same chemical substance, but with a different molecular structure, which makes their properties individualized.

In particular, various PPIs bind to different sites of H + / K + ATPase, which determines:

• the duration of the effect of reducing acidity;
• the time of transformation and activation of the substance;
• number of negative influences;
• stability of the molecule of the active substance in an acidic environment.

Nolpaza stands out against the background of previous generation IPPs:

• prolonged antacid effect;
• lack of "ricochet" hypersecretion of acid;
• selective intracellular exposure;
• the lowest level of negative manifestations.

Pantoprazole, the only one of the PPI, irreversibly blocks the proton pump.

It binds immediately with 2 cysteines (cysteine ​​813 and 822) and it takes about 46 hours to restore function of parietal cells. While drugs of the first generation (Lansoprazole) are only 15 hours, the second (Omeprazole and Rabeprazole) - 30 hours.

In the stomach, Nolpaza is absorbed in an inactive form - the so-called prodrug. Activates the active substance intracellular pH. The drug selectively acts only in an acidic environment - 0.8-1.0 secretory tubules of glandular tissue. The rate of inhibition of the proton pump of various agents is different. The activation rate of Nolpase decreases by 2 times at pH = 3.0, and at pH + 4.0 it goes into an inactive form.

Nolpase does not affect the level of renal enzymes and, therefore, does not interact with other drugs. Pathologies of the liver of mild to moderate degree do not change the mechanism of its action, which leads to a stable clinical effect. Pantoprazole is also the best tool for anti-Helicobacter therapy, as it does not enter into biochemical reactions with antibiotics used in the standard treatment regimen.

The pharmacokinetics of Nolpase does not have significant differences in age groups, which is very important in the treatment of elderly patients who often take several drugs at once because of the presence of concomitant diseases.

Russian analogues of antiulcer drug

Nolpaza is an imported antiulcer drug that has no less effective and affordable analogues and substitutes from domestic manufacturers.

Russian similar drugs are:

• Gastrozole;
• Pantoprazole Canon;
• Ultra.

Pantoprazole is included in all analogues in a dosage similar to the prototype.

Foreign drug substitutes

Imported substitutes Nolpazy are presented in a wider assortment.

Nolpaza on average costs 1,146 rubles, and analogues are cheaper. The price varies from 15 to 956 rubles. Despite the fact that the analogs include the same active substance, it is possible to replace the prescribed Nolpase with them only after agreement with the attending physician, since additional ingredients can cause adverse reactions.

Instructions for use and dosage

Each package of Nolpase is accompanied by instructions for the use of the drug and recommended therapeutic dosages. In clinical studies, the optimal therapeutic dose was established - 40 mg. According to the instructions, Nolpazu is taken once a day for 4-8 weeks, although improvement is already noted on the 3rd day of admission.

The tablet does not need to be crushed or divided. As a rule, the medicine is taken before breakfast. If the dose is divided into 2 doses, then the second tablet is swallowed before dinner.

The table below lists recommended doses of Nolpase.

For liver problems, it is recommended to adhere to the optimal dose of 40 mg / day. During the entire course of treatment, monitoring of the level of liver enzymes is prescribed.

The recommended therapeutic dose for older patients should not exceed 40 mg / day. And with combined antibacterial therapy, the course of treatment should be no more than 1 week.

In renal failure, the daily dose of Nolpase should not exceed 40 mg. In the case of a severe stage of pathology, high doses (160 mg) of the drug can be used. Reception begins with 80 mg. After stopping the symptoms, the dose is titrated, achieving a sustainable therapeutic effect.

Nolpase is prescribed not only for the treatment of diseases, but also for the purpose of their prevention, as an anti-relapse and supportive treatment. The medicine can be taken occasionally - during an acute attack.

Contraindications, side effects and overdose

The medicine is not recommended for patients:

• under the age of 18;
• with an allergic reaction to the ingredients;
• with suspected malignant pathology;
• during gestation and lactation;
• with the neurogenic nature of acid hypersecretion.

During clinical trials, no side effects were detected, which indicates good tolerability of the drug, following the recommendations and the prescribed dosage. The instructions list the negative manifestations that can occur if the dose is exceeded or prolonged use.

Side effects can occur in the form of:

• dyspeptic phenomena;
• increased gas formation;
• hyposalivation;
• visual impairment;
• the formation of edema;
• Dizziness
• depression.

If you are prone to drug allergies, skin manifestations may occur.

There have been no cases of overdose. Intoxication is possible with a single dose of the drug, 2 times the maximum therapeutic dose (˃240 mg). In case of symptoms of poisoning, first aid should be provided to the patient - rinse the stomach and give absorbent.