Omez D

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Hvorfor bestille fra MedsBase

Vores generiske medicin kommer fra WHO-GMP certificerede producenter og sendes verdensomspændende i diskret, neutral emballage — ingen medicinnavn på pakkens ydre. Kortbetalinger håndteres af en reguleret processor (kontoudtogsbeskrivelser inkluderer en reguleret betalingsprocessor — aldrig “MedsBase” eller medicinnavn). Crypto og SEPA bankoverførsel accepteres også. Hver ordre er dækket af vores Reshipment Assurance Policy.

When is the PPI + domperidone combination preferred over a PPI alone?

Plain PPI monotherapy (Omez, Pan, Razo etc.) is the standard for uncomplicated GERD or peptic ulcer. Adding domperidone helps when the dominant symptom is regurgitation, postprandial fullness, nausea, or when there is delayed gastric emptying (diabetic gastroparesis, post-vagotomy, idiopathic). For uncomplicated heartburn the simpler PPI is preferred — domperidone has a small but real cardiac signal that does not justify routine use.

Hvorfor bestille fra MedsBase

Omez D is supplied from a WHO-GMP certificeret producent. Hver ordre sendes diskret over hele verden og er dækket af vores Reshipment Assurance Policy — if it does not arrive within 20 business days, we reship at no cost. Omeprazole is one of the most prescribed PPIs worldwide and the SR-domperidone fraction adds gastric-emptying support without the IR-domperidone’s pulse-and-trough exposure profile.

Virkningsmekanisme

Omeprazol is a substituted benzimidazole PPI that is activated by the acidic environment of the parietal-cell secretory canaliculus. Once activated it covalently binds Cys813 (and other cysteines) on the α-subunit of the H+/K+-ATPase, irreversibly inhibiting acid secretion. Recovery requires synthesis of new pump protein (~24–48 h half-life of the pump itself).

Domperidon is a peripheral dopamine D2 receptor antagonist that does not cross the blood-brain barrier in significant amounts (so it lacks the central D2-antagonism extrapyramidal signature of metoclopramide). In the gut it increases lower-oesophageal sphincter tone, accelerates gastric emptying, and improves antroduodenal coordination. It also blocks D2 receptors in the chemoreceptor trigger zone (which sits outside the BBB) producing antiemetic effect.

Indikationer

• GERD with prominent regurgitation or postprandial fullness
• Diabetic gastroparesis (functional motility disorder)
• Functional dyspepsia (postprandial distress syndrome subtype)
• Symptomatic relief in chemo- or radiotherapy-induced nausea (short course)
• Reflux symptoms in scleroderma-related oesophageal dysmotility

Dosis

One Omez D capsule once daily, 30–60 minutes before breakfast, swallow whole. Typical course is 4–8 weeks for symptom-driven use; if symptoms recur on discontinuation, switch to PPI monotherapy for maintenance and reserve domperidone for breakthrough symptoms (EMA short-course rule). Severe gastroparesis may require longer courses under specialist supervision with periodic ECG.

Bivirkninger

• Common (> 1%): headache, dry mouth, abdominal cramp, diarrhoea, drowsiness
• Long-term PPI: low B12, low magnesium, fracture risk, fundic-gland polyps, increased CDI risk
• Domperidone-specific: hyperprolactinaemia (galactorrhoea, gynaecomastia, menstrual disturbance), QT prolongation, rare arrhythmia
• Sjældne: anaphylaxis, Stevens-Johnson syndrome, acute interstitial nephritis (PPI class effect)

Lægemiddelinteraktioner

• Clopidogrel: omeprazole inhibits CYP2C19 and may reduce clopidogrel activation — switch to pantoprazole or rabeprazole if both are required.
• QT-forlængende lægemidler (azithromycin, fluoroquinolones, ondansetron, citalopram, methadone, hydroxychloroquine): avoid concurrent use.
• Stærke CYP3A4-hæmmere (ketoconazole, ritonavir, clarithromycin, grapefruit juice): raise domperidone exposure 4–8 fold — avoid.
• Levodopa, dopamine agonists: domperidone antagonises peripheral D2 effects (can be used intentionally to control levodopa-induced nausea).
• Atazanavir, nelfinavir, posaconazole: need acid for absorption — PPI reduces blood levels significantly.

Ofte stillede spørgsmål

Is Omez D safe to take long-term?

PPI exposure is generally well tolerated for months but risks accumulate (B12 / magnesium / fractures / CDI). The domperidone fraction should be limited to short courses (typically ≤ 7 days, max 30 mg/day per EMA). For chronic GERD maintenance, switch to PPI monotherapy.

Why take it before food?

PPIs require active proton pumps to bind. Pumps activate when food triggers acid secretion. Taking Omez D 30–60 minutes before the first meal gives maximum pump occupancy.

Will it interact with my heart medication?

Domperidone can prolong the QT interval. Tell the prescriber about every cardiac drug, antibiotic, antifungal, antidepressant, and antimalarial you take. A baseline ECG is sensible if you are over 60 or have known cardiac disease.

Can I drink coffee or alcohol on it?

Alcohol and coffee can both worsen reflux. Reduce intake during a flare. There is no disulfiram-like reaction with this combination.

Er det sikkert under graviditet?

PPIs are class B/C; data in pregnancy is reassuring for omeprazole but not zero-risk. Domperidone has limited human pregnancy data — avoid unless the prescriber decides benefits outweigh. Breastfeeding: domperidone is excreted in breast milk in small amounts and is sometimes used off-label as a galactagogue.

Hvad hvis jeg glemmer en dosis?

Take it as soon as you remember. If it is close to the next dose, skip and continue the schedule. Do not double-dose — stacking domperidone increases QT risk.

Can I crush or open the capsule?

No. The SR pellets are designed to release domperidone gradually over the dose interval. Crushing dumps the dose and produces a high peak that is more arrhythmogenic.

How quickly will it work?

Acid suppression is detectable within hours but maximal at day 3–5. Domperidone-driven gastric-emptying acceleration is felt within 30–60 minutes of the first dose.

What if my symptoms do not improve after 4–8 weeks?

Reassess the diagnosis. Consider H. pylori eradication, oesophageal manometry for motility disorder, or referral for endoscopy (alarm symptoms: weight loss, dysphagia, anaemia, vomiting blood, age > 55 with new symptoms).

Opbevaring

Opbevares under 30°C og beskyttes mod fugt. Opbevares utilgængeligt for børn.

Andre mave-tarm-medicin

• Pantocid DSR — Pantoprazole 40 + Domperidone 30 SR
• Famocid — Famotidine (H2 blocker)
• Omez — Omeprazole 20 mg (PPI mono)
• Dompewal — Domperidone 10 mg
• Reglan — Metoclopramide 10 mg
• Se alle mave-tarm-medicin

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