Kvamatel 0,02 N28 film-coated pills
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Active ingredients
Famotidine
Release form
Pills
Composition
Active ingredient: zinc hyaluronate, obtained according to the recipe: sodium hyaluronate, zinc chloride, - 20.5 mg water bottle; Excipients: potassium sorbate, sorbitol, water for injection.
Pharmacological effect
Kvamatel - histamine H2-receptor blocker. Reduces the basal and stimulated gastrin, pentagastrin, betazol, caffeine, histamine, acetylcholine and physiological vagal reflex secretion of hydrochloric acid. This increases the pH and decreases the activity of pepsin. Practically does not affect gastrin levels on an empty stomach and after meals. It does not affect gastric motility, exocrine activity of the pancreas, blood circulation in the portal system, hormone levels, does not have an anti-androgenic effect. Famotidine has little effect on liver microsomal enzymes. After taking the drug inside the action occurs within 1 hour, the maximum action - 3 hours after administration, the duration of the effect varies from 12-24 hours, depending on the dose. The preparation in the form of a lyophilisate for preparing a solution for intravenous administration after administration in a single dose of 20 or 40 mg in the evening suppresses basal and nocturnal secretion for 10–12 hours.
Pharmacokinetics
Pharmacokinetics is linear. Absorption After oral administration is not completely absorbed from the gastrointestinal tract. Cmax is reached in 1-3 hours and is 0.07-0.1 mg / l. Bioavailability - 40-45%, increases with simultaneous food intake and decreases with simultaneous admission of anti-antacids. Distribution Binding to plasma proteins is 10-20%. It penetrates through the placental barrier and through the BBB. It is excreted in breast milk. Metabolism 30-35% of the drug is metabolized in the liver to form S-oxide. Withdrawal of T1 / 2 is 2.3-3.5 hours. After oral administration of 30-35% famotidine, and after intravenous administration, 65-70% of famotidine is excreted in the urine unchanged. Pharmacokinetics in special clinical situations With CC <10 ml / min T1 / 2 can reach 20 hours.
Indications
peptic ulcer of the duodenum and stomach in the acute phase, prevention of relapse; treatment and prevention of symptomatic gastric and duodenal ulcers (associated with the use of NSAIDs, stress, postoperative); erosive gastroduodenitis; functional dyspepsia,associated with increased gastric secretion; reflux esophagitis; Zollinger-Ellison syndrome; prevention of recurrence of bleeding from the upper GI tract; prevention of gastric juice aspiration during general anesthesia (Mendelssohn's syndrome).
Contraindications
pregnancy; lactation period (breastfeeding); childhood; hypersensitivity to the drug; hypersensitivity to other histamine H2 receptor blockers.
Precautionary measures
With caution: the drug should be prescribed for kidney and liver failure, with liver cirrhosis with a history of portosystemic encephalopathy.
Use during pregnancy and lactation
The drug is contraindicated for use in pregnancy. If necessary, the use of the drug during lactation breastfeeding should be discontinued.
Dosage and administration
When gastric ulcer and duodenal ulcer in the acute phase of Kvamatel prescribed in a dose of 40 mg 1 time per day before bedtime or 20 mg 2 times a day, morning and evening. If necessary, the daily dose can be increased to 80-160 mg. The duration of treatment is an average of 4-8 weeks. In order to prevent exacerbations of gastric ulcer and duodenal ulcer. Kvamatel prescribed in a dose of 20 mg 1 time per day before bedtime. When reflux esophagitis drug is prescribed in a dose of 20 mg 2 times a day (morning and evening) for 6 weeks; if necessary, 40 mg 2 times a day. With Zollinger-Ellison syndrome, the initial dose is 20-40 mg every 6 hours; if necessary, the daily dose can be increased to 240-480 mg. The duration of the drug depends on the clinical condition of the patient. In order to prevent aspiration of gastric contents during general anesthesia, Quamel is prescribed in a dose of 40 mg on the eve of the operation and / or in the morning on the day of surgery.
Side effects
On the part of the digestive system: dry mouth, nausea, vomiting, abdominal pain, flatulence, constipation, diarrhea, loss of appetite; increased activity of liver transaminases, hepatocellular, cholestatic or mixed hepatitis, acute pancreatitis. On the part of the hematopoietic system: very rarely - agranulocytosis, pancytopenia, leukopenia, thrombocytopenia, hypo- or aplasia of the bone marrow.Allergic reactions: urticaria, skin rash, itching, bronchospasm, angioedema, anaphylactic shock. Since the cardiovascular system: arrhythmia, bradycardia, AV-blockade, lowering blood pressure. From the side of the central nervous system: headache, dizziness, drowsiness, hallucinations, confusion, fatigue, depression, agitation, anxiety. From the senses: decreased visual acuity, tinnitus. On the part of the reproductive system: with prolonged use in high doses - hyperprolactinemia, gynecomastia, amenorrhea, decreased libido. On the part of the musculoskeletal system: arthralgia, muscle spasms. Dermatological reactions: alopecia, acne vulgaris, dry skin, toxic epidermal necrolysis. Other: fever.
Overdose
Symptoms: vomiting, motor agitation, tremor, decrease in blood pressure, tachycardia, collapse. Treatment: gastric lavage, symptomatic and supportive therapy; hemodialysis.
Interaction with other drugs
Due to an increase in the pH of the contents of the stomach, Kvamatel, while being applied simultaneously, reduces the absorption of ketoconazole and itraconazole; increases the absorption of amoxicillin and clavulanic acid. Antacids and sucralfat, used simultaneously with Kvamatel, slow down the absorption of famotidine. At the same time taking Kvamatela and drugs that inhibit bone marrow hematopoiesis, the risk of developing neutropenia increases.
special instructions
The use of Quamatel can mask the symptoms of gastric cancer, so before starting treatment with famotidine, it is necessary to exclude the presence of a malignant neoplasm. With a sharp cessation of treatment, famotidine can cause withdrawal syndrome, so treatment is stopped, gradually reducing its dose. Patients with impaired liver function Kvamatel should be prescribed with caution and in lower doses. With long-term treatment of debilitated patients or patients under stress, bacterial lesions of the stomach are possible with a further spread of infection. Kvamatel should be taken 2 hours after taking itraconazole or ketoconazole in order to avoid a significant decrease in their absorption. You should also observe a 1-2 hour break between taking Kvamatela and antacids. Histamine H2 receptor blockers (includingKvamatel) can inhibit the acid-stimulating effect of pentagastrin and histamine, so 24 hours before the test, you should refuse the appointment of Kvamatela. Histamine H2 receptor blockers can suppress the skin reaction to histamine, thus leading to false-negative results. Therefore, before conducting diagnostic skin tests to identify an allergic skin reaction of the immediate type, Kvamatel should be canceled. During treatment, avoid eating foods, drinks and other medicines that may irritate the lining of the stomach. Influence on the ability to drive motor vehicles and control mechanisms During the period of taking the drug Kvamatel patients should be careful when driving and engaging in potentially hazardous activities that require increased concentration and psychomotor speed.