برجاء الإنتظار ...

Search Results



نشرة الممارس الصحي نشرة معلومات المريض بالعربية نشرة معلومات المريض بالانجليزية صور الدواء بيانات الدواء
  SFDA PIL (Patient Information Leaflet (PIL) are under review by Saudi Food and Drug Authority)

Each GastrocapTM (gastro - resistant capsule) contains 10 mg, 20 mg or 40 mg of omeprazole, respectively.

It belongs to a group of medicines called ‘proton pump inhibitors’. They work by reducing the amount of acid that your stomach produces. Gasec™ is used to treat the following conditions:

 In adults:

 •  ‘Gastro-esophageal reflux disease’ (GERD). This is the gullet (the tube which connects your throat to your stomach) causing pain, inflammation  and heartburn.   •  Ulcers in the upper part of the intestine (duodenal ulcer) or stomach (gastric ulcer). 

 •  Ulcers which are infected with bacteria called ‘Helicobacter pylori’. your doctor may also prescribe antibiotics to treat the infection and allow the ulcer to heal.   •  Ulcers caused by medicines called NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). Gasec™ can also be used to stop ulcers from forming if you are taking NSAIDs.   •  Too much acid in the stomach caused by a growth in the pancreas (Zollinger-Ellison syndrome). 

 In children: Children over 1 year of age and ≥ 10 Kg

 • ‘Gastro-esophageal reflux disease’ (GERD). This is the gullet (the tube which connects your throat to your stomach) causing pain, inflammation  and heartburn.   In children, the symptoms of the condition can include the return of stomach contents into the mouth (regurgitation), being sick (vomiting) and poor weight gain.

Children and adolescents over 4 years of age • Ulcers which are infected with bacteria called ‘Helicobacter pylori’. If your child has this condition, your doctor may also prescribe antibiotics to treat the infection and allow the ulcer to heal.


Do not take Gasec™ • if you are allergic (hypersensitive) to omeprazole or any of the other ingredients of Gasec™. 

 • if you are allergic to medicines containing other proton pump inhibitors (e.g. pantoprazole, lansoprazole, rabeprazole, esomeprazole).   • if you are taking a medicine containing nelfinavir (for HIV infection). 

 If you are not sure, talk to your doctor or pharmacist before taking Gasec™.

 Take special care with Gasec™

 Gasec™ may hide the symptoms of other diseases. Therefore, if any of the following happen to you before you start taking Gasec™ or while you are taking it, talk to your doctor straight away:

 

• You lose a lot of weight for no reason and have problems swallowing.  • You get stomach pain or indigestion.  • You begin to vomit food or blood.  • You pass black stools (blood-stained faeces). 

 • You experience severe or persistent diarrhoea, as omeprazole has been associated with a small increase in infectious diarrhoea.   • You have severe liver problems.  • You are due to have a specific blood test (Chromogranin A).

 

If you take Gasec™ on a long-term basis (longer than 1 year) your doctor will probably keep you under regular surveillance. You should report any new and exceptional symptoms and circumstances whenever you see your doctor.

 

Taking a proton pump inhibitor like Gasec™, especially over a period of more than one year, may slightly increase your risk of fracture in the hip, wrist or spine. Tell your doctor if you have osteoporosis or if you are taking corticosteroids (which can increase the risk of osteoporosis).

 Subacute cutaneous lupus erythematosus (SCLE): Proton pump inhibitors are associated with very infrequent cases of SCLE. If lesions occur, especially in sun-exposed areas of the skin, and if accompanied by arthralgia, the patient should seek medical help promptly and the health care professional should consider stopping this medication. SCLE after previous treatment with a proton pump inhibitor may increase the risk of SCLE with other proton pump inhibitors.

 This medicine contains sucrose. Patients with rare hereditary problems of fructose intolerance, glucose - galactose malabsorption or sucrase - isomaltase insufficiency should not take this medicine. Taking other medicines

 Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. This is because Gasec™ can affect the way some medicines work and some medicines can have an effect on Gasec™.

 

 Do not take Gasec™ if you are taking a medicine containing nelfinavir (used to treat HIV infection).

 Tell your doctor or pharmacist if you are taking any of the following medicines:

 • Ketoconazole, itraconazole, posaconazole or voriconazole (used to treat infections caused by a fungus).   • Digoxin (used to treat heart problems)  • Diazepam (used to treat anxiety, relax muscles or in epilepsy). 

 • Phenytoin (used in epilepsy). If you are taking phenytoin, your doctor will need to monitor you when you start or stop taking Gasec™   • Medicines that are used to thin your blood, such as warfarin or other vitamin K blockers. Your doctor may need to monitor you when you start or stop taking Gasec™.   • Rifampicin (used to treat tuberculosis)  • Atazanavir (used to treat HIV infections) 

 • Tacrolimus (in cases of organ transplantation) • St   John’sHypericumwortperforatum() (used to treat mild depression) • Cilostazol (used to treat intermittent claudication) 

 • Saquinavir (used to treat HIV infection) 

 • Clopidogrel (used to prevent blood clots (thrombi))  • Erlotinib (used to treat cancer). 

 • Methotrexate (a chemotherapy medicine used in high doses to treat cancer) –if you are taking a high dose of methotrexate, your doctor may temporarily stop your Gasec™ treatment.

 

If your doctor has prescribed the antibiotics amoxicillin and clarithromycin as well as Gasec™ to treat ulcers caused by Helicobacter pylori infection, it is very important that you tell your doctor about any other medicines you are taking.

 Pregnancy and breast-feeding

 Before taking Gasec™, tell your doctor if you are pregnant or trying to get pregnant. Your doctor will decide whether you can take Gasec™ during this time.

 Your doctor will decide whether you can take Gasec™ if you are breastfeeding.

 Driving and using machines

 Gasec™ is not likely to affect your ability to drive or use any tools or machines. Side effects such as dizziness and visual disturbances may occur (see section 4). If affected, you should not drive or operate machinery.


Always take Gasec™ exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.

 

Your doctor will tell you how many capsules to take and how long to take them for. This will depend on your condition and how old you are.

 The usual doses are given below.

 Adults:

 To treat symptoms of GERD such as heartburn and acid regurgitation:

 • If your doctor has found that your food pipe (gullet) has been slightly damaged, the usual dose is 20 mg once a day for 4-8 weeks. Your doctor may tell you to take a dose of 40 mg for a further 8 weeks if your gullet has not yet healed. 

• The usual dose once the gullet has healed is 10 mg once a day. 

 • If your gullet has not been damaged, the usual dose is 10 mg once a day. 

 To treat ulcers in the upper part of the intestine (duodenal ulcer):

 • The usual dose is 20 mg once a day for 2 weeks. Your doctor may tell you to take the same dose for a further 2 weeks if your ulcer has not yet healed.   • If the ulcer do not fully heal, the dose can be increased to 40 mg once a day for 4 weeks.

 

To treat ulcers in the stomach (gastric ulcer):

 • The usual dose is 20 mg once a day for 4 weeks. Your doctor may tell you to take the same dose for a further 4 weeks if your ulcer has not yet healed.   • If the ulcer do not fully heal, the dose can be increased to 40 mg once a day for 8 weeks. 

 To prevent the duodenal and stomach ulcers from coming back:

 • The usual dose is 10 mg or 20 mg once a day. Your doctor may increase the dose to 40 mg once a day. 

 To treat duodenal and stomach ulcers caused by NSAIDs (Non-Steroidal Anti-Inflammatory Drugs): • The usual dose is 20 mg once a day for 4 to 8 weeks. 

 To prevent duodenal and stomach ulcers if you are taking NSAIDs: • The usual dose is 20 mg once a day. 

 To treat ulcers caused by Helicobacter pylori infection and to stop them coming back: • The usual dose is 20 mg Gasec™ twice a day for one week. 

 • Your doctor will also tell you to take two antibiotics among amoxicillin, clarithromycin and metronidazole. 

 

To treat too much acid in the stomach caused by a growth in the pancreas (Zollinger-Ellison syndrome): • The usual dose is 60 mg daily. 

 • Your doctor will adjust the dose depending on your needs and will also decide how long you need to take the medicine for. 

 Children:

 To treat symptoms of GERD such as heartburn and acid regurgitation: • Children over 1 year of age and with a body weight of more than 10 kg may take Gasec™. The 

 dose   for   children   is   based   on   the   child’s   weight doctor will decide the correct dose. 

 To treat ulcers caused by Helicobacter pylori infection and to stop them coming back:

 • Children aged over 4 years may take Gasec™. The dose for c weight and the doctor will decide the correct dose.

 • Your doctor will also prescribe two antibiotics called amoxicillin and clarithromycin for your child. 

 Taking this medicine • It is recommended that you take your capsules in the morning.  • You can take your capsules with food or on an empty stomach. 

 • Swallow your capsules whole with half a glass of water. Do not chew or crush

the capsules. 

 If you take more Gasec™ than you should  If you take more Gasec™ than prescribed by your doctor, talk to your doctor or pharmacist straight away.

 If you forget to take Gasec™  If you forget to take a dose, take it as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose. Do not take a double dose to make up for a forgotten dose.  


Like all medicines, Gasec™ can cause side effects, although not everybody gets them.

 

If you notice any of the following rare but serious side effects, stop taking Gasec™ and contact a doctor immediately:  • Sudden wheezing, swelling of your lips, tongue and throat or body, rash, fainting or difficulties in swallowing (severe allergic reaction).   • Reddening of the skin with blisters or peeling. There may also be severe blisters and bleeding   in the lips, eyes, mouth, nose-Johnsonand syndrome’genitals. epidermal necrolysis’. 

 • Yellow skin, dark urine and tiredness which can be symptoms of liver problems. 

 

The frequency of adverse events listed below is defined using the following convention:

 

very common (> 1/10); common (> 1/100 and < 1/10); uncommon (> 1/1,000 and < 1/100);  rare (> 1/10,000 and < 1/1,000); very rare (< 1/10,000),  not known (cannot be estimated from the available data).

 Other side effects include: Common side effects  • Headache.  • Effects on your stomach or gut: diarrhoea, stomach pain, constipation, wind (flatulence).   • Feeling sick (nausea) or being sick (vomiting). 

 Uncommon side effects • Swelling of the feet and ankles.  • Disturbed sleep (insomnia).  • Dizziness,   tingling   feelings   such   as   “pins   an   • Spinning feeling (vertigo).  • Changes in blood tests that check how the liver is working.  • Skin rash, lumpy rash (hives) and itchy skin.  • Generally feeling unwell and lacking energy. 

 Rare side effects  • Blood problems such as a reduced number of white cells or platelets. This can cause weakness, bruising or make infections more likely.  • Allergic reactions, sometimes very severe, including swelling of the lips, tongue and throat, fever, wheezing.   • Low levels of sodium in the blood. This may cause weakness, being sick (vomiting) and cramps.   • Feeling agitated, confused or depressed. 

• Taste changes.  • Eyesight problems such as blurred vision. 

 • Suddenly feeling wheezy or short of breath (bronchospasm).  • Dry mouth.  • An inflammation of the inside of the mouth.  • An   infection   called   “thrush”ausedbya funguswhich.   can   affect • Liver problems, including jaundice which can cause yellow skin, dark urine, and tiredness.  • Hair loss (alopecia). 

 • Skin rash on exposure to sunshine.  • Joint pains (arthralgia) or muscle pains (myalgia).  • Severe kidney problems (interstitial nephritis). 

 • Increased sweating. 

 Very rare side effects • Changes in blood count including agranulocytosis (lack of white blood cells)  • Aggression.  • Seeing, feeling or hearing things that are not there (hallucinations).  • Severe liver problems leading to liver failure and inflammation of the brain. 

 • Sudden onset of a severe rash or blistering or peeling skin. This may be associated with a high fever and joint pains (Erythema multiforme, StevensJohnson syndrome, toxic epidermal necrolysis)   • Muscle weakness.  • Enlarged breasts in men. 

 Not known • Inflammation in the gut (leading to diarrhoea). 

 • If you are on Gasec™ for more than three months it is possible that the levels of magnesium in your blood may fall. Low levels of magnesium can be seen as fatigue, involuntary muscle contractions, disorientation, convulsions, dizziness or increased heart rate. If you get any of these symptoms, please tell your doctor promptly. Low levels of magnesium can also lead to a reduction in potassium or calcium levels in the blood. Your doctor may decide to perform regular blood tests to monitor your levels of magnesium. 

 

Gasec™ may in very rare cases affect the white blood cells leading to immune deficiency. If you have an infection with symptoms such as fever with a severely reduced general condition or fever with symptoms of a local infection such as pain in the neck, throat or mouth or difficulties in urinating, you must consult your doctor as soon as possible so that a lack of white blood cells (agranulocytosis) can be ruled out by a blood test. It is important for you to give information about your medicine at this time.

 

Do not be concerned by this list of possible side effects. You may not get any of them. If any of the side effects get serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist.


 Keep out of the reach and sight of children.

 Do not store above 30° C. Keep the bottle tightly closed in order to protect from moisture. Use within 4 weeks after opening.

Do not use this medicine after the expiry date which is stated on the carton after «EXP». The expiry date refers to the last day of that month.

 


 - The active substance is omeprazole. Each GastrocapsTM (gastro resistant capsule) contains 10 mg, 20 mg or 40 mg of omeprazole.   - The other ingredients are; - Gastro - resistant pellets: Sugar sphere, hydroxypropyl methylcellulose, disodium hydrogen phosphate, Syloid 244, titanium dioxide (E 171), Eudragit L30 D, Citroflex 2, talc. - Capsule composition: Gelatine, titanium dioxide (E 171), iron oxide (E 172), indigotine (E 132). 


White bottle of high density polyethylene (HDPE) with cap and desiccant. Gasec - 10: Packs of 14 and 28 Gastrocaps. Gasec - 20: Packs of 7, 14, 28 and 56 Gastrocaps. Gasec - 40: Packs of 14 and 28 Gastrocaps. Not all pack sizes may be marketed.

Marketing Authorization Holder

Acino AG, Miesbach, Germany

 

Manufacturer

Manufactured by Acino Pharma AG, Aesch, Switzerland. Secondary Packaged by Batterjee Pharma, Jeddah, Saudi Arabia


- This leaflet was last revised in September 2017.
  نشرة الدواء تحت مراجعة الهيئة العامة للغذاء والدواء (اقرأ هذه النشرة بعناية قبل البدء في استخدام هذا المنتج لأنه يحتوي على معلومات مهمة لك)

ﺗﺣﺗﻭﻱ ﻛﻝ ﻏﺎﺳﺗﺭﻭﻛﺎﺏ (ﻛﺑﺳﻭﻟﺔ ﻣﻘﺎﻭﻣﺔ ﻟﻠﻣﻌﺩﺓ) ۱۰ ﻣﻠﺟﻡ ، ۲۰ ﻣﻠﺟﻡ أو ٤۰ ﻣﻠﺟﻡ من ﺃﻭﻣﻳﺑﺭﺍﺯﻭﻝ، ﻋﻠﻰ ﺍﻟﺗﻭﺍﻟﻲ.

ﻭﻫﻭ ﺩﻭﺍء ﻳﻧﺗﻣﻲ ﺇﻟﻰ ﻣﺟﻣﻭﻋﺔ ﻣﻥ ﺍﻷﺩﻭﻳﺔ ﺗﺳﻣﻰ "ﻣﺛﺑﻁﺎﺕ ﻣﺿﺧﺔ ﺍﻟﺑﺭﻭﺗﻭﻥ" ﺗﻌﻣﻝ ﻫﺫﻩ ﺍﻷﺩﻭﻳﺔ ﻋﻥ ﻁﺭﻳﻖ ﺍﻟﺣﺩ ﻣﻥ ﻛﻣﻳﺔ ﺍﻟﺣﻣﺽ ﺍﻟﺫﻱ ﺗﻧﺗﺟﻪ ﺍﻟﻣﻌﺩﺓ .

ﻳﺳﺗﺧﺩﻡ ﺟﺎﺳﻳﻙ ﻓﻲ ﻋﻼﺝ ﺍﻟﺣﺎﻻﺕ ﺍﻟﺗﺎﻟﻳﺔ:  

ﻋﻧﺩ ﺍﻟﺑﺎﻟﻐﻳﻥ:

·         "ﻣﺭﺽ ﺍﻻﺭﺗﺟﺎﻉ ﺍﻟﻣﻌﺩﻱ ﺍﻟﻣﺭﻳﺋﻲ" (GERD) . ﻫﺫﺍ ﻫﻭ ﺍﻟﻣﺭﻱء (ﺍﻷﻧﺑﻭﺏ ﺍﻟﺫﻱ ﻳﺭﺑﻁ ﺍﻟﺣﻠﻖ ﺇﻟﻰ ﻣﻌﺩﺗﻙ) ﻣﻣﺎ ﻳﺳﺑﺏ ﺍﻷﻟﻡ، ﺍﻟﺗﻬﺎﺏ ﻭﺣﺭﻗﺔ ﺍﻟﻣﻌﺩﺓ.

·         ﻗﺭﺣﺔ ﻓﻲ ﺍﻟﺟﺯء ﺍﻟﻌﻠﻭﻱ ﻣﻥ ﺍﻷﻣﻌﺎء (ﻗﺭﺣﺔ ﺍﻻﺛﻧﻲ ﻋﺷﺭ) ﺃﻭ ﻓﻲ ﺍﻟﻣﻌﺩﺓ (ﻗﺭﺣﺔ ﺍﻟﻣﻌﺩﺓ)

·         ﺍﻟﻘﺭﺣﺎﺕ المعدي ﺍﻟﻣﺻﺎﺑﺔ ﺑﺎﻟﺑﻛﺗﻳﺭﻳﺎ ﺍﻟﺗﻲ ﺗﺳﻣﻰ 'ﻫﻳﻠﻳﻛﻭﺑﺎﻛﺗﺭ ﺑﻳﻠﻭﺭﻱ' .ﻗﺩ ﻳﺻﻑ ﻟﻙ ﻁﺑﻳﺑﻙ ﺍﻟﻣﺿﺎﺩﺍﺕ ﺍﻟﺣﻳﻭﻳﺔ ﺑﺎﻹﺿﺎﻓﺔ ﻟﻬﺫﺍ ﺍﻟﺩﻭﺍء ﻟﻌﻼﺝ ﺍﻟﻌﺩﻭﻯ ﺍﻟﺟﺭﺛﻭمية ﻭﺑﺎﻟﺗﺎﻟﻲ ﺍﻟﺳﻣﺎﺡ ﻟﻠﻘﺭﺣﺔ ﺑﺎﻟﺷﻔﺎء.

·         ﺍﻟﻘﺭﺣﺎﺕ ﺍﻟﺗﻲ ﺗﺳﺑﺑﻬﺎ ﺃﺩﻭﻳﺔ ﺗﺳﻣﻰ ﻣﺿﺎﺩﺍﺕ ﺍﻻﻟﺗﻬﺎﺏ ﻏﻳﺭ ﺍﻟﺳﺗﻳﺭﻭﻳﺩﻳﺔ (ﺍﻷﺩﻭﻳﺔ ﺍﻟﻣﺿﺎﺩﺓ ﻟﻼﻟﺗﻬﺎﺑﺎﺕ ﻏﻳﺭ ﺍﻟﺳﺗﻳﺭﻭﻳﺩﻳﺔ). ﻳﻣﻛﻥ ﺍﺳﺗﺧﺩﺍﻡ ﺟﺎﺳﻳﻙ ﺃﻳﺿﺎ ﻟﻣﻧﻊ ﺣﺩﻭﺙ ﺍﻟﻘﺭﺣﺔ ﺇﺫﺍ ﻛﻧﺕ ﺗﺗﻧﺎﻭﻝ ﺃﺣﺩ ﻣﺿﺎﺩﺍﺕ ﺍﻻﻟﺗﻬﺎﺏ ﻏﻳﺭ ﺍﻟﺳﺗﻳﺭﻭﺋﻳﺩﻳﺔ.

·         ﻭﺟﻭﺩ ﻛﻣﻳﺎﺕ ﻛﺑﻳﺭﺓ ﻣﻥ ﺣﻣﺽ ﺍﻟﻣﻌﺩﺓ ﺍﻟﻧﺎﺟﻡ ﻋﻥ ﻧﻣﻭ ﻏﻳﺭ ﻁﺑﻳﻌﻲ ﻓﻲ ﺍﻟﺑﻧﻛﺭﻳﺎﺱ (ﻣﺗﻼﺯﻣﺔ ﺯﻭﻟﻳﻧﺟﺭ ﺇﻟﻳﺳﻭﻥ.(

 

ﻋﻧﺩ ﺍﻷﻁﻔﺎﻝ:

ﺍﻷﻁﻔﺎﻝ ﺍﻟﺫﻳﻥ ﻳﺑﻠﻐﻭﻥ ﺃﻛﺛﺭ ﻣﻥ  ﺳﻧﺔ ﻣﻥ ﺍﻟﻌﻣﺭ ﻭﺗﺻﻝ ﺃﻭﺯﺍﻧﻬﻡ ﺇﻟﻰ ≥ ۱۰ ﻛﺟﻡ

·         "ﻣﺭﺽ ﺍﻻﺭﺗﺟﺎﻉ ﺍﻟﻣﻌﺩﻱ ﺍﻟﻣﺭﻳﺋﻲ" (GERD) . ﻫﺫﺍ ﻫﻭ ﺍﻟﻣﺭﻱء (ﺍﻷﻧﺑﻭﺏ ﺍﻟﺫﻱ ﻳﺭﺑﻁ ﺍﻟﺣﻠﻖ ﺇﻟﻰ ﻣﻌﺩﺗﻙ) ﻣﻣﺎ ﻳﺳﺑﺏ ﺍﻷﻟﻡ، ﺍﻟﺗﻬﺎﺏ ﻭﺣﺭﻗﺔ ﺍﻟﻣﻌﺩﺓ.

ﻳﻣﻛﻥ ﺃﻥ ﺗﺷﻣﻝ ﺃﻋﺭﺍﺽ ﻫﺫﻩ ﺍﻟﺣﺎﻟﺔ ﻋﻧﺩ ﺍﻷﻁﻔﺎﻝ ﻋﻭﺩﺓ ﻣﺣﺗﻭﻳﺎﺕ ﺍﻟﻣﻌﺩﺓ ﺇﻟﻰ ﺍﻟﻔﻡ (ﻗﻠﺱ ﺃﻭ ﺗﺭﺟﻳﻊ)، ﻭﺍﻟﻣﺭﺽ (ﺍﻟﺗﻘﻳﺅ ) ﻭﻋﺩﻡ ﺯﻳﺎﺩﺓ ﺍﻟﻭﺯﻥ .

ﺍﻷﻁﻔﺎﻝ ﻓﻭﻕ ٤ ﺳﻧﻭﺍﺕ ﻣﻥ ﺍﻟﻌﻣﺭ ﻭﺍﻟﻣﺭﺍﻫﻘﻳﻥ

·         ﺍﻟﻘﺭﺣﺎﺕ ﺍﻟﻣﺻﺎﺑﺔ ﺑﺎﻟﺑﻛﺗﻳﺭﻳﺎ ﺍﻟﺗﻲ ﺗﺳﻣﻰ 'ﻫﻳﻠﻳﻛﻭﺑﺎﻛﺗﺭ ﺑﻳﻠﻭﺭﻱ' ﺇﺫﺍ ﺃﺻﻳﺏ ﻁﻔﻠﻙ ﺑﻬﺫﻩ ﺍﻟﺣﺎﻟﺔ، ﻗﺩ ﻳﺻﻑ ﻟﻪ ﺍﻟﻁﺑﻳﺏ ﺍﻟﻣﺿﺎﺩﺍﺕ ﺍﻟﺣﻳﻭﻳﺔ ﺑﺎﻹﺿﺎﻓﺔ ﺇﻟﻰ ﻫﺫﺍ ﺍﻟﺩﻭﺍء ﻟﻌﻼﺝ ﺍﻟﻌﺩﻭﻯ ﺍﻟﺟﺭﺛﻭمية ﻭﺑﺎﻟﺗﺎﻟﻲ ﺍﻟﺳﻣﺎﺡ ﻟﻠﻘﺭﺣﺔ ﺑﺎﻟﺷﻔﺎء.

ﻻ ﺗﺗﻧﺎﻭﻝ ﺟﺎﺳﻳﻙ

·         ﺇﺫﺍ ﻛﺎﻥ ﻟﺩﻳﻙ ﺣﺳﺎﺳﻳﺔ (ﻓﺭﻁ ﺍﻟﺣﺳﺎﺳﻳﺔ) ﺗﺟﺎﻩ ﺍﻷﻭﻣﻳﺑﺭﺍﺯﻭﻝ ﺃﻭ ﺗﺟﺎﻩ ﺃﻱ ﻣﻥ ﺍﻟﻣﻛﻭﻧﺎﺕ ﺍﻷﺧﺭﻯ ﻓﻲ ﺟﺎﺳﻳﻙ.

·         ﺇﺫﺍ ﻛﺎﻥ ﻟﺩﻳﻙ ﺣﺳﺎﺳﻳﺔ ﺗﺟﺎﻩ ﺍﻷﺩﻭﻳﺔ ﺍﻟﺗﻲ ﺗﺣﺗﻭﻱ ﻋﻠﻰ ﻣﺛﺑﻁﺎﺕ ﻣﺿﺧﺔ ﺑﺭﻭﺗﻭﻥ ﺍﻷﺧﺭﻯ (ﻣﺛﻝ ﺑﺎﻧﺗﻭﺑﺭﺍﺯﻭﻝ، ﻻﻧﺳﻭﺑﺭﺍﺯﻭﻝ، ﺭﺍﺑﻳﺑﺭﺍﺯﻭﻝ، ﺇﻳﺳﻭﻣﻳﺑﺭﺍﺯﻭﻝ)

·         ﺇﺫﺍ ﻛﻧﺕ ﺗﺗﻧﺎﻭﻝ ﺩﻭﺍء ﻳﺣﺗﻭﻱ ﻋﻠﻰ ﻧﻠﻔﻳﻧﺎﻓﻳﺭ (ﻟﻌﻼﺝ ﺍﻹﺻﺎﺑﺔ ﺑﻔﻳﺭﻭﺱ ﻧﻘﺹ ﺍﻟﻣﻧﺎﻋﺔ ﺍﻟﺑﺷﺭﻳﺔ  

 ﺇﺫﺍ ﻟﻡ ﺗﻛﻥ ﻣﺗﺄﻛﺩﺍ، ﺗﺣﺩﺙ ﺇﻟﻰ ﻁﺑﻳﺑﻙ ﺃﻭ ﺍﻟﺻﻳﺩﻟﻲ ﻗﺑﻝ ﺗﻧﺎﻭﻟﻙ ﺟﺎﺳﻳﻙ.

 ﺭﻋﺎﻳﺔ ﺧﺎﺻﺔ ﻣﻊ ﺟﺎﺳﻳﻙ

ﻗﺩ ﻳﺧﻔﻲ ﺗﻧﺎﻭﻝ ﺟﺎﺳﻳﻙ ﺃﻋﺭﺍﺽ ﺃﻣﺭﺍﺽ ﺃﺧﺭﻯ. ﻟﺫﻟﻙ، ﺇﺫﺍ ﻛﺎﻥ ﺃﻱ ﻣﻥ ﺍﻟﺗﺎﻟﻲ ﻳﺣﺩﺙ ﻟﻙ ﻗﺑﻝ ﺍﻟﺑﺩء ﻓﻲ ﺗﻧﺎﻭﻝ ﺟﺎﺳﻳﻙ ﺃﻭ ﺃﺛﻧﺎء ﺗﻧﺎﻭﻟﻪ، ﺍﺳﺗﺷﺭ ﺍﻟﻁﺑﻳﺏ ﻋﻠﻰ ﺍﻟﻔﻭﺭ:

·         ﻛﻧﺕ ﺗﻔﻘﺩ ﺍﻟﻛﺛﻳﺭ ﻣﻥ ﺍﻟﻭﺯﻥ ﺩﻭﻥ ﺳﺑﺏ ﻭﻟﺩﻳﻙ ﻣﺷﺎﻛﻝ ﻓﻲ ﺍﻟﺑﻠﻊ

·         ﻟﺩﻳﻙ ﺁﻻﻡ ﻓﻲ ﺍﻟﻣﻌﺩﺓ ﺃﻭ ﻋﺳﺭ ﺍﻟﻬﺿﻡ

·         ﺑﺩﺃﺕ ﻓﻲ ﺗﻘﻳﺅ ﺍﻟﻁﻌﺎﻡ ﺃﻭ ﺍﻟﺩﻡ

·         ﻻﺣﻅﺕ ﺧﺭﻭﺝ ﺑﺭﺍﺯ ﺃﺳﻭﺩ (ﺑﺭﺍﺯ ﻣﻠﻁﺦ ﺑﺎﻟﺩﻡ)

·         ﻛﻧﺕ ﺗﻌﺎﻧﻲ ﻣﻥ ﺇﺳﻬﺎﻝ ﺷﺩﻳﺩ ﺃﻭ ﻣﺳﺗﻣﺭ، ﺣﻳﺙ ﺃﻥ ﺗﻧﺎﻭﻝ ﺃﻭﻣﻳﺑﺭﺍﺯﻭﻝ ﻗﺩ ﻳﺅﺩﻱ ﺇﻟﻰ ﺯﻳﺎﺩﺓ ﻁﻔﻳﻔﺔ ﻓﻲ ﺣﺩﻭﺙ ﺍﻹﺳﻬﺎﻝ ﺍﻟﻣﻌﺩﻱ.

·         ﻟﺩﻳﻙ ﻣﺷﺎﮐﻝ ﮐﺑﻳﺭﺓ ﻓﻲ ﺍﻟﮑﺑﺩ.

·         ﺗﻠﺯم ﻋﻠﻳﻙ ﺇﺟﺭﺍء ﻓﺣﺹ ﻣﻌﻳﻥ ﻟﻠﺩﻡ (ﻛﺭﻭﻣﻭﻏﺭﺍﻧﻳﻥ A )

 ﺇﺫﺍ ﻛﻧﺕ ﺗﺗﻧﺎﻭﻝ ﺟﺎﺳﻳﻙ ﻟﻔﺗﺭﺍﺕ ﺯﻣﻧﻳﺔ ﻁﻭﻳﻠﺔ (ﺃﻁﻭﻝ ﻣﻥ ﺳﻧﺔ) ﻗﺩ ﻳﺿﻌﻙ ﻁﺑﻳﺑﻙ ﺗﺣﺕ ﺍﻟﻣﺭﺍﻗﺑﺔ ﺍﻟﻣﻧﺗﻅﻣﺔ. ﻳﺟﺏ ﻋﻠﻳﻙ ﺍﻹﺑﻼﻍ ﻋﻥ ﺃﻱ ﺃﻋﺭﺍﺽ ﻭﻅﺭﻭﻑ ﺟﺩﻳﺩﺓ ﻭﺍﺳﺗﺛﻧﺎﺋﻳﺔ ﻋﻧﺩ ﺯﻳﺎﺭﺗﻙ ﻟﻠﻁﺑﻳﺏ.

ﺇﻥ ﺗﻧﺎﻭﻝ ﻣﺛﺑﻁ ﻣﺿﺧﺔ ﺍﻟﺑﺭﻭﺗﻭﻥ ﻣﺛﻝ ﺟﺎﺳﻳﻙ ﻭﺧﺎﺻﺔ ﻋﻠﻰ ﻣﺩﻯ ﻓﺗﺭﺓ ﺃﻛﺛﺭ ﻣﻥ ﺳﻧﺔ ﻭﺍﺣﺩﺓ، ﻗﺩ ﻳﺯﻳﺩ ﻗﻠﻳﻼ ﻣﻥ ﺧﻁﺭ ﻛﺳﺭ ﻓﻲ ﺍﻟﻭﺭﻙ ﻭﺍﻟﻣﻌﺻﻡ ﺃﻭ ﺍﻟﻌﻣﻭﺩ ﺍﻟﻔﻘﺭﻱ .ﺃﺧﺑﺭ ﻁﺑﻳﺑﻙ ﺇﺫﺍ ﻛﺎﻥ ﻟﺩﻳﻙ ﻫﺷﺎﺷﺔ ﺍﻟﻌﻅﺎﻡ ﺃﻭ ﺇﺫﺍ ﻛﻧﺕ ﺗﺗﻧﺎﻭﻝ ﺍﻟﻛﻭﺭﺗﻳﻛﻭﺳﺗﻳﺭﻭﻳﺩ (ﺍﻟﺗﻲ ﻳﻣﻛﻥ ﺃﻥ ﺗﺯﻳﺩ ﻣﻥ ﺧﻁﺭ ﻫﺷﺎﺷﺔ ﺍﻟﻌﻅﺎﻡ.(

 الذئبة الحمامية الجلدية تحت الحادة (SCLE)

ﻳﺭﺗﺑﻁ ﺗﻧﺎﻭﻝ ﻣﺛﺑﻁﺎﺕ ﻣﺿﺧﺔ ﺍﻟﺑﺭﻭﺗﻭﻥ ﻣﻊ ﺣﺎﻻﺕ ﻧﺎﺩﺭﺓ ﺟﺩﺍ من SCLE ﺇﺫﺍ ﻅﻬﺭﺕ ﺍﻵﻓﺎﺕ ﺍﻟﺟﻠﺩﻳﺔ ، ﻭﺧﺎﺻﺔ ﻓﻲ ﺍﻟﻣﻧﺎﻁﻖ ﺍﻟﻣﻌﺭﺿﺔ ﻷﺷﻌﺔ ﺍﻟﺷﻣﺱ ﻣﻥ ﺍﻟﺟﻠﺩ، ﻭﺇﺫﺍ ﻛﺎﻧﺕ ﻣﺻﺣﻭﺑﺔ ﺑﺄﻟﻡ ﻣﻔﺻﻠﻲ، ﻳﺟﺏ ﻋﻠﻰ ﺍﻟﻣﺭﻳﺽ ﻁﻠﺏ ﺍﻟﻣﺳﺎﻋﺩﺓ ﺍﻟﻁﺑﻳﺔ ﻋﻠﻰ ﻭﺟﻪ ﺍﻟﺳﺭﻋﺔ، ﻭﻳﻧﺑﻐﻲ ﺃﻥ ﻳﺄﺧﺫ ﺍﻟﻁﺑﻳﺏ ﻓﻲ ﻋﻳﻥ ﺍﻻﻋﺗﺑﺎﺭ ﺇﻳﻘﺎﻑ ﻫﺫﺍ ﺍﻟﺩﻭﺍء. ﺇﻥ ﻅﻬﻭﺭ SCLE ﺍﻟﺫﻱ ﻳﻌﻘﺏ ﻋﻼﺝ ﺳﺎﺑﻖ ﺑﻣﺛﺑﻁ ﻣﺿﺧﺔ ﺍﻟﺑﺭﻭﺗﻭﻥ ﻗﺩ ﻳﺯﻳﺩ ﻣﻥ ﺧﻁﺭ ﺣﺩﻭﺛﻪ مع ﻣﺛﺑﻁﺎﺕ ﻣﺿﺧﺔ ﺍﻟﺑﺭﻭﺗﻭﻥ ﺍﻷﺧﺭﻯ.

ﻳﺣﺗﻭﻱ ﻫﺫﺍ ﺍﻟﺩﻭﺍء ﻋﻠﻰ ﺍﻟﺳﻛﺭﻭﺯ. ﻭﻳﻧﺑﻐﻲ ﻋﻠﻰ ﺍﻟﻣﺭﺿﻰ ﺍﻟﺫﻳﻥ ﻳﻌﺎﻧﻭﻥ ﻣﻥ ﻣﺷﺎﻛﻝ ﻭﺭﺍﺛﻳﺔ ﻧﺎﺩﺭﺓ ﻣﺛﻝ ﻋﺩﻡ ﺗﺣﻣﻝ ﺍﻟﻔﺭﻛﺗﻭﺯ، ﺃﻭ ﺳﻭء ﺍﻣﺗﺻﺎﺹ ﺍﻟﺟﻠﻭﻛﻭﺯ - ﺍﻟﺟﺎﻻﻛﺗﻭﺯ، ﺃﻭ ﻗﺻﻭﺭ ﺃﻳﺯﻭﻣﺎﻟﺗﺎﺯ -  ﺳﻭﻛﺭﻳﺯ ﺗﺟﻧﺏ ﺗﻧﺎﻭﻝ ﻫﺫﺍ ﺍﻟﺩﻭﺍء.

ﺗﻧﺎﻭﻝ ﺃﺩﻭﻳﺔ ﺃﺧﺭﻯ

ﻳﺭﺟﯽ ﺇﺧﺑﺎﺭ ﺍﻟﻁﺑﻳﺏ ﺃﻭ ﺍﻟﺻﻳﺩﻟﻲ ﺇﺫﺍ ﮐﻧﺕ ﺗﺗﻧﺎﻭﻝ ﺃﻭ ﺗﻧﺎﻭﻟﺕ ﻣﺅﺧﺭﺍ ﺃﺩﻭﻳﺔ ﺃﺧﺭﻯ، ﺑﻣﺎ ﻓﻲ ﺫﻟﻙ ﺍﻷﺩﻭﻳﺔ ﺍﻟﺗﻲ ﻳﺗﻡ ﺍﻟﺣﺻﻭﻝ ﻋﻠﻳﻬﺎ ﺑﺩﻭﻥ ﻭﺻﻔﺔ ﻁﺑﻳﺔ. ﻫﺫﺍ ﻷﻥ ﺟﺎﺳﻳﻙ ﻳﻣﻛﻥ ﺃﻥ ﻳﺅﺛﺭ ﻋﻠﻰ ﺍﻟﻁﺭﻳﻘﺔ ﺍﻟﺗﻲ ﺗﻌﻣﻝ ﺑﻬﺎ ﺑﻌﺽ ﺍﻷﺩﻭﻳﺔ ﻛﻣﺎ ﻳﻣﻛﻥ ﺃﻥ ﺗﺅﺛﺭ ﺑﻌﺽ ﺍﻷﺩﻭﻳﺔ ﻋﻠﻰ ﺟﺎﺳﻳﻙ.

 

ﻻ ﺗﺗﻧﺎﻭﻝ ﺟﺎﺳﻳﻙ ﺇﺫﺍ ﻛﻧﺕ ﺗﺗﻧﺎﻭﻝ ﺩﻭﺍء ﻳﺣﺗﻭﻱ ﻋﻠﻰ ﻧﻠﻔﻳﻧﺎﻓﻳﺭ (ﻳﺳﺗﺧﺩﻡ ﻓﻲ ﻋﻼﺝ ﺍﻹﺻﺎﺑﺔ ﺑﻔﻳﺭﻭﺱ ﻧﻘﺹ ﺍﻟﻣﻧﺎﻋﺔ ﺍﻟﺑﺷﺭﻳﺔ).

ﺃﺧﺑﺭ ﻁﺑﻳﺑﻙ ﺃﻭ ﺍﻟﺻﻳﺩﻟﻲ ﺇﺫﺍ ﻛﻧﺕ ﺗﺗﻧﺎﻭﻝ ﺃﻱ ﻣﻥ ﺍﻷﺩﻭﻳﺔ ﺍﻟﺗﺎﻟﻳﺔ:

·         ﻛﻳﺗﻭﻛﻭﻧﺎﺯﻭﻝ، ﺇﺗﺭﺍﻛﻭﻧﺎﺯﻭﻝ، ﺑﻭﺳﺎﻛﻭﻧﺎﺯﻭﻝ ﺃﻭ ﻓﻭﺭﻳﻛﻭﻧﺎﺯﻭﻝ (ﺗﺳﺗﺧﺩﻡ ﻓﻲ ﻋﻼﺝ ﺍﻻﻟﺗﻬﺎﺑﺎﺕ ﺍﻟﺗﻲ ﺗﺳﺑﺑﻬﺎ ﺍﻟﻔﻁﺭﻳﺎﺕ).

·         ﺩﻳﺟﻭﻛﺳﻳﻥ (ﻳﺳﺗﺧﺩﻡ ﻓﻲ ﻋﻼﺝ ﻣﺷﺎﻛﻝ ﺍﻟﻘﻠﺏ).

·         ﺍﻟﺩﻳﺎﺯﻳﺑﺎﻡ (ﻳﺳﺗﺧﺩﻡ ﻓﻲ ﻋﻼﺝ ﺍﻟﻘﻠﻖ، ﻭﻹﺭﺧﺎء ﺍﻟﻌﺿﻼﺕ ﺃﻭ ﻟﻠﺻﺭﻉ).

·         ﺍﻟﻔﻳﻧﻳﺗﻭﻳﻥ (ﺍﻟﻣﺳﺗﺧﺩﻡ ﻓﻲ ﻋﻼﺝ ﺍﻟﺻﺭﻉ). ﺇﺫﺍ ﻛﻧﺕ ﺗﺗﻧﺎﻭﻝ ﺍﻟﻔﻳﻧﻳﺗﻭﻳﻥ، ﺳﻳﺣﺗﺎﺝ ﻁﺑﻳﺑﻙ ﺇﻟﻰ ﻣﺭﺍﻗﺑﺗﻙ ﻋﻧﺩ ﺑﺩء ﺃﻭ ﺍﻟﺗﻭﻗﻑ ﻋﻥ ﺗﻧﺎﻭﻝ ﺟﺎﺳﻳﻙ.  

·         ﺍﻷﺩﻭﻳﺔ ﺍﻟﺗﻲ ﺗﻌﻣﻝ ﻋﻠﻰ ﺳﻳﻭﻟﺔ ﺍﻟﺩﻡ، ﻣﺛﻝ ﺍﻟﻭﺍﺭﻓﺎﺭﻳﻥ ﺃﻭ ﺣﺎﺻﺭﺍﺕ ﻓﻳﺗﺎﻣﻳﻥ ﻙ ﺍﻷﺧﺭﻯ .ﻗﺩ ﻳﺣﺗﺎﺝ ﻁﺑﻳﺑﻙ ﺇﻟﻰ ﻣﺭﺍﻗﺑﺗﻙ ﻋﻧﺩ ﺑﺩء ﺃﻭ ﺇﻳﻘﺎﻑ ﺗﻧﺎﻭﻝ ﺟﺎﺳﻳﻙ ﻣﻌﻬﺎ.

·         ﺭﻳﻔﺎﻣﺑﻳﺳﻳﻥ (ﻳﺳﺗﺧﺩﻡ ﻓﻲ ﻋﻼﺝ ﺍﻟﺳﻝ).

·         ﺃﺗﺎﺯﺍﻧﺎﻓﻳﺭ (ﻳﺳﺗﺧﺩﻡ ﻓﻲ ﻋﻼﺝ ﻋﺩﻭﻯ ﻓﻳﺭﻭﺱ ﻧﻘﺹ ﺍﻟﻣﻧﺎﻋﺔ ﺍﻟﺑﺷﺭﻱ).

·         ﺗﺎﻛﺭﻭﻟﻳﻣﻭﺱ (ﻓﻲ ﺣﺎﻻﺕ ﺯﺭﻉ ﺍﻷﻋﺿﺎء)

·         ﺳﺎﻧﺕ ﺟﻭﻧﺯ ﻫﻳﺑﻳﺭﻳﻛﻭﻣﻭﺭﺗﺑﺭﻓﻭﺭﺍﺗﻭﻡ (ﻳﺳﺗﺧﺩﻡ ﻓﻲ ﻋﻼﺝ ﺍﻻﻛﺗﺋﺎﺏ ﺍﻟﺧﻔﻳﻑ).

·         ﺳﻳﻠﻭﺳﺗﺎﺯﻭﻝ (ﻳﺳﺗﺧﺩﻡ ﻓﻲ ﻋﻼﺝ ﺍﻟﻌﺭﺝ ﺍﻟﻣﺗﻘﻁﻌﺔ).

·         ﺳﺎﻛﻳﻧﺎﻓﻳﺭ (ﻳﺳﺗﺧﺩﻡ ﻓﻲ ﻋﻼﺝ ﻋﺩﻭﻯ ﻓﻳﺭﻭﺱ ﻧﻘﺹ ﺍﻟﻣﻧﺎﻋﺔ ﺍﻟﺑﺷﺭﻱ).

·         ﻛﻠﻭﺑﻳﺩﻭﻏﺭﻳﻝ (ﻳﺳﺗﺧﺩﻡ ﻟﻣﻧﻊ ﺣﺩﻭﺙ ﺟﻠﻁﺎﺕ ﺍﻟﺩﻡ - ﺍﻟﺗﺧﺛﺭ)

·         ﺇﺭﻟﻭﺗﻳﻧﻳﺏ (ﻳﺳﺗﺧﺩﻡ ﻓﻲ ﻋﻼﺝ ﺍﻟﺳﺭﻁﺎﻥ)

·         ﻣﻳﺛﻭﺗﺭﻳﻛﺳﻳﺕ (ﺩﻭﺍء ﻛﻳﻣﻳﺎﺋﻲ ﻳﺳﺗﺧﺩﻡ ﺑﺟﺭﻋﺎﺕ ﻋﺎﻟﻳﺔ ﻓﻲ ﻋﻼﺝ ﺍﻟﺳﺭﻁﺎﻥ) - ﺇﺫﺍ ﻛﻧﺕ ﺗﺗﻧﺎﻭﻝ ﺟﺭﻋﺔ ﻋﺎﻟﻳﺔ ﻣﻥ ﺍﻟﻣﻳﺛﻭﺗﺭﻳﻛﺳﻳﺕ، ﻗﺩ ﻳﻭﻗﻑ ﻟﻙ ﻁﺑﻳﺑﻙ ﻣﺅﻗﺗﺎ ﺍﻟﻌﻼﺝ ﺑﺟﺎﺳﻳﻙ.

ﺇﺫﺍ ﻭﺻﻑ ﻟﻙ ﻁﺑﻳﺑﻙ ﺍﻟﻣﺿﺎﺩﺍﺕ ﺍﻟﺣﻳﻭﻳﺔ ﺃﻣﻭﻛﺳﻳﺳﻳﻠﻳﻥ ﻭ ﻛﻼﺭﻳﺛﺭﻭﻣﻳﺳﻳﻥ ﻣﻊ ﺩﻭﺍء ﺟﺎﺳﻳﻙ ﻟﻌﻼﺝ ﺍﻟﻘﺭﺣﺔ ﺍﻟﻧﺎﺟﻣﺔ ﻋﻥ ﻋﺩﻭﻯ ﻫﻳﻠﻳﻛﻭﺑﺎﻛﺗﺭ ﺑﻳﻠﻭﺭﻱ، ﻓﻣﻥ ﺍﻟﻣﻬﻡ ﺟﺩﺍ ﺃﻥ ﺗﺧﺑﺭ ﻁﺑﻳﺑﻙ ﻋﻥ ﺃﻱ ﺃﺩﻭﻳﺔ ﺃﺧﺭﻯ ﺗﺗﻧﺎﻭﻟﻬﺎ.

 

ﺍﻟﺣﻣﻝ ﻭﺍﻟﺭﺿﺎﻋﺔ ﺍﻟﻁﺑﻳﻌﻳﺔ

ﻗﺑﻝ ﺃﻥ ﺗﺑﺩﺃﻱ ﺑﺗﻧﺎﻭﻝ ﺟﺎﺳﻳﻙ ، ﺃﺧﺑﺭﻱ ﻁﺑﻳﺑﻙ ﺇﺫﺍ ﻛﻧﺕ ﺣﺎﻣﻼ ﺃﻭ ﺗﺣﺎﻭﻟﻳﻥ ﺍﻟﺣﻣﻝ .ﺳﻭﻑ ﻳﻘﺭﺭ ﻁﺑﻳﺑﻙ ﻣﺎ ﺇﺫﺍ ﻛﺎﻥ ﺑﺈﻣﻛﺎﻧﻙ ﺗﻧﺎﻭﻝ ﺟﺎﺳﻳﻙ ﺧﻼﻝ ﻫﺫﺍ ﺍﻟﻭﻗﺕ.

ﺳﻭﻑ ﻳﻘﺭﺭ ﻁﺑﻳﺑﻙ ﻣﺎ ﺇﺫﺍ ﻛﺎﻥ ﺑﺈﻣﻛﺎﻧﻙ ﺗﻧﺎﻭﻝ ﺟﺎﺳﻳﻙ ﺇﺫﺍ ﻛﻧﺕ ﺗﺭﺿﻌﻳﻥ ﻁﻔﻠﻙ ﻣﻥ ﺍﻟﺛﺩﻱ.

 

ﺍﻟﻘﻳﺎﺩﺓ ﻭﺍﺳﺗﺧﺩﺍﻡ ﺍﻵﻻﺕ

ﻟﻳﺱ ﻣﻥ ﺍﻟﻣﺭﺟﺢ ﺃﻥ ﻳﺅﺛﺭ ﺟﺎﺳﻳﻙ ﻋﻠﻰ ﻗﺩﺭﺗﻙ ﻋﻠﻰ ﺍﻟﻘﻳﺎﺩﺓ ﺃﻭ ﺍﺳﺗﺧﺩﺍﻡ ﺃﻱ ﺃﺩﻭﺍﺕ ﺃﻭ ﺁﻻﺕ. ﻗﺩ ﺗﺣﺩﺙ ﺁﺛﺎﺭ ﺟﺎﻧﺑﻳﺔ ﻣﺛﻝ ﺍﻟﺩﻭﺧﺔ ﻭﺍﻻﺿﻁﺭﺍﺑﺎﺕ ﺍﻟﺑﺻﺭﻳﺔ (ﺍﻧﻅﺭ ﺍﻟﻔﻘﺭﺓ ﺭﻗﻡ ٤) ﺇﺫﺍ ﺗﺄﺛﺭﺕ، ﻳﻧﺑﻐﻲ ﺃﻥ ﺗﺗﺟﻧﺏ ﺍﻟﻘﻳﺎﺩﺓ ﺃﻭ ﺗﺷﻐﻳﻝ ﺍﻵﻻﺕ.

https://localhost:44358/Dashboard

ﺗﻧﺎﻭﻝ ﺟﺎﺳﻳﻙ ﺩﺍﺋﻣﺎ ﻛﻣﺎ ﻭﺻﻔﻪ ﻟﻙ ﻁﺑﻳﺑﻙ ﺗﻣﺎﻣﺎ. ﻳﺟﺏ ﻋﻠﻳﻙ ﻣﺭﺍﺟﻌﺔ ﺍﻟﻁﺑﻳﺏ ﺃﻭ ﺍﻟﺻﻳﺩﻟﻲ ﺇﺫﺍ ﻟﻡ ﺗﻛﻥ ﻣﺗﺄﻛﺩﺍ.

ﺳﻳﺧﺑﺭﻙ ﻁﺑﻳﺑﻙ ﺑﻌﺩﺩ ﺍﻟﻛﺑﺳﻭﻻﺕ ﺍﻟﺗﻲ ﻳﺟﺏ ﺃﻥ ﺗﺗﻧﺎﻭﻟﻬﺎ ﻭﻣﺩﺓ ﺗﻧﺎﻭﻟﻬﺎ. ﻭﻫﺫﺍ ﻳﻌﺗﻣﺩ ﻋﻠﻰ ﺣﺎﻟﺗﻙ ﻭﻋﻣﺭﻙ.

ﻣﺩﺭﺝ ﺃﺩﻧﺎﻩ ﺍﻟﺟﺭﻋﺎﺕ ﺍﻟﻣﻌﺗﺎﺩﺓ ﻟﻬﺫﺍ ﺍﻟﺩﻭﺍء.  

 

ﺍﻟﻛﺑﺎﺭ:

ﻟﻌﻼﺝ ﺃﻋﺭﺍﺽ ﺍﺭﺗﺟﺎﻉ ﺍﻟﻣﺭﻱء ﻣﺛﻝ ﺣﺭﻗﺔ ﺍﻟﻣﻌﺩﺓ ﻭﺗﺭﺟﻳﻊ ﺍﻟﺣﻣﺽ:

·         ﺇﺫﺍ ﻭﺟﺩ ﻁﺑﻳﺑﻙ ﺃﻥ ﺃﻧﺑﻭﺏ ﺍﻟﻁﻌﺎﻡ ﺍﻟﺧﺎﺹ ﺑﻙ (ﺍﻟﻣﺭﻱء) ﻗﺩ ﺃﺻﻳﺏ ﺑﺄﺿﺭﺍﺭ ﻁﻔﻳﻔﺔ، ﻓﺈﻥ ﺍﻟﺟﺭﻋﺔ ﺍﻟﻣﻌﺗﺎﺩﺓ ﻫﻲ ۲۰ ﻣﻠﺟﻡ ﻣﺭﺓ ﻭﺍﺣﺩﺓ ﻳﻭﻣﻳﺎ ﻟﻣﺩﺓ ٤- ۸ ﺃﺳﺎﺑﻳﻊ. ﻭﻗﺩ ﻳﺻﻑ ﻟﻙ ﻁﺑﻳﺑﻙ ﺃﻥ ﺗﺗﻧﺎﻭﻝ ﺟﺭﻋﺔ ﻣﻥ ٤۰ ﻣﻠﺟﻡ ﻟﻣﺩﺓ ۸ ﺳﺎﺑﻳﻊ ﺃﺧﺭﻯ ﺇﺫﺍ ﻟﻡ ﻳﻠﺗﺋﻡ ﺍﻟﻣﺭﻱء ﺍﻟﺧﺎﺹ ﺑﻙ ﺑﻌﺩ.

·         ﺍﻟﺟﺭﻋﺔ ﺍﻟﻣﻌﺗﺎﺩﺓ ﺑﻣﺟﺭﺩ ﺷﻔﺎء ﺍﻟﻣﺭﻱء ﻫﻲ ۱۰ ﻣﻠﺟﻡ ﻣﺭﺓ ﻭﺍﺣﺩﺓ ﻓﻲ ﺍﻟﻳﻭﻡ.

·         ﺇﺫﺍ ﻟﻡ ﻳﺗﺿﺭﺭ ﺍﻟﻣﺭﻱء ﻟﺩﻳﻙ، ﻓﺈﻥ ﺍﻟﺟﺭﻋﺔ ﺍﻟﻣﻌﺗﺎﺩﺓ ﻫﻲ ۱۰ ﻣﻠﺟﻡ ﻣﺭﺓ ﻭﺍﺣﺩﺓ ﻓﻲ ﺍﻟﻳﻭﻡ.

 

ﻟﻌﻼﺝ ﺍﻟﻘﺭﺣﺔ ﻓﻲ ﺍﻟﺟﺯء ﺍﻟﻌﻠﻭﻱ ﻣﻥ ﺍﻷﻣﻌﺎء (ﻗﺭﺣﺔ ﺍﻻﺛﻧﻲ ﻋﺷﺭ):

·         ﺍﻟﺟﺭﻋﺔ ﺍﻟﻣﻌﺗﺎﺩﺓ ﻫﻲ ۲۰  ﻣﻠﺟﻡ ﻣﺭﺓ ﻭﺍﺣﺩﺓ ﻓﻲ ﺍﻟﻳﻭﻡ ﻟﻣﺩﺓ ﺃﺳﺑﻭﻋﻳﻥ . ﻗﺩ ﻳﺧﺑﺭﻙ ﻁﺑﻳﺑﻙ ﺃﻥ ﺗﺗﻧﺎﻭﻝ ﻧﻔﺱ ﺍﻟﺟﺭﻋﺔ ﻟﻣﺩﺓ ﺃﺳﺑﻭﻋﻳﻥ ﺇﺿﺎﻓﻳﻳﻥ ﺇﺫﺍ ﻟﻡ ﺗﻠﺗﺋﻡ ﺍﻟﻘﺭﺣﺔ ﺑﻌﺩ.

·         ﺇﺫﺍ ﻛﺎﻧﺕ ﺍﻟﻘﺭﺣﺔ ﻻ ﺗﺷﻔﻰ ﺗﻣﺎﻣﺎ، ﻳﻣﻛﻥ ﺯﻳﺎﺩﺓ ﺍﻟﺟﺭﻋﺔ ﺇﻟﻰ ٤۰ ﻣﻠﺟﻡ ﻣﺭﺓ ﻭﺍﺣﺩﺓ ﻳﻭﻣﻳﺎ ﻟﻣﺩﺓ ٤ ﺃﺳﺎﺑﻳﻊ.  

 

 

ﻟﻌﻼﺝ ﺍﻟﻘﺭﺣﺎﺕ ﺍﻟﺗﻲ ﺗﻅﻬﺭ ﻓﻲ ﺍﻟﻣﻌﺩﺓ (ﻗﺭﺣﺔ ﺍﻟﻣﻌﺩﺓ):

·         ﺍﻟﺟﺭﻋﺔ ﺍﻟﻣﻌﺗﺎﺩﺓ ﻫﻲ ۲۰  ﻣﻠﺟﻡ ﻣﺭﺓ ﻭﺍﺣﺩﺓ ﻓﻲ ﺍﻟﻳﻭﻡ ﻟﻣﺩﺓ ٤ ﺃﺳﺎﺑﻳﻊ. ﻗﺩ ﻳﺧﺑﺭﻙ ﻁﺑﻳﺑﻙ ﺃﻥ ﺗﺗﻧﺎﻭﻝ ﻧﻔﺱ ﺍﻟﺟﺭﻋﺔ ﻟﻣﺩﺓ ٤ ﺃﺳﺎﺑﻳﻊ ﺃﺧﺭﻯ ﺇﺫﺍ ﻟﻡ ﺗﻠﺗﺋﻡ ﻗﺭﺣﺔ ﺍﻟﻣﻌﺩﺓ ﻟﺩﻳﻙ.

·         ﺇﺫﺍ ﻛﺎﻧﺕ ﺍﻟﻘﺭﺣﺔ ﻻ ﺗﺷﻔﻰ ﺗﻣﺎﻣﺎ، ﻳﻣﻛﻥ ﺯﻳﺎﺩﺓ ﺍﻟﺟﺭﻋﺔ ﺇﻟﻰ ٤۰ ﻣﻠﺟﻡ ﻣﺭﺓ ﻭﺍﺣﺩﺓ ﻳﻭﻣﻳﺎ ﻟﻣﺩﺓ ۸ ﺃﺳﺎﺑﻳﻊ.  

 

ﻟﻣﻧﻊ ﻗﺭﺣﺔ ﺍﻻﺛﻧﻲ ﻋﺷﺭ ﻭﺍﻟﻣﻌﺩﺓ ﻣﻥ ﺍﻟﻌﻭﺩﺓ ﻣﺭﺓ ﺃﺧﺭﻯ:

·         ﺍﻟﺟﺭﻋﺔ ﺍﻟﻣﻌﺗﺎﺩﺓ ﻫﻲ ۱۰ ﻣﻠﺟﻡ أو ۲۰  ﻣﻠﺟﻡ ﻣﺭﺓ ﻭﺍﺣﺩﺓ ﻓﻲ ﺍﻟﻳﻭﻡ. ﻗﺩ ﻳزيد ﻁﺑﻳﺑﻙ ﺍﻟﺟﺭﻋﺔ ﺇﻟﻰ ٤۰ ﻣﻠﺟﻡ ﻣﺭﺓ ﻭﺍﺣﺩﺓ ﻓﻲ ﺍﻟﻳﻭﻡ.

 

ﻟﻌﻼﺝ ﻗﺭﺣﺔ ﺍﻻﺛﻧﻲ ﻋﺷﺭ ﻭﺍﻟﻣﻌﺩﺓ ﺍﻟﻧﺎﺟﻣﺔ ﻋﻥ ﺗﻧﺎﻭﻝ ﻣﺿﺎﺩﺍﺕ ﺍﻻﻟﺗﻬﺎﺏ ﻏﻳﺭ ﺍﻟﺳﺗﻳﺭﻭﻳﺩﻳﺔ (ﻏﻳﺭ ﺍﻟﺳﺗﻳﺭﻭﻳﺩﻳﺔ ﺍﻟﻣﺿﺎﺩﺓ ﻟﻼﻟﺗﻬﺎﺑﺎﺕ ﺍﻟﻣﺧﺩﺭﺍﺕ) :

·         ﺍﻟﺟﺭﻋﺔ ﺍﻟﻣﻌﺗﺎﺩﺓ ﻫﻲ ۲۰ ﻣﻠﺟﻡ ﻣﺭﺓ ﻭﺍﺣﺩﺓ ﻳﻭﻣﻳﺎ ﻟﻣﺩﺓ ٤- ۸ ﺃﺳﺎﺑﻳﻊ.

 

ﻟﻣﻧﻊ ﻗﺭﺣﺔ ﺍﻻﺛﻧﻲ ﻋﺷﺭ ﻭﺍﻟﻣﻌﺩﺓ ﺇﺫﺍ ﻛﻧﺕ ﺗﺗﻧﺎﻭﻝ ﻣﺿﺎﺩﺍﺕ ﺍﻻﻟﺗﻬﺎﺏ ﻏﻳﺭ ﺍﻟﺳﺗﻳﺭﻭﻳﺩﻳﺔ:

·         ﺍﻟﺟﺭﻋﺔ ﺍﻟﻣﻌﺗﺎﺩﺓ ﻫﻲ ۲۰ ﻣﻠﺟﻡ ﻣﺭﺓ ﻭﺍﺣﺩﺓ ﻓﻲ ﺍﻟﻳﻭﻡ.

 

ﻟﻌﻼﺝ ﺍﻟﻘﺭﺣﺔ ﺍﻟﺗﻲ ﺗﺳﺑﺑﻬﺎ ﻋﺩﻭﻯ ﻫﻳﻠﻳﻛﻭﺑﺎﻛﺗﺭ ﺑﻳﻠﻭﺭﻱ ﻭﺍﻟﺣﻠﻭﻝ ﺩﻭﻥ ﻋﻭﺩﺗﻬﺎ:

·         ﺍﻟﺟﺭﻋﺔ ﺍﻟﻣﻌﺗﺎﺩﺓ ﻫﻲ ۲۰ ﻣﻠﺟﻡ ﻣﺭتين ﻳﻭﻣﻳﺎ ﻟﻣﺩﺓ ﺃﺳﺑوع واحد.

·         ﺳﻭﻑ ﻳﺧﺑﺭﻙ ﻁﺑﻳﺑﻙ ﺃﻳﺿﺎ ﺑﺄﺧﺫ ﻣﺿﺎﺩﺍﺕ ﺣﻳﻭﻳﺔ ﺑﻳﻥ ﺃﻣﻭﻛﺳﻳﺳﻳﻠﻳﻥ ﻭ ﻛﻼﺭﻳﺛﺭﻭﻣﻳﺳﻳﻥ ﻭ ﻣﻳﺗﺭﻭﻧﻳﺩﺍﺯﻭﻝ .

 

ﻟﻌﻼﺝ ﺯﻳﺎﺩﺓ ﺇﻓﺭﺍﺯ ﺣﻣﺽ ﺍﻟﻣﻌﺩﺓ ﺃﻛﺛﺭ ﻣﻥ ﺍﻟﻼﺯﻡ ﺍﻟﻧﺎﺟﻣﺔ ﻋﻥ ﻧﻣﻭ ﻏﻳﺭ ﻁﺑﻳﻌﻲ ﻓﻲ ﺍﻟﺑﻧﻛﺭﻳﺎﺱ (ﻣﺗﻼﺯﻣﺔ ﺯﻭﻟﻳﻧﺟﺭ ﺇﻟﻳﺳﻭﻥ):

·         ﺍﻟﺟﺭﻋﺔ ﺍﻟﻣﻌﺗﺎﺩﺓ ﻫﻲ ٦۰ ﻣﻠﺟﻡ ﻳﻭﻣﻳﺎ .

·         ﺳﻳﻘﻭﻡ ﻁﺑﻳﺑﻙ ﺑﺗﻌﺩﻳﻝ ﺍﻟﺟﺭﻋﺔ ﺗﺑﻌﺎ ﻻﺣﺗﻳﺎﺟﺎﺗﻙ ﻭﺳﻳﻘﺭﺭ ﺃﻳﺿﺎ ﻛﻡ ﻣﻥ ﺍﻟﻭﻗﺕ ﺗﺣﺗﺎﺝ ﺇﻟﻰ ﺗﻧﺎﻭﻝ ﺍﻟﺩﻭﺍء .

 

ﺍﻷﻁﻔﺎﻝ:

 

ﻟﻌﻼﺝ ﺃﻋﺭﺍﺽ ﺍﻻﺭﺗﺟﺎﻉ ﺍﻟﻣﺭﻳﺋﻲ ﻣﺛﻝ ﺣﺭﻗﺔ ﺍﻟﻣﻌﺩﺓ ﻭﺗﺭﺟﻳﻊ ﺍﻟﺣﻣﺽ:

·         ﻳﻣﻛﻥ ﻟﻸﻁﻔﺎﻝ ﺍﻟﺫﻳﻥ ﺗﺯﻳﺩ ﺃﻋﻣﺎﺭﻫﻡ ﻋﻥ ﺳﻧﺔ ﻭﺍﺣﺩﺓ ﻭﻟﺩﻳﻬﻡ ﻭﺯﻥ ﺍﻟﺟﺳﻡ ﺃﻛﺛﺭ ﻣﻥ ۱۰ ﻛﺟﻡ ﺃﻥ ﻳﺗﻧﺎﻭﻟﻭﺍ ﺟﺎﺳﻳﻙ. ﻭﺗﺳﺗﻧﺩ ﺍﻟﺟﺭﻋﺔ ﻟﺩﻯ ﺍﻷﻁﻔﺎﻝ ﻋﻠﻰ ﻭﺯﻥ ﺍﻟﻁﻔﻝ ﻭﺳﻭﻑ ﻳﻘﺭﺭ ﺍﻟﻁﺑﻳﺏ ﺍﻟﺟﺭﻋﺔ ﺍﻟﺻﺣﻳﺣﺔ.

 

ﻟﻌﻼﺝ ﺍﻟﻘﺭﺣﺔ ﺍﻟﺗﻲ ﺗﺳﺑﺑﻬﺎ ﻋﺩﻭﻯ ﻫﻳﻠﻳﻛﻭﺑﺎﻛﺗﺭ ﺑﻳﻠﻭﺭﻱ ﻭﺍﻟﺣﻠﻭﻝ ﺩﻭﻥ ﺭﺟﻭﻋﻬﺎ:

ﻳﻣﻛﻥ ﻟﻸﻁﻔﺎﻝ ﺍﻟﺫﻳﻥ ﺗﺯﻳﺩ ﺃﻋﻣﺎﺭﻫﻡ ﻋﻥ ٤ ﺳﻧﻭﺍﺕ ﺃﻥ ﻳﺗﻧﺎﻭﻟﻭﺍ ﺟﺎﺳﻳﻙ. ﻭﺗﺳﺗﻧﺩ ﺍﻟﺟﺭﻋﺔ ﻟﺩﻯ ﺍﻷﻁﻔﺎﻝ ﻋﻠﻰ ﻭﺯﻥ ﺍﻟﻁﻔﻝ ﻭﺳﻭﻑ ﻳﻘﺭﺭ ﺍﻟﻁﺑﻳﺏ ﺍﻟﺟﺭﻋﺔ ﺍﻟﺻﺣﻳﺣﺔ.

 

ﻛﻳﻔﻳﺔ ﺗﻧﺎﻭﻝ ﻫﺫﺍ ﺍﻟﺩﻭﺍء

 

·         ﻣﻥ ﺍﻟﻣﺳﺗﺣﺳﻥ ﺃﻥ ﺗﺗﻧﺎﻭﻝ ﺍﻟﻛﺑﺳﻭﻻﺕ ﻓﻲ ﺍﻟﺻﺑﺎﺡ.

·         ﻳﻣﻛﻧﻙ ﺗﻧﺎﻭﻝ ﺍﻟﻛﺑﺳﻭﻻﺕ ﻣﻊ ﺍﻟﻁﻌﺎﻡ ﺃﻭ ﻋﻠﻰ ﻣﻌﺩﺓ ﻓﺎﺭﻏﺔ.

·         ﻗﻡ ﺑﺎﺑﺗﻼﻉ ﺍﻟﻛﺑﺳﻭﻟﺔ ﺑﻛﺎﻣﻠﻬﺎ ﻣﻊ ﻧﺻﻑ ﻛﻭﺏ ﻣﻥ ﺍﻟﻣﺎء ، ﻻ ﺗﻣﺿﺧﻬﺎ ﺃﻭ ﺗﻁﺣﻧﻬﺎ.

 

ﺇﺫﺍ ﺗﻧﺎﻭﻟﺕ ﺃﻛﺛﺭ ﻣﻣﺎ ﻳﺟﺏ ﻣﻥ ﺟﺎﺳﻳﻙ

ﺇﺫﺍ ﺗﻧﺎﻭﻟﺕ ﻣﻥ ﺟﺎﺳﻳﻙ ﺟﺭﻋﺔ ﺃﻛﺑﺭ ﻣﻣﺎ ﻭﺻﻔﻪ ﻟﻙ ﺍﻟﻁﺑﻳﺏ، ﻋﻠﻳﻙ ﺍﻟﺗﺣﺩﺙ ﺇﻟﻰ ﺍﻟﻁﺑﻳﺏ ﺃﻭ ﺍﻟﺻﻳﺩﻟﻲ ﻋﻠﻰ ﺍﻟﻔﻭﺭ.

 

ﺇﺫﺍ ﻧﺳﻳﺕ ﺃﻥ ﺗﺗﻧﺎﻭﻝ ﺟﺭﻋﺔ ﺟﺎﺳﻳﻙ

ﺇﺫﺍ ﻧﺳﻳﺕ ﺃﻥ ﺗﺗﻧﺎﻭﻝ ﺟﺭﻋﺔ ﺍﻟﺩﻭﺍء، ﺗﻧﺎﻭﻟﻬﺎ ﺑﻣﺟﺭﺩ ﺃﻥ ﺗﺗﺫﻛﺭ ﺫﻟﻙ .ﺇﻻ ﺇﺫﺍ ﺍﻗﺗﺭﺏ ﻣﻭﻋﺩ ﺍﻟﺟﺭﻋﺔ ﺍﻟﺗﺎﻟﻳﺔ، ﻋﻧﺩﻫﺎ ﺗﺧﻁﻰ ﺍﻟﺟﺭﻋﺔ ﺍﻟﻔﺎﺋﺗﺔ .ﻻ ﺗﺄﺧﺫ ﺟﺭﻋﺔ ﻣﺿﺎﻋﻔﺔ ﻟﺗﻌﻭﻳﺽ ﺍﻟﺟﺭﻋﺔ ﺍﻟﻣﻧﺳﻳﺔ.

ﻳﻣﻛﻥ ﺃﻥ ﻳﺳﺑﺏ ﺟﺎﺳﻳﻙ ﺁﺛﺎﺭاً ﺟﺎﻧﺑﻳﺔ ﻛﻣﺎ ﻫﻭ ﺍﻟﺣﺎﻝ ﻣﻊ ﺟﻣﻳﻊ ﺍﻷﺩﻭﻳﺔ ، ﻋﻠﻰ ﺍﻟﺭﻏﻡ ﻣﻥ ﺃﻧﻬﺎ ﻻ ﺗﺣﺩﺙ ﻟﺩﻯ ﻛﻝ ﻣﻥ ﻳﺗﻧﺎﻭﻟﻪ .

ﺇﺫﺍ ﻻﺣﻅﺕ ﺃﻱ ﻣﻥ ﺍﻵﺛﺎﺭ ﺍﻟﺟﺎﻧﺑﻳﺔ ﺍﻟﻧﺎﺩﺭﺓ ﻭﺍﻟﺧﻁﻳﺭﺓ ﺍﻟﺗﺎﻟﻳﺔ ، ﺗﻭﻗﻑ ﻋﻥ ﺗﻧﺎﻭﻝ ﺟﺎﺳﻳﻙ ﻭﺍﺗﺻﻝ ﺑﺎﻟﻁﺑﻳﺏ ﻓﻭﺭﺍ:

·         ﺍﻟﺻﻔﻳﺭ ﺍﻟﻣﻔﺎﺟﺊ، ﻭﺗﻭﺭﻡ ﺷﻔﺗﻳﻙ، ﻭﺍﻟﻠﺳﺎﻥ ﻭﺍﻟﺣﻠﻖ ﺃﻭ ﺍﻟﺟﺳﻡ، ﻭﺍﻟﻁﻔﺢ ﺍﻟﺟﻠﺩﻱ، ﻭﺇﻏﻣﺎء ﺃﻭ ﺻﻌﻭﺑﺎﺕ ﻓﻲ ﺍﻟﺑﻠﻊ (ﺭﺩ ﻓﻌﻝ ﺗﺣﺳﺳﻲ ﺷﺩﻳﺩ).

·         ﺍﺣﻣﺭﺍﺭ ﺍﻟﺟﻠﺩ ﻣﻊ ﻅﻬﻭﺭ ﺑﺛﻭﺭ ﺃﻭ ﺗﻘﺷﻳﺭ .ﻗﺩ ﻳﻛﻭﻥ ﻫﻧﺎﻙ ﺃﻳﺿﺎ ﺑﺛﻭﺭ ﺧﻁﻳﺭﺓ ﻭﻧﺯﻳﻑ ﻓﻲ ﺍﻟﺷﻔﺗﻳﻥ ﻭﺍﻟﻌﻳﻧﻳﻥ  ﻭﺍﻟﻔﻡ ﻭﺍﻷﻧﻑ، ﻭﺍﻷﻋﺿﺎء ﺍﻟﺗﻧﺎﺳﻠﻳﺔ ﻭﻣﺗﻼﺯﻣﺔ ﺟﻭﻧﺳﻭﻥ ، ﺗﻘﺷر ﺃﻧﺳﺟﺔ ﺍﻟﺑﺷﺭﺓ ﺍﻻﻧﺣﻼﻟﻲ ﺍﻟﺗﺳﻣﻣﻲ.  

·         ﺍﻟﺟﻠﺩ ﺍﻷﺻﻔﺭ، ﺍﻟﺑﻭﻝ ﺍﻟﺩﺍﻛﻥ ﻭﺍﻟﺗﻌﺏ ﺍﻟﺫﻱ ﻳﻣﻛﻥ ﺃﻥ ﻳﻛﻭﻥ ﺃﻋﺭﺍﺽ ﻣﺷﺎﻛﻝ  ﻓﻲ ﺍﻟﻛﺑﺩ.

 

ﻳﺗﻡ ﺗﻌﺭﻳﻑ ﺣﺩﻭﺙ ﺍﻵﺛﺎﺭ ﺍﻟﺟﺎﻧﺑﻳﺔ ﺍﻟﻣﺩﺭﺟﺔ ﺃﺩﻧﺎﻩ ﺑﺎﺳﺗﺧﺩﺍﻡ ﺍﻟﻣﺻﻁﻠﺣﺎﺕ ﺍﻟﺗﺎﻟﻳﺔ:

  ﺷﺎﺋﻌﺔ ﺟﺩﺍ (ﺗﺣﺩﺙ ﻟﺩﻯ < 10/1 ﻣﻥ ﺍﻟﻣﺭﺿﻰ) ، ﺷﺎﺋﻌﺔ (ﺗﺣﺩﺙ ﻟﺩﻯ < 100/1 و 10/1 > ﻣﻥ ﺍﻟﻣﺭﺿﻰ) ، ﻏﻳﺭ ﺷﺎﺋﻊ (ﺗﺣﺩﺙ ﻟﺩﻯ < 1000/1 و 100/1 > ﻣﻥ ﺍﻟﻣﺭﺿﻰ) ، ﻧﺎﺩﺭ (ﺗﺣﺩﺙ ﻟﺩﻯ < 10000/1 و 1000/1 > ﻣﻥ ﺍﻟﻣﺭﺿﻰ) ، ﻧﺎﺩﺭ ﺟﺩﺍ (ﺗﺣﺩﺙ ﻟﺩﻯ > 10000/1) ، ﻏﻳﺭ ﻣﻌﺭﻭﻑ (ﻻ ﻳﻣﻛﻥ ﺗﻘﺩﻳﺭﻩ ﻣﻥ ﺍﻟﺑﻳﺎﻧﺎﺕ ﺍﻟﻣﺗﺎﺣﺔ) .

 

ﻭﺗﺷﻣﻝ ﺍﻵﺛﺎﺭ ﺍﻟﺟﺎﻧﺑﻳﺔ ﺍﻷﺧﺭﻯ:

ﺍﻵﺛﺎﺭ ﺍﻟﺟﺎﻧﺑﻳﺔ ﺍﻟﺷﺎﺋﻌﺔ:

·         ﺻﺩﺍﻉ.

·         ﺁﺛﺎﺭ ﻋﻠﻰ ﻣﻌﺩﺗﻙ ﺃﻭ ﺍﻷﻣﻌﺎء :ﺍﻹﺳﻬﺎﻝ، ﺁﻻﻡ ﻓﻲ ﺍﻟﻣﻌﺩﺓ، ﻭﺍﻹﻣﺳﺎﻙ، ﻭﺍﻟﻐﺎﺯﺍﺕ (ﺍﻧﺗﻔﺎﺥ ﺍﻟﺑﻁﻥ).

·         ﺍﻟﺷﻌﻭﺭ ﺑﺎﻟﻣﺭﺽ (ﺍﻟﻐﺛﻳﺎﻥ) ﺃﻭ ﺍﻟﻣﺭﺽ (ﺍﻟﺗﻘﻳﺅ.

 

ﺁﺛﺎﺭ ﺟﺎﻧﺑﻳﺔ ﻏﻳﺭ ﺷﺎﺋﻌﺔ:

·         ﺗﻭﺭﻡ ﺍﻟﻘﺩﻣﻳﻥ ﻭﺍﻟﻛﺎﺣﻠﻳﻥ.

·         ﺍﺿﻁﺭﺍﺏ ﺍﻟﻧﻭﻡ (ﺍﻷﺭﻕ).

·         ﺍﻟﺩﻭﺧﺔ، ﻭﺍﻟﺷﻌﻭﺭ ﺑﺎﻟﻭﺧﺯ ﻣﺛﻝ "ﻭﺧﺯ ﺍﻟﺩﺑﺎﺑﻳﺱ"

·         ﺍﻟﺷﻌﻭﺭ ﺑﺎﻟﺩﻭﺍﺭ (ﺍﻟﺩﻭﺍﺭ).

·         ﺗﻐﻳﻳﺭﺍﺕ ﻓﻲ ﺍﺧﺗﺑﺎﺭﺍﺕ ﺍﻟﺩﻡ ﺍﻟﺗﻲ ﺗﺗﺣﻘﻖ ﻣﻥ ﻋﻣﻝ ﺍﻟﻛﺑﺩ.  

·         ﻁﻔﺢ ﺟﻠﺩﻱ، ﻁﻔﺢ ﻣﺻﺣﻭﺏ ﺑﺣﻛﺔ (ﺍﻟﺷﺭﻯ) ﻭﺣﻛﺔ ﻓﻲ ﺍﻟﺟﻠﺩ.

·         ﺍﻟﺷﻌﻭﺭ ﺍﻟﻌﺎﻡ ﺑﺎﻟﺗﻭﻋﻙ ﻭﺍﻻﻓﺗﻘﺎﺭ ﺇﻟﻰ ﺍﻟﻁﺎﻗﺔ .

 

ﺁﺛﺎﺭ ﺟﺎﻧﺑﻳﺔ ﻧﺎﺩﺭﺓ :

·         ﻣﺷﺎﻛﻝ ﻓﻲ ﺍﻟﺩﻡ ﻣﺛﻝ ﺍﻧﺧﻔﺎﺽ ﻋﺩﺩ ﺍﻟﺧﻼﻳﺎ ﺍﻟﺑﻳﺿﺎء ﺃﻭ ﺍﻟﺻﻔﺎﺋﺢ ﺍﻟﺩﻣﻭﻳﺔ .ﻳﻣﻛﻥ ﺃﻥ ﻳﺳﺑﺏ ﻫﺫﺍ ﺿﻌﻑ، ﻛﺩﻣﺎﺕ ﺃﻭ ﻗﺩ ﻳﺻﺑﺢ ﺣﺩﻭﺙ ﺍﻻﻟﺗﻬﺎﺑﺎﺕ ﺃﻛﺛﺭ ﺍﺣﺗﻣﺎﻻ.

·         ﺍﻟﺣﺳﺎﺳﻳﺔ، ﻭﺃﺣﻳﺎﻧﺎ ﺗﻛﻭﻥ ﺷﺩﻳﺩﺓ ﺟﺩﺍ، ﺑﻣﺎ ﻓﻲ ﺫﻟﻙ ﺗﻭﺭﻡ ﻓﻲ ﺍﻟﺷﻔﺗﻳﻥ ﻭﺍﻟﻠﺳﺎﻥ ﻭﺍﻟﺣﻠﻖ، ﻭﺍﻟﺣﻣﻰ، ﻭﺍﻟﺻﻔﻳﺭ ﺧﻼﻝ ﺍﻟﺗﻧﻔﺱ.

·         ﺍﻧﺧﻔﺎﺽ ﻣﺳﺗﻭﻳﺎﺕ ﺍﻟﺻﻭﺩﻳﻭﻡ ﻓﻲ ﺍﻟﺩﻡ. ﻗﺩ ﻳﺅﺩﻱ ﺫﻟﻙ ﺇﻟﻰ ﺍﻟﺷﻌﻭﺭ ﺑﺎﻟﺿﻌﻑ، ﻭﺍﻟﻣﺭﺽ (ﺍﻟﺗﻘﻳﺅ) ﻭﺍﻟﺗﺷﻧﺟﺎﺕ.

·         ﺍﻟﺷﻌﻭﺭ ﺑﺎﻟﺗﻬﻳﺞ ﺃﻭ ﺍﻟﺧﻠﻁ ﺃﻭ ﺍﻻﻛﺗﺋﺎﺏ.

·         ﺗﻐﻳﻳﺭﺍﺕ ﻓﻲ ﺣﺎﺳﺔ ﺍﻟﺗﺫﻭﻕ.

·         ﻣﺷﺎﻛﻝ ﻓﻲ ﺍﻟﺑﺻﺭ ﻣﺛﻝ ﻋﺩﻡ ﻭﺿﻭﺡ ﺍﻟﺭﺅﻳﺔ.

·         ﺍﻟﺷﻌﻭﺭ ﺍﻟﻣﻔﺎﺟﻰء ﺑﺎﻟﺻﻔﻳﺭ ﺃﻭ ﺿﻳﻖ ﺍﻟﺗﻧﻔﺱ (ﺗﺷﻧﺞ ﻗﺻﺑﻲ).

·         ﺟﻔﺎﻑ ﺍﻟﻔﻡ.

·         ﺍﻟﺗﻬﺎﺏ ﻓﻲ ﺩﺍﺧﻝ ﺍﻟﻔﻡ.

·         ﻋﺩﻭﻯ ﺗﺳﻣﻰ "ﺍﻟﻘﻼﻉ "ﺗﺳﺑﺑﻬﺎ ﻋﺎﺩﺓ ﺍﻟﻔﻁﺭﻳﺎﺕ.

·         ﻣﺷﺎﻛﻝ ﻓﻲ ﺍﻟﻛﺑﺩ، ﺑﻣﺎ ﻓﻲ ﺫﻟﻙ ﺍﻟﻳﺭﻗﺎﻥ ﺍﻟﺫﻱ ﻳﻣﻛﻥ ﺃﻥ ﻳﺳﺑﺏ ﺍﻟﺟﻠﺩ ﺍﻷﺻﻔﺭ ﻭﺍﻟﺑﻭﻝ ﺍﻟﺩﺍﻛﻥ، ﻭﺍﻟﺗﻌﺏ.  

·         ﺗﺳﺎﻗﻁ ﺍﻟﺷﻌﺭ (ﺛﻌﻠﺑﺔ).

·         ﻁﻔﺢ ﺟﻠﺩﻱ ﻋﻧﺩ ﺍﻟﺗﻌﺭﺽ ﻷﺷﻌﺔ ﺍﻟﺷﻣﺱ.

·         ﺁﻻﻡ ﺍﻟﻣﻔﺎﺻﻝ (ﺃﻟﻡ ﻣﻔﺻﻠﻲ) ﺃﻭ ﺁﻻﻡ ﺍﻟﻌﺿﻼﺕ (ﺃﻟﻡ ﻋﺿﻠﻲ)

·         ﻣﺷﺎﻛﻝ ﺍﻟﻛﻠﻰ ﺍﻟﺷﺩﻳﺩﺓ (ﺍﻟﺗﻬﺎﺏ ﺍﻟﻛﻠﻳﺔ ﺍﻟﺧﻼﻟﻲ).

 

ﺁﺛﺎﺭ ﺟﺎﻧﺑﻳﺔ ﻧﺎﺩﺭﺓ ﺟﺩﺍ:

·         ﺍﻟﺗﻐﻳﺭﺍﺕ ﻓﻲ ﻋﺩﺩ ﻛﺭﻳﺎﺕ ﺍﻟﺩﻡ ﺑﻣﺎ ﻓﻲ ﺫﻟﻙ ﻧﺩﺭﺓ ﺍﻟﻣﺣﺑﺑﺎﺕ (ﻧﻘﺹ ﺧﻼﻳﺎ ﺍﻟﺩﻡ ﺍﻟﺑﻳﺿﺎء)

·         ﺍﻟﺷﻌﻭﺭ ﺑﺎﻟﻌﺩﻭﺍﻧﻳﺔ

·         ﺭﺅﻳﺔ ﺃﻭ ﺍﻟﺷﻌﻭﺭ ﺃﻭ ﺳﻣﻊ ﺃﺷﻳﺎء ﻏﻳﺭ ﻣﻭﺟﻭﺩﺓ (ﺍﻟﻬﻠﻭﺳﺔ).

·         ﻣﺷﺎﻛﻝ ﺷﺩﻳﺩﺓ ﻓﻲ ﺍﻟﻛﺑﺩ ﺍﻟﺗﻲ ﺗﺅﺩﻱ ﺇﻟﻰ ﻓﺷﻝ ﺍﻟﻛﺑﺩ ﻭﺍﻟﺗﻬﺎﺏ ﺍﻟﺩﻣﺎﻍ.

·         ﻅﻬﻭﺭ ﻣﻔﺎﺟﺊ ﻟﻁﻔﺢ ﺟﻠﺩﻱ ﺣﺎﺩ ﺃﻭ ﺗﻘﺭح ﺃﻭ ﺗﻘﺷﻳﺭ. ﻗﺩ ﺗﺗﺭﺍﻓﻖ ﻫﺫﺍ ﻣﻊ ﺍﺭﺗﻔﺎﻉ ﻓﻲ ﺩﺭﺟﺔ ﺍﻟﺣﺭﺍﺭﺓ ﻭﺁﻻﻡ  ﺍﻟﻣﻔﺎﺻﻝ (ﺣﻣﺎﻣﻲ ﻋﺩﻳﺩﺓ ﺍﻷﺷﻛﺎﻝ، ﻣﺗﻼﺯﻣﺔ ﺳﺗﻳﻔﻧﺯ ﺟﻭﻧﺳﻭﻥ، ﺗﻘﺷر ﺃﻧﺳﺟﺔ ﺍﻟﺑﺷﺭﺓ ﺍﻻﻧﺣﻼﻟﻲ ﺍﻟﺗﺳﻣﻣﻲ).

·         ﺿﻌﻑ ﺍﻟﻌﺿﻼﺕ.

·         ﺗﺿﺧﻡ ﺍﻟﺛﺩﻱ ﻟﺩﻯ ﺍﻟﺭﺟﺎﻝ

 

ﺁﺛﺎﺭ ﺟﺎﻧﺑﻳﺔ ﻏﻳﺭ ﻣﻌﺭﻭﻑ:

·         ﺍﻟﺗﻬﺎﺏ ﻓﻲ ﺍﻷﻣﻌﺎء (ﻣﻣﺎ ﻳﺅﺩﻱ ﺇﻟﻰ ﺍﻹﺳﻬﺎﻝ).

·         ﺇﺫﺍ ﺗﻧﺎﻭﻟﺕ ﺟﺎﺳﻳﻙ ﻷﻛﺛﺭ ﻣﻥ ﺛﻼﺛﺔ ﺃﺷﻬﺭ ﻓﻣﻥ ﺍﻟﻣﻣﻛﻥ ﺃﻥ ﻳﺅﺩﻱ ﺫﻟﻙ ﺇﻟﻰ ﺍﻧﺧﻔﺎﺽ ﻣﺳﺗﻭﻳﺎﺕ ﺍﻟﻣﻐﻧﻳﺳﻳﻭﻡ ﻓﻲ ﺩﻣﻙ. ﻳﻣﻛﻥ ﺃﻥ ﺗﻅﻬﺭ ﺍﻧﺧﻔﺎﺽ ﻣﺳﺗﻭﻳﺎﺕ ﻣﻧﺧﻔﺿﺔ ﻣﻥ ﺍﻟﻣﻐﻧﻳﺳﻳﻭﻡ ﻋﻠﻰ ﺷﻛﻝ ﺍﺣﺳﺎﺱ ﺑﺎﻟﺗﻌﺏ، ﺗﻘﻠﺻﺎﺕ ﺍﻟﻌﺿﻼﺕ ﺍﻟﻼﺇﺭﺍﺩﻳﺔ، ﻭﺍﻻﺭﺗﺑﺎﻙ، ﻭﺍﻟﺗﺷﻧﺟﺎﺕ، ﻭﺍﻟﺩﻭﺧﺔ ﺃﻭ ﺯﻳﺎﺩﺓ ﻣﻌﺩﻝ ﺿﺭﺑﺎﺕ ﺍﻟﻘﻠﺏ .ﺇﺫﺍ ﻛﻧﺕ ﺗﻭﺍﺟﻪ ﺃﻱ ﻣﻥ ﻫﺫﻩ ﺍﻷﻋﺭﺍﺽ، ﻳﺭﺟﻰ ﺇﺧﺑﺎﺭ ﺍﻟﻁﺑﻳﺏ ﻋﻠﻰ ﻭﺟﻪ ﺍﻟﺳﺭﻋﺔ. ﺍﻧﺧﻔﺎﺽ ﻣﺳﺗﻭﻳﺎﺕ ﺍﻟﻣﻐﻧﻳﺳﻳﻭﻡ ﻳﻣﻛﻥ ﺃﻥ ﻳﺅﺩﻱ ﺃﻳﺿﺎ ﺇﻟﻰ ﺍﻧﺧﻔﺎﺽ ﻓﻲ ﻣﺳﺗﻭﻳﺎﺕ ﺍﻟﺑﻭﺗﺎﺳﻳﻭﻡ ﺃﻭ ﺍﻟﻛﺎﻟﺳﻳﻭﻡ ﻓﻲ ﺍﻟﺩﻡ .ﻗﺩ ﻳﻘﺭﺭ ﻁﺑﻳﺑﻙ ﺇﺟﺭﺍء ﻓﺣﻭﺹ ﺩﻡ ﻣﻧﺗﻅﻣﺔ ﻟﻣﺭﺍﻗﺑﺔ ﻣﺳﺗﻭﻳﺎﺕ ﺍﻟﻣﻐﻧﻳﺳﻳﻭﻡ ﻟﺩﻳﻙ.

 

ﻗﺩ ﻳﺅﺛﺭ ﺟﺎﺳﻳﻙ ﻓﻲ ﺣﺎﻻﺕ ﻧﺎﺩﺭﺓ ﺟﺩﺍ ﻋﻠﻰ ﺧﻼﻳﺎ ﺍﻟﺩﻡ ﺍﻟﺑﻳﺿﺎء ﺍﻭﻳﺅﺩﻱ ﺑﺫﻟﻙ ﺇﻟﻰ ﻧﻘﺹ ﺍﻟﻣﻧﺎﻋﺔ .ﺇﺫﺍ ﻛﺎﻥ  ﻟﺩﻳﻙ ﻋﺩﻭﻯ ﻣﻊ ﺃﻋﺭﺍﺽ ﻣﺛﻝ ﺍﻟﺣﻣﻰ ﺍﻟﻣﺻﺣﻭﺑﺔ ﺑﺿﻌﻑ ﺷﺩﻳﺩ ﻓﻲ ﺍﻟﺣﺎﻟﺔ ﺍﻟﻌﺎﻣﺔ ﺃﻭ ﺍﻟﺣﻣﻰ ﻣﻊ ﺃﻋﺭﺍﺽ ﻋﺩﻭﻯ ﻣﻭﺿﻌﻳﺔ ﻣﺛﻝ ﺃﻟﻡ ﻓﻲ ﺍﻟﺭﻗﺑﺔ ﻭﺍﻟﺣﻠﻖ ﺃﻭ ﺍﻟﻔﻡ ﺃﻭ ﺻﻌﻭﺑﺎﺕ ﻓﻲ ﺍﻟﺗﺑﻭﻝ، ﻳﺟﺏ ﻋﻠﻳﻙ ﺍﺳﺗﺷﺎﺭﺓ ﺍﻟﻁﺑﻳﺏ ﻓﻲ ﺃﻗﺭﺏ ﻭﻗﺕ ﻣﻣﻛﻥ ﺑﺣﻳﺙ ﻳﻣﻛﻥ ﺍﻟﺗﺣﻘﻖ ﻣﻥ ﻋﺩﻡ ﻭﺟﻭﺩ ﻧﻘﺹ ﻓﻲ ﺧﻼﻳﺎ ﺍﻟﺩﻡ ﺍﻟﺑﻳﺿﺎء (ﻧﺩﺭﺓ ﺍﻟﻣﺣﺑﺑﺎﺕ) ﻣﻥ ﺧﻼﻝ ﺍﺧﺗﺑﺎﺭ ﺍﻟﺩﻡ .ﻣﻥ ﺍﻟﻣﻬﻡ ﺑﺎﻟﻧﺳﺑﺔ ﻟﻙ ﺃﻥ ﺗﻌﻁﻲ ﻣﻌﻠﻭﻣﺎﺕ ﻋﻥ ﺍﻟﺩﻭﺍء ﺍﻟﺫﻱ ﺗﺗﻧﺎﻭﻟﻪ ﺣﻳﻧﻬﺎ .

 

ﻻ ﺗﺷﻌﺭ ﺑﺎﻟﻘﻠﻖ ﻣﻥ ﻗﺎﺋﻣﺔ ﺍﻵﺛﺎﺭ ﺍﻟﺟﺎﻧﺑﻳﺔ ﺍﻟﻣﺣﺗﻣﻠﺔ ﻫﺫﻩ .ﻗﺩ ﻻ ﺗﻭﺍﺟﻪ ﺃﻱ ﻣﻧﻬﺎ .ﺇﺫﺍ ﺃﺻﺑﺢ ﺃﻱ ﻣﻥ ﺍﻵﺛﺎﺭ ﺍﻟﺟﺎﻧﺑﻳﺔ ﺍﻟﺗﻲ ﺗﻭﺍﺟﻬﻬﺎ ﺧﻁﻳﺭﺍ، ﺃﻭ ﺇﺫﺍ ﻭﺍﺟﻬﺕ ﺃﻱ ﺁﺛﺎﺭ ﺟﺎﻧﺑﻳﺔ ﻏﻳﺭ ﻣﺩﺭﺟﺔ ﻓﻲ ﻫﺫﻩ ﺍﻟﻧﺷﺭﺓ، ﻳﺭﺟﻰ ﺇﺧﺑﺎﺭ ﺍﻟﻁﺑﻳﺏ ﺃﻭ ﺍﻟﺻﻳﺩﻟﻲ.

ﺍﺣﺗﻔﻅ ﺑﻪ ﺑﻌﻳﺩﺍ ﻋﻥ ﻣﺗﻧﺎﻭﻝ ﻭﻧﻅﺭ ﺍﻷﻁﻔﺎﻝ.

ﻻ ﻳﺣﻔﻅ ﻓﻰ ﺩﺭﺟﺔ ﺣﺭﺍﺭﺓ ﺃﻋﻠﻰ ﻣﻥ 30 ﺩﺭﺟﺔ ﻣﺋﻭﻳﺔ.

ﺍﺣﻔﻅ ﺍﻟﻘﺎﺭﻭﺭﺓ ﻣﻐﻠﻘﺔ ﺑﺈﺣﻛﺎﻡ ﻟﻠﺣﻣﺎﻳﺔ ﻣﻥ ﺍﻟﺭﻁﻭﺑﺔ.

ﻳﺳﺗﺧﺩﻡ ﺧﻼﻝ 4 ﺃﺳﺎﺑﻳﻊ ﺑﻌﺩ ﺍﻟﻔﺗﺢ.

ﻻ ﺗﺳﺗﺧﺩﻡ ﻫﺫﺍ ﺍﻟﺩﻭﺍء ﺑﻌﺩ ﺗﺎﺭﻳﺦ ﺍﻧﺗﻬﺎء ﺍﻟﺻﻼﺣﻳﺔ ﺍﻟمدون ﻋﻠﻰ ﺍﻟﻛﺭﺗﻭﻥ ﺑﻌﺩ«EXP»  ﻳﺷﻳﺭ ﺗﺎﺭﻳﺦ ﺍﻧﺗﻬﺎء ﺍﻟﺻﺎﻟﺣﻳﺔ ﺇﻟﻰ ﺁﺧﺭ ﻳﻭﻡ ﻣﻥ ﺫﻟﻙ ﺍﻟﺷﻬﺭ.

- ﺍﻟﻣﺎﺩﺓ ﺍﻟﻔﻌﺎﻟﺔ ﻫﻲ ﺃﻭﻣﻳﺑﺭﺍﺯﻭﻝ. ﻛﻝ ﺟﺎﺳﺗﺭﻭﻛﺎﺑﺱ (ﻛﺑﺳﻭﻟﺔ ﻣﻘﺎﻭﻣﺔ ﺍﻟﻣﻌﺩﺓ) ﺗﺣﺗﻭﻱ ﻋﻠﻰ 10 ﻣﻠﺟﻡ، 20 ﻣﻠﺟﻡ أو 40 ﻣﻠﺟﻡ ﻣﻥ ﺃﻭﻣﻳﺑﺭﺍﺯﻭﻝ.

- ﺍﻟﻣﻛﻭﻧﺎﺕ ﺍﻷﺧﺭﻯ ﻫﻲ:

- ﺍﻟﺣﺑﻳﺑﺎﺕ ﺍﻟﻣﻘﺎﻭﻣﺔ ﻟﻠﻣﻌﺩﺓ: ﺟﺳﻡ ﻛﺭﻭﻱ ﺳﻛﺭﻱ، ﻫﻳﺩﺭﻭﻛﺳﻲ ﺑﺭﻭﺑﻳﻝ ﻣﻳﺛﻳﻝ ﺳﻳﻠﻭﻟﻭﺯ، ﻓﻭﺳﻔﺎﺕ ﺍﻟﻬﻳﺩﺭﻭﺟﻳﻥ ﺛﻧﺎﺋﻳﺔ ﺍﻟﺻﻭﺩﻳﻭﻡ ، ﺳﻳﻠﻭﻳﺩ 244 ، ﺛﺎﻧﻲ ﺃﻛﺳﻳﺩ ﺍﻟﺗﻳﺗﺎﻧﻳﻭﻡ (E 171) ، ﻳﻭﺩﺭﺍﺟﻳﺕ L30 D ، ﺳﻳﺗﺭﻭﻓﻠﻛﺱ 2 ، ﺍﻟﺗﺎﻟﻙ.

 

ﻣﻛﻭﻧﺎﺕ ﺍﻟﻛﺑﺳﻭﻟﺔ :ﺟﻳﻼﺗﻳﻥ ، ﻭﺛﺎﻧﻲ ﺃﻛﺳﻳﺩ ﺍﻟﺗﻳﺗﺎﻧﻳﻭﻡ (E 171) ﻭﺃﻛﺳﻳﺩ ﺍﻟﺣﺩﻳﺩ (E 172) ﺇﻧﺩﻳﻐﻭﺗﻳﻥ (E 132).

ﻗﺎﺭﻭﺭﺓ ﺑﻳﺿﺎء ﻣﻥ ﺍﻟﺑﻭﻟﻲ ﺍﻳﺛﻳﻠﻳﻥ ﻋﺎﻟﻳﺔ ﺍﻟﻛﺛﺎﻓﺔ  (HDPE) ﻣﻊ ﻏﻁﺎء ومادة مجففة.

ﺟﺎﺳﻳﻙ 10 ملجم : ﻋﺑﻭﺓ ﻣﻥ 14 و28 ﺟﺎﺳﺗﺭﻭﻛﺎﺑﺱ.

ﺟﺎﺳﻳﻙ 20 ملجم : ﻋﺑﻭﺓ ﻣﻥ 7 و 14 و 28 و 56 ﺟﺎﺳﺗﺭﻭﻛﺎﺑﺱ.

ﺟﺎﺳﻳﻙ 40 ملجم : ﻋﺑﻭﺓ ﻣﻥ 14 و28 ﺟﺎﺳﺗﺭﻭﻛﺎﺑﺱ.

ﻻ ﺗﺗﻭﻓﺭ ﺟﻣﻳﻊ ﺃﺣﺟﺎﻡ ﺍﻟﻌﺑﻭﺍﺕ ﻓﻲ ﺍﻷﺳﻭﺍﻕ.

ﻣﺎﻟﻙ ﺭﺧﺻﺔ ﺍﻟﺗﺳﻭﻳﻖ

ﺃﺳﻳﻧﻭ ﺇﻳﻪ ﺟﻲ، ﻣﻳﺳﺑﺎﺥ، ﺃﻟﻣﺎﻧﻳﺎ.

 

المصنع

يصنع ﻣﻥ ﻗﺑﻝ ﺃﺳﻳﻧﻭ ﻓﺎﺭﻣﺎ ﺇﻳﻪ ﺟﻲ، ﺁﻳﺵ ، ﺳﻭﻳﺳﺭﺍ

ﺍﻟﺗﻐﻠﻳﻑ ﺍﻟﺛﺎﻧﻭﻯ ﻣﻥ ﻗﺑﻝ  ﺷﺭﻛﺔ ﺑﺗﺭﺟﻲ ﻓﺎﺭﻣﺎ، ﺟﺩﺓ، ﺍﻟﻣﻣﻠﻛﺔ ﺍﻟﻌﺭﺑﻳﺔ ﺍﻟﺳﻌﻭﺩﻳﺔ

- ﺗﻡ ﺁﺧﺭ ﻣﺭﺍﺟﻌﺔ ﻟﻬﺫﻩ ﺍﻟﻧﺷﺭﺓ ﻓﻲ ﺳﺑﺗﻣﺑﺭ 2017
 Read this leaflet carefully before you start using this product as it contains important information for you

Gasec™ 20, Gastrocaps™ (gastro-resistant capsules) Gasec™ 40, Gastrocaps™ (gastro-resistant capsules)

Each GastrocapTM (gastro - resistant capsule) contains 20 mg or 40 mg of omeprazole. For a full list of excipients, see section 6.1.

Gastro-resistant capsule, hard (gastro-resistant capsule). - Gasec 20, Red / light green hard-gelatine capsules filled with white to off white pellets, imprinted 20. - Gasec 40 , Olive/ orange hard-gelatine capsules filled with white to off white pellets – imprinted 40.

 Gasec gastro-resistant capsules are indicated for:

 

Adults • Treatment of duodenal ulcers • Prevention of relapse of duodenal ulcers • Treatment of gastric ulcers • Prevention of relapse of gastric ulcers • In combination with appropriate antibiotics, Helicobacter pylori (H. pylori) eradication in peptic ulcer disease • Treatment of NSAID-associated gastric and duodenal ulcers • Prevention of NSAID-associated gastric and duodenal ulcers in patients at risk • Treatment of reflux esophagitis • Long-term management of patients with healed reflux esophagitis • Treatment of symptomatic gastro-esophageal reflux disease • Treatment of Zollinger-Ellison syndrome

 

Paediatric use Children over 1 year of age and ≥10 kg • Treatment of reflux esophagitis • Symptomatic treatment of heartburn and acid regurgitation in gastro-esophageal reflux disease

 

Children and adolescents over 4 years of age • In combination with antibiotics in treatment of duodenal ulcer caused by H. pylori


Posology in adults Treatment of duodenal ulcers The recommended dose in patients with an active duodenal ulcer is Gasec 20 mg once daily. In most patients healing occurs within two weeks. For those patients who may not be fully healed after the initial course, healing usually occurs during a further two weeks treatment period. In patients with poorly responsive duodenal ulcer Gasec 40 mg once daily is recommended and healing is usually achieved within four weeks.

 

Prevention of relapse of duodenal ulcers For the prevention of relapse of duodenal ulcer in H. pylori negative patients or when H. pylori eradication is not possible the recommended dose is Gasec 20 mg once daily. In some patients a daily dose of 10 mg may be sufficient. In case of therapy failure, the dose can be increased to 40 mg.

 

Treatment of gastric ulcers The recommended dose is Gasec 20 mg once daily. In most patients healing occurs within four weeks. For those patients who may not be fully healed after the initial course, healing usually occurs during a further four weeks treatment period. In patients with poorly responsive gastric ulcer Gasec 40 mg once daily is recommended and healing is usually achieved within eight weeks.

 

Prevention of relapse of gastric ulcers For the prevention of relapse in patients with poorly responsive gastric ulcer the recommended dose is Gasec 20 mg once daily. If needed the dose can be increased to Gasec 40 mg once daily.

 

H. pylori eradication in peptic ulcer disease For the eradication of H. pylori the selection of antibiotics should tolerance, and should be undertaken in accordance with national, regional and local resistance patterns and treatment guidelines.

 

• Gasec 20 mg + clarithromycin 500 mg + amoxicillin 1,000 mg, each twice daily for one week, or

 

• Gasec 20 mg + clarithromycin 250 mg (alternatively 500 mg) + metronidazole 400 mg (or 500 mg or tinidazole 500 mg), each twice daily for one week, or • Gasec 40 mg once daily with amoxicillin 500 mg and metronidazole 400 mg (or 500 mg or tinidazole 500 mg), both three times a day for one week.

 

In each regimen, if the patient is still H. pylori positive, therapy may be repeated.

Treatment of NSAID-associated gastric and duodenal ulcers For the treatment of NSAID-associated gastric and duodenal ulcers, the recommended dose is Gasec 20 mg once daily. In most patients healing occurs within four weeks. For those patients who may not be fully healed after the initial course, healing usually occurs during a further four weeks treatment period.

 

Prevention of NSAID-associated gastric and duodenal ulcers in patients at risk For the prevention of NSAID associated gastric ulcers or duodenal ulcers in patients at risk (age> 60, previous history of gastric and duodenal ulcers, previous history of upper GI bleeding) the recommended dose is Gasec 20 mg once daily.

 

Treatment of reflux esophagitis The recommended dose is Gasec 20 mg once daily. In most patients healing occurs within four weeks. For those patients who may not be fully healed after the initial course, healing usually occurs during a further four weeks treatment period. In patients with severe esophagitis Gasec 40 mg once daily is recommended and healing is usually achieved within eight weeks.

 

Long-term management of patients with healed reflux esophagitis For the long-term management of patients with healed reflux esophagitis the recommended dose is Gasec 10 mg once daily. If needed, the dose can be increased to Gasec 20-40 mg once daily.

 

Treatment of symptomatic gastro-esophageal reflux disease The recommended dose is Gasec 20 mg daily. Patients may respond adequately to 10 mg daily, and therefore individual dose adjustment should be considered. Continuously treatment in 2-3 days may be required in order to get relief of symptom. Most patients get full relief of the heartburn within 7 days. When full relief of symptom is attained the treatment should be discontinued. If symptom control has not been achieved after 4 weeks treatment with Gasec 20 mg daily, further investigation is recommended.

 

Treatment of Zollinger-Ellison syndrome In patients with Zollinger-Ellison syndrome the dose should be individually adjusted and treatment continued as long as clinically indicated. The recommended initial dose is Gasec 60 mg daily. All patients with severe disease and inadequate response to other therapies have been effectively controlled and more than 90% of the patients maintained on doses of Gasec 20–120 mg daily. When dose exceed Gasec 80 mg daily, the dose should be divided and given twice daily.

 

Posology in children

 

Children over 1 year of age and ≥10 kg Treatment of reflux esophagitis

 

Symptomatic treatment of heartburn and acid regurgitation in gastro-esophageal reflux disease

The posology recommendations are as follows:

 

Age Weight Posology ≥1 year of age 10-20 kg 10 mg once daily. The dose can be increased to 20 mg once daily if needed ≥2 years of age > 20 kg 20 mg once daily. The dose can be increased to 40 mg once daily if needed

 

Reflux esophagitis: The treatment time is 4–8 weeks.

 

Symptomatic treatment of heartburn and acid regurgitation in gastro-esophageal reflux disease: The treatment time is 2–4 weeks. If symptom control has not been achieved after 2–4 weeks the patient should be investigated further.

 Children and adolescents over 4 years of age  Treatment of duodenal ulcer caused by H. pylori When selecting appropriate combination therapy, consideration should be given to official national, regional and local guidance regarding bacterial resistance, duration of treatment (most commonly 7 days but sometimes up to 14 days), and appropriate use of antibacterial agents.

 

The treatment should be supervised by a specialist.

The posology recommendations are as follows:

Weight Posology 15-30 kg Combination with two antibiotics: Gasec 10 mg, amoxicillin 25 mg/kg body weight and clarithromycin 7.5 mg/kg body weight are all administrated together two times daily for one week 31-40 kg Combination with two antibiotics: Gasec 20 mg, amoxicillin 750 mg and clarithromycin 7.5 mg/kg body weight are all administrated two times daily for one week > 40 kg Combination with two antibiotics: Gasec 20 mg, amoxicillin 1 g and clarithromycin 500 mg are all administrated two times daily for one week.

 

Special populations Impaired renal function Dose adjustment is not needed in patients with impaired renal function (see section 5.2).

 

Impaired hepatic function In patients with impaired hepatic function a daily dose of 10–20 mg may be sufficient (see section 5.2).

 

Elderly (> 65 years old) Dose adjustment is not needed in the elderly (see section 5.2).

 

Method of administration It is recommended to take Gasec capsules in the morning, swallowed whole with half a glass of water. The capsules must not be chewed or crushed.


Hypersensitivity to omeprazole, substituted benzimidazoles or to any of the excipients. Omeprazole like other proton pump inhibitors must not be used concomitantly with nelfinavir (see section 4.5).

 In the presence of any alarm symptom (e.g. significant unintentional weight loss, recurrent vomiting, dysphagia, haematemesis or melena) and when gastric ulcer is suspected or present, malignancy should be excluded, as treatment may alleviate symptoms and delay diagnosis.

 

Co-administration of atazanavir with proton pump inhibitors is not recommended (see section 4.5). If the combination of atazanavir with a proton pump inhibitor is judged unavoidable, close clinical monitoring (e.g. virus load) is recommended in combination with an increase in the dose of atazanavir to 400 mg with 100 mg of ritonavir; omeprazole 20 mg should not be exceeded.

 

Omeprazole, as all acid-blocking medicines, may reduce the absorption of vitamin B12 (cyanocobalamin) due to hypo- or achlorhydria. This should be considered in patients with reduced body stores or risk factors for reduced vitamin B12 absorption on long-term therapy.

 

Omeprazole is a CYP2C19 inhibitor. When starting or ending treatment with omeprazole, the potential for interactions with drugs metabolised through CYP2C19 should be considered. An interaction is observed between clopidogrel and omeprazole (see section 4.5). The clinical relevance of this interaction is uncertain. As a precaution, concomitant use of omeprazole and clopidogrel should be discouraged.

 

Severe hypomagnesaemia has been reported in patients treated with proton pump inhibitors (PPIs) like omeprazole for at least three months, and in most cases for a year. Serious manifestations of hypomagnesaemia such as fatigue, tetany, delirium, convulsions, dizziness and ventricular arrhythmia can occur but they may begin insidiously and be overlooked. In most affected patients, hypomagnesaemia improved after magnesium replacement and discontinuation of the PPI. For patients expected to be on prolonged treatment or who take PPIs with digoxin or drugs that may cause hypomagnesaemia (e.g. diuretics), healthcare professionals should consider measuring magnesium levels before starting PPI treatment and periodically during treatment.

 

Proton pump inhibitors, especially if used in high doses and over long durations (>1 year), may modestly increase the risk of hip, wrist and spine fracture, predominantly in the elderly or in presence of other recognized risk factors. Observational studies suggest that proton pump inhibitors may increase the overall risk of fracture by 10-40%. Some of this increase may be due to other risk factors. Patients at risk of osteoporosis should receive care according to current clinical guidelines and they should have an adequate intake of vitamin D and calcium.

 

Interference with laboratory tests Increased CgA level may interfere with investigations for neuroendocrine tumours. To avoid this interference the omeprazole treatment should be temporarily stopped five days before CgA measurements.

 

Some children with chronic illnesses may require long-term treatment although it is not recommended.

Gasec gastro-resistant capsules contain sucrose. Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine.

 Treatment with proton pump inhibitors may lead to slightly increased risk of gastrointestinal infections such as Salmonella and Campylobacter (see section 5.1).

 As in all long-term treatments, especially when exceeding a treatment period of 1 year, patients should be kept under regular surveillance.

 

Patients with long-term recurrent symptoms of indigestion or heartburn should see their doctor at regular intervals. Especially, patients over 55 years taking-the-couanter’y‘over-prescription) (OTC, non indigestion or heartburn remedy on a daily basis should inform their pharmacist or doctor.

 

Subacute cutaneous lupus erythematosus (SCLE): Proton pump inhibitors are associated with very infrequent cases of SCLE. If lesions occur, especially in sun-exposed areas of the skin, and if accompanied by arthralgia, the patient should seek medical help promptly and the health care professional should consider stopping this medication. SCLE after previous treatment with a proton pump inhibitor may increase the risk of SCLE with other proton pump inhibitors.

 

Patients should be instructed to consult a doctor if:

 

• They have had previous gastric ulcer or gastrointestinal surgery • They are on continuous symptomatic treatment of indigestion or heartburn for 4 or more weeks • They have jaundice or severe liver disease. • They are aged over 55 years with new or recently changed symptoms.

 

Patients should not take omeprazole as a preventative medication.


Effects of omeprazole on the pharmacokinetics of other active substances

 

Active substances with pH dependent absorption The decreased intragastric acidity during treatment with omeprazole might increase or decrease the absorption of active substances with a gastric pH dependent absorption.

 

Nelfinavir, atazanavir The plasma levels of nelfinavir and atazanavir are decreased in case of co-administration with omeprazole.

 

Concomitant administration of omeprazole with nelfinavir is contraindicated (see section 4.3). Co- administration of omeprazole (40 mg once daily) reduced mean nelvinavir exposure by ca. 40% and the mean exposure of the pharmacologically active metabolite M8 was reduced by ca. 75-90%. The interaction may also involve CYP2C19 inhibition.

 

Concomitant administration of omeprazole with atazanavir is not recommended (see section 4.4). Concomitant administration of omeprazole (40 mg once daily) and atazanavir 300 mg/ritonavir 100 mg to healthy volunteers resulted in a 75% decrease of the atazanavir exposure. Increasing the atazanavir

dose to 400 mg did not compensate for the impact of omeprazole on atazanavir exposure. The co- administration of omeprazole (20 mg once daily) with atazanavir 400 mg/ritonavir 100 mg to healthy volunteers resulted in a decrease of approximately 30% in the atazanavir exposure as compared to atazanavir 300 mg/ritonavir 100 mg once daily.

 

Digoxin Concomitant treatment with omeprazole (20 mg daily) and digoxin in healthy subjects increased the bioavailability of digoxin by 10%. Digoxin toxicity has been rarely reported. However caution should be exercised when omeprazole is given at high doses in elderly patients. Therapeutic drug monitoring of digoxin should be then be reinforced.

 

Clopidogrel In a crossover clinical study, clopidogrel (300 mg loading dose followed by 75 mg/day) alone and with omeprazole (80 mg at the same time as clopidogrel) were administered for 5 days. The exposure to the active metabolite of clopidogrel was decreased by 46% (Day 1) and 42% (Day 5) when clopidogrel and omeprazole were administered together. Mean inhibition of platelet aggregation (IPA) was diminished by 47% (24 hours) and 30% (Day 5) when clopidogrel and omeprazole were administered together. In another study it was shown that administering clopidogrel and omeprazole at different times did not prevent their interaction that is likely to be driven by the inhibitory effect of omeprazole on CYP2C19. Inconsistent data on the clinical implications of this PK/PD interaction in terms of major cardiovascular events have been reported from observational and clinical studies.

 

Other active substances The absorption of posaconazole, erlotinib, ketoconazole and itraconazole is significantly reduced and thus clinical efficacy may be impaired. For posaconazole and erlotinib concomitant use should be avoided.

 

Active substances metabolised by CYP2C19 Omeprazole is a moderate inhibitor of CYP2C19, the major omeprazole metabolising enzyme. Thus, the metabolism of concomitant active substances also metabolised by CYP2C19, may be decreased and the systemic exposure to these substances increased. Examples of such drugs are R-warfarin and other vitamin K antagonists, cilostazol, diazepam and phenytoin.

 

Cilostazol Omeprazole, given in doses of 40 mg to healthy subjects in a cross-over study, increased Cmax and AUC for cilostazol by 18% and 26% respectively, and one of its active metabolites by 29% and 69% respectively.

 

Phenytoin Monitoring phenytoin plasma concentration is recommended during the first two weeks after initiating omeprazole treatment and, if a phenytoin dose adjustment is made, monitoring and a further dose adjustment should occur upon ending omeprazole treatment.

 

Unknown mechanism

 

Saquinavir Concomitant administration of omeprazole with saquinavir/ritonavir resulted in increased plasma levels up to approximately 70% for saquinavir associated with good tolerability in HIV-infected patients.

Tacrolimus Concomitant administration of omeprazole has been reported to increase the serum levels of tacrolimus.  A reinforced monitoring of tacrolimus concentrations as well as renal function (creatinine clearance) should be performed, and dosage of tacrolimus adjusted if needed.

 

Methotrexate When given together with proton pump inhibitors, methotrexate levels have been reported to increase in some patients. In high-dose methotrexate administration a temporary withdrawal of omeprazole may need to be considered.

 

 

Effects of other active substances on the pharmacokinetics of omeprazole

 

Inhibitors of CYP2C19 and/or CYP3A4 Since omeprazole is metabolised by CYP2C19 and CYP3A4, active substances known to inhibit CYP2C19 or CYP3A4 (such as clarithromycin and voriconazole) may lead to increased omeprazole serum levels by decreasing of metabolism omeprazole’s. Concomitant voriconazole treatment rate resulted in more than doubling of the omeprazole exposure. As high doses of omeprazole have been well-tolerated adjustment of the omeprazole dose is not generally required. However, dose adjustment should be considered in patients with severe hepatic impairment and if long-term treatment is indicated.

 

Inducers of CYP2C19 and/or CYP3A4 Active substances known to induce CYP2C19 or CYP3A4 or both may lead to decreased omeprazole serum levels by increasing omeprazole's rate of metabolism.


Results from three prospective epidemiological studies (more than 1000 exposed outcomes) indicate no adverse effects of omeprazole on pregnancy or on the health of the foetus/newborn child. Omeprazole can be used during pregnancy.

 Omeprazole is excreted in breast milk but is not likely to influence the child when therapeutic doses are used.


 Gasec is not likely to affect the ability to drive or use machines. Adverse drug reactions such as dizziness and visual disturbances may occur (see section 4.8). If affected, patients should not drive or operate machinery.

 


The most common side effects (1-10% of patients) are headache, abdominal pain, constipation, diarrhoea, flatulence and nausea/vomiting.

 

The following adverse drug reactions have been identified or suspected in the clinical trials programme for omeprazole and post-marketing. None was found to be dose-

related. Adverse reactions listed below are classified according to frequency and System Organ Class (SOC). Frequency categories are defined according to the following very common (> 1/10); common (> 1/100 and < 1/10); uncommon (> 1/1,000 and < 1/100); rare (> 1/10,000 and < 1/1,000); very rare (< 1/10,000), not known (cannot be estimated from the available data). SOC/frequency Adverse reaction

Blood and lymphatic system disorders Rare: Leukopenia, thrombocytopenia Very rare: Agranulocytosis, pancytopenia Immune system disorders Rare: Hypersensitivity reactions e.g. fever, angioedema and anaphylactic reaction/shock

 

Metabolism and nutrition disorders Rare: Hyponatraemia Not known: Hypomagnesaemia Psychiatric disorders Uncommon: Insomnia Rare: Agitation, confusion, depression Very rare: Aggression, hallucinations Nervous system disorders Common: Headache Uncommon: Dizziness, paraesthesia, somnolence Rare: Taste disturbance Eye disorders  Rare: Blurred vision Ear and labyrinth disorders Uncommon: Vertigo Respiratory, thoracic and mediastinal disorders Rare: Bronchospasm Gastrointestinal disorders Common: Abdominal pain, constipation, diarrhoea, flatulence, nausea/vomiting Rare: Dry mouth, stomatitis, gastrointestinal candidiasis Not known: Microscopic colitis Hepatobiliary disorders Uncommon: Increased liver enzymes Rare: Hepatitis with or without jaundice Very rare: Hepatic failure, encephalopathy in patients with pre-existing liver disease Skin and subcutaneous tissue disorders Uncommon: Dermatitis, pruritus, rash, urticaria Rare: Alopecia, photosensitivity Very rare: Erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis  (TEN) Musculoskeletal and connective tissue disorders Uncommon Fracture of the hip, wrist or spine

Rare: Arthralgia, myalgia Very rare: Muscular weakness Renal and urinary disorders Rare: Interstitial nephritis Reproductive system and breast disorders Very rare: Gynaecomastia General disorders and administration site conditions Uncommon: Malaise, peripheral oedema Rare: Increased sweating

 

Paediatric population The safety of omeprazole has been assessed in a total of 310 children aged 0 to 16 years with acid-related disease. There are limited long term safety data from 46 children who received maintenance therapy of omeprazole during a clinical study for severe erosive esophagitis for up to 749 days. The adverse event profile was generally the same as for adults in short- as well as in long-term treatment. There are no long term data regarding the effects of omeprazole treatment on puberty and growth.

 

To report any side effect(s):

• Saudi Arabia:

-The National Pharmacovigilance and Drug Safety Centre (NPC) o Fax: +966-11-205-7662 o Call NPC at +966-11-2038222, Exts: 2317-2356-2353-2354-2334-2340. o Toll free phone: 8002490000 o E-mail: npc.drug@sfda.gov.sa o Website: www.sfda.gov.sa/npc.

 


There is limited information available on the effects of overdoses of omeprazole in humans. In the literature, doses of up to 560 mg have been described, and occasional reports have been received when single oral doses have reached up to 2,400 mg omeprazole (120 times the usual recommended clinical dose). Nausea, vomiting, dizziness, abdominal pain, diarrhoea and headache have been reported. Also apathy, depression and confusion have been described in single cases.

 

The symptoms described in connection to omeprazole overdose have been transient, and no serious outcome has been reported. The rate of elimination was unchanged (first order kinetics) with increased doses. Treatment, if needed, is symptomatic.


Pharmacotherapeutic group: Proton pump inhibitors, ATC code: A02BC01

Mechanism of action Omeprazole, a racemic mixture of two enantiomers reduces gastric acid secretion through a highly targeted mechanism of action. It is a specific inhibitor of the acid pump in the parietal cell. It is rapidly acting and provides control through reversible inhibition of gastric acid secretion with once daily dosing.

 Omeprazole is a weak base and is concentrated and converted to the active form in the highly acidic environment of the intracellular canaliculi within the parietal cell, where it inhibits the enzyme H+ K+- ATPase - the acid pump. This effect on the final step of the gastric acid formation process is dose- dependent and provides for highly effective inhibition of both basal acid secretion and stimulated acid secretion, irrespective of stimulus.

 

Pharmacodynamic effects All pharmacodynamic effects observed can be explained by the effect of omeprazole on acid secretion.

 

Effect on gastric acid secretion Oral dosing with omeprazole once daily provides for rapid and effective inhibition of daytime and night-time gastric acid secretion with maximum effect being achieved within 4 days of treatment. With omeprazole 20 mg, a mean decrease of at least 80% in 24-hour intragastric acidity is then maintained in duodenal ulcer patients, with the mean decrease in peak acid output after pentagastrin stimulation being about 70% 24 hours after dosing.

 

Oral dosing with omeprazole 20 mg maintains an intragastric pH of ≥3 for a mean time of 17 hours of the 24-hour period in duodenal ulcer patients.

 

As a consequence of reduced acid secretion and intragastric acidity, omeprazole dose-dependently reduces/normalizes acid exposure of the esophagus in patients with gastro-esophageal reflux disease. The inhibition of acid secretion is related to the area under the plasma concentration-time curve (AUC) of omeprazole and not to the actual plasma concentration at a given time.

 

No tachyphylaxis has been observed during treatment with omeprazole.

 

Effect on H. pylori H. pylori is associated with peptic ulcer disease, including duodenal and gastric ulcer disease. H. pylori is a major factor in the development of gastritis. H. pylori together with gastric acid are major factors in the development of peptic ulcer disease. H. pylori is a major factor in the development of atrophic gastritis which is associated with an increased risk of developing gastric cancer.

 Eradication of H. pylori with omeprazole and antimicrobials is associated with high rates of healing and long-term remission of peptic ulcers

 

Dual therapies have been tested and found to be less effective than triple therapies. They could, however, be considered in cases where known hypersensitivity precludes use of any triple combination.

Other effects related to acid inhibition During long-term treatment gastric glandular cysts have been reported in a somewhat increased frequency. These changes are a physiological consequence of pronounced inhibition of acid secretion, are benign and appear to be reversible.

 

Decreased gastric acidity due to any means including proton pump inhibitors, increases gastric counts of bacteria normally present in the gastrointestinal tract. Treatment with acid-reducing drugs may lead to slightly increased risk of gastrointestinal infections such as Salmonella and Campylobacter.

 Chromogranin A (CgA) also increases due to decreased gastric acidity. This CgA modifying effect cannot be demonstrated five days after stopping treatment with PPIs.

 

Paediatric use In a non-controlled study in children (1 to 16 years of age) with severe reflux esophagitis, omeprazole at doses of 0.7 to 1.4 mg/kg improved esophagitis level in 90% of the cases and significantly reduced reflux symptoms. In a single-blind study, children aged 0–24 months with clinically diagnosed gastro- esophageal reflux disease were treated with 0.5, 1.0 or 1.5 mg omeprazole/kg. The frequency of vomiting/regurgitation episodes decreased by 50% after 8 weeks of treatment irrespective of the dose.

 

Eradication of H. pylori in children A randomised, double blind clinical study (Héliot study) concluded that omeprazole, in combination with two antibiotics (amoxicillin and clarithromycin), was safe and effective in the treatment of H. pylori infection in children age 4 years old and above with gastritis: H. pylori eradication rate: 74.2% (23/31 patients) with omeprazole + amoxicillin + clarithromycin versus 9.4% (3/32 patients) with amoxicillin + clarithromycin. However, there was no evidence of any clinical benefit with respect to dyspeptic symptoms. This study does not support any information for children aged less than 4 years.


Absorption Omeprazole and omeprazole magnesium are acid labile and are therefore administered orally as enteric-coated granules in capsules or capsules. Absorption of omeprazole is rapid, with peak plasma levels occurring approximately 1-2 hours after dose. Absorption of omeprazole takes place in the small intestine and is usually completed within 3-6 hours. Concomitant intake of food has no influence on the bioavailability. The systemic availability (bioavailability) from a single oral dose of omeprazole is approximately 40%. After repeated once-daily administration, the bioavailability increases to about 60%.

 

 

Distribution The apparent volume of distribution in healthy subjects is approximately 0.3 l/kg body weight. Omeprazole is 97% plasma protein bound.

 

Bioequivalence between Gasec capsules and Gasec gastro-resistant capsules, based on both area under the omeprazole plasma concentration-time curve (AUC) and maximum plasma concentration (Cmax) of omeprazole, has been demonstrated for all doses, 10 mg, 20 mg and 40 mg.

Metabolism Omeprazole is completely metabolised by the cytochrome P450 system (CYP). The major part of its metabolism is dependent on the polymorphically expressed CYP2C19, responsible for the formation of hydroxyomeprazole, the major metabolite in plasma. The remaining part is dependent on another specific isoform, CYP3A4, responsible for the formation of omeprazole sulphone. As a consequence of high affinity of omeprazole to CYP2C19, there is a potential for competitive inhibition and metabolic drug-drug interactions with other substrates for CYP2C19. However, due to low affinity to CYP3A4, omeprazole has no potential to inhibit the metabolism of other CYP3A4 substrates. In addition, omeprazole lacks an inhibitory effect on the main CYP enzymes.

 

Approximately 3% of the Caucasian population and 15-20% of Asian populations lack a functional CYP2C19 enzyme and are called poor metabolisers. In such individuals the metabolism of omeprazole is probably mainly catalysed by CYP3A4. After repeated once-daily administration of 20 mg omeprazole, the mean AUC was 5 to 10 times higher in poor metabolisers than in subjects having a functional CYP2C19 enzyme (extensive metabolisers). Mean peak plasma concentrations were also higher, by 3 to 5 times. These findings have no implications for the posology of omeprazole.

 

Excretion The plasma elimination half-life of omeprazole is usually shorter than one hour both after single and repeated oral once-daily dosing. Omeprazole is completely eliminated from plasma between doses with no tendency for accumulation during once-daily administration. Almost 80% of an oral dose of omeprazole is excreted as metabolites in the urine, the remainder in the faeces, primarily originating from bile secretion.

 

The AUC of omeprazole increases with repeated administration. This increase is dose-dependent and results in a non-linear dose-AUC relationship after repeated administration. This time- and dose-dependency is due to a decrease of first pass metabolism and systemic clearance probably caused by an inhibition of the CYP2C19 enzyme by omeprazole and/or its metabolites (e.g. the sulphone). No metabolite has been found to have any effect on gastric acid secretion.

Special populations

Impaired hepatic function The metabolism of omeprazole in patients with liver dysfunction is impaired, resulting in an increased AUC. Omeprazole has not shown any tendency to accumulate with once-daily dosing.

 

Impaired renal function The pharmacokinetics of omeprazole, including systemic bioavailability and elimination rate, are unchanged in patients with reduced renal function.

 

Elderly The metabolism rate of omeprazole is somewhat reduced in elderly subjects (75-79 years of age).

 

Paediatric patients During treatment with the recommended doses to children from the age of 1 year, similar plasma concentrations were obtained as compared to adults. In children younger than 6 months, clearance of omeprazole is low due to low capacity to metabolise omeprazole.


Gastric ECL-cell hyperplasia and carcinoids, have been observed in life-long studies in rats treated with omeprazole. These changes are the result of sustained hypergastrinaemia secondary to acid inhibition. Similar findings have been made after treatment with H2-receptor antagonists, proton pump inhibitors and after partial fundectomy. Thus, these changes are not from a direct effect of any individual active substance.


- Gastro - resistant pellets: Sugar sphere, hydroxypropyl methylcellulose, disodium hydrogen phosphate, Syloid 244, titanium dioxide (E 171), Eudragit L30 D, Citroflex 2, talc. - Capsule composition: Gelatine, titanium dioxide (E 171), iron oxide (E 172), indigotine (E 132).


Not applicable.


3 years.

Keep out of the reach and sight of children.  

Do not store above 30 ºC. Keep the bottle tightly closed in order to protect from moisture.

Use within 4 weeks after opening.


White bottle of high density polyethylene (HDPE) with cap and desiccant.

Gasec - 10: Packs of 14 and 28 Gastrocaps.

Gasec - 20: Packs of 7, 14, 28 and 56 Gastrocaps.

Gasec - 40: Packs of 14 and 28 Gastrocaps.

Not all pack sizes may be marketed.


No special requirements


Acino AG, Miesbach - Germany

September 2017
}

صورة المنتج على الرف

الصورة الاساسية