{"id":58813,"date":"2024-02-28T05:29:33","date_gmt":"2024-02-28T05:29:33","guid":{"rendered":"https:\/\/medsname.com\/gr8-od\/"},"modified":"2026-04-30T10:24:07","modified_gmt":"2026-04-30T10:24:07","slug":"gr8-od","status":"publish","type":"product","link":"https:\/\/medsbase.com\/ro\/product\/gr8-od\/","title":{"rendered":"GR8-OD"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 R\u0103spuns rapid \u2014 Ce este GR8-OD?<\/h3>\n<p style=\"margin:0;\"><strong>GR8-OD<\/strong> este o capsul\u0103 oral\u0103 cu doz\u0103 fix\u0103 care combin\u0103 un <strong>inhibitor de pomp\u0103 protonic\u0103 (Pantoprazole 40 mg)<\/strong> cu <strong>antagonistul dopaminergic prokinetic domperidon 30 mg cu eliberare prelungit\u0103<\/strong>. PPI-ul suprim\u0103 secre\u021bia acid\u0103 gastric\u0103 prin inhibarea ireversibil\u0103 a H+\/K+-ATPazei din celulele parietale; domperidonul accelereaz\u0103 golirea gastric\u0103 \u0219i \u00eent\u0103re\u0219te tonusul sfincterului esofagian inferior, fiind util c\u00e2nd RGE este \u00eenso\u021bit de <strong>regurgitare, gastroparez\u0103 sau dispepsie func\u021bional\u0103<\/strong>. Lua\u021bi <strong>30\u201360 de minute \u00eenaintea primei mese<\/strong>, \u00eenghi\u021bi\u021bi \u00eentreg, nu zdrobi\u021bi pelletul SR. Fabricat de Mankind Pharma conform standardelor WHO-GMP.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f5f6f8;border:1px solid #e1e4e8;border-radius:6px;padding:14px 18px;margin:24px 0;font-size:14px;\"><strong>De ce s\u0103 comanzi de la MedsBase:<\/strong> \u2714 <strong>produc\u0103tor certificat WHO-GMP<\/strong> \u2714 Ambalaj discret \u2714 Livrare worldwide \u2714 <a href=\"https:\/\/medsbase.com\/ro\/reviews\/\">Recenzii verificate ale clien\u021bilor (peste 1.400 de clien\u021bi)<\/a><\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Fiecare comand\u0103 este acoperit\u0103 de politica noastr\u0103 de <a href=\"https:\/\/medsbase.com\/ro\/medsbase-re-shipment-assurance-policy\/\"><strong>Politica noastr\u0103 de Reexpediere Garantat\u0103<\/strong><\/a> \u2014 dac\u0103 coletul dumneavoastr\u0103 nu sose\u0219te \u00een 20 de zile lucr\u0103toare, \u00eel relivr\u0103m.<\/p>\n<h3>De ce s\u0103 comanzi de la MedsBase<\/h3>\n<p>Medicamentele noastre generice sunt procurate de la produc\u0103tori certifica\u021bi WHO-GMP \u0219i expediate la nivel mondial \u00een ambalaje discrete \u0219i simple \u2014 f\u0103r\u0103 denumirea medicamentului pe exteriorul coletului. Pl\u0103\u021bile cu cardul sunt procesate printr-un procesor reglementat (descrierile de pe extrasul de cont includ un procesor de pl\u0103\u021bi cu card reglementat \u2014 niciodat\u0103 \u201cMedsBase\u201d sau numele vreunui medicament). Accept\u0103m \u0219i criptomonede \u0219i transferuri bancare SEPA. Fiecare comand\u0103 este sus\u021binut\u0103 de Politica noastr\u0103 de Asigurare pentru Relivrare.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:18px 0;border-radius:4px;\"><strong>\u26a0\ufe0f Semnal de restric\u021bie EMA privind prelungirea intervalului QT la domperidon.<\/strong> \u00cen urma unui review european din 2014, domperidonul este restric\u021bionat la ameliorarea simptomelor de grea\u021b\u0103\/v\u0103rs\u0103turi la cea mai mic\u0103 doz\u0103 eficient\u0103 \u0219i pentru cea mai scurt\u0103 durat\u0103 (de obicei \u2264 7 zile, max 30 mg\/zi). Evita\u021bi la v\u00e2rsta &gt; 60 de ani, cu excep\u021bia cazurilor \u00een care beneficiile dep\u0103\u0219esc riscurile, \u00een caz de prelungire cunoscut\u0103 a intervalului QT, tulburare electrolitic\u0103 (K+\/Mg++ sc\u0103zut), insuficien\u021b\u0103 hepatic\u0103 sever\u0103 sau \u00een asociere cu medicamente care prelungesc QT sau inhib\u0103 puternic CYP3A4 (claritromicin\u0103, ketoconazol, ritonavir). Hiperprolactinemia \u0219i galactoree pot ap\u0103rea la utilizarea prelungit\u0103. Evita\u021bi \u00een boala Parkinson (antagonismul D2 agraveaz\u0103 simptomele motorii).<\/div>\n<h2 class=\"wp-block-heading\">C\u00e2nd este preferat\u0103 combina\u021bia PPI + domperidon \u00een locul PPI singur?<\/h2>\n<p>Monoterapia simpl\u0103 cu PPI (Omez, Pan, Razo etc.) este standardul pentru GERD necomplicat sau ulcer peptic. Ad\u0103ugarea domperidonului ajut\u0103 c\u00e2nd simptomul dominant este <strong>regurgitare<\/strong>, <strong>senza\u021bie de plenitudine postprandial\u0103<\/strong>, <strong>grea\u021b\u0103<\/strong>, sau c\u00e2nd exist\u0103 <strong>golire gastric\u0103 \u00eent\u00e2rziat\u0103<\/strong> (gastroparezie diabetic\u0103, post-vagotomie, idiopatic\u0103). Pentru arsur\u0103 necomplicat\u0103, PPI-ul simplu este preferat \u2014 domperidonul are un mic dar real semnal cardiac care nu justific\u0103 utilizarea de rutin\u0103.<\/p>\n<h3 class=\"wp-block-heading\">De ce s\u0103 comanzi de la MedsBase<\/h3>\n<p>GR8-OD este furnizat dintr-un <strong>produc\u0103tor certificat WHO-GMP<\/strong>. Fiecare comand\u0103 este expediat\u0103 discret \u00een \u00eentreaga lume \u0219i este acoperit\u0103 de <a href=\"https:\/\/medsbase.com\/ro\/medsbase-re-shipment-assurance-policy\/\">Politica noastr\u0103 de Reexpediere Garantat\u0103<\/a> \u2014 dac\u0103 nu sose\u0219te \u00een 20 de zile lucr\u0103toare, retrimitem f\u0103r\u0103 costuri suplimentare. Pantoprazolul este unul dintre cele mai prescrise PPI-uri la nivel mondial, iar frac\u021bia SR-domperidon adaug\u0103 suport pentru golirea gastric\u0103 f\u0103r\u0103 profilul de expunere puls-trough al domperidonului IR.<\/p>\n<h2 class=\"wp-block-heading\">Mecanism de ac\u021biune<\/h2>\n<p><strong>Pantoprazol<\/strong> este un PPI benzimidazol substituit care este activat de mediul acid al canalicului secretor al celulei parietale. Odat\u0103 activat, se leag\u0103 covalent de Cys813 (\u0219i alte cisteine) pe subunitatea \u03b1 a H+\/K+-ATPazei, inhib\u00e2nd ireversibil secre\u021bia acid\u0103. Recuperarea necesit\u0103 sinteza de noi proteine ale pompei (cu o timp de \u00eenjum\u0103t\u0103\u021bire de ~24\u201348 de ore pentru pompa \u00een sine).<\/p>\n<p><strong>Domperidonul<\/strong> este un antagonist periferic al receptorului D2 de dopamin\u0103 care nu trece bariera hemato-encefalic\u0103 \u00een cantit\u0103\u021bi semnificative (deci nu are semn\u0103tura extrapiramidal\u0103 a antagonismului central D2 al metoclopramidei). \u00cen intestin, m\u0103re\u0219te tonusul sfincterului esofagian inferior, accelereaz\u0103 golirea gastric\u0103 \u0219i \u00eembun\u0103t\u0103\u021be\u0219te coordonarea antroduodenal\u0103. Blocheaz\u0103 \u0219i receptori D2 \u00een zona trigger a chemoreceptorului (care se afl\u0103 \u00een afara BHE), produc\u00e2nd efect antiemetic.<\/p>\n<h2 class=\"wp-block-heading\">Indica\u021bii<\/h2>\n<ul>\n<li>GERD cu regurgita\u021bie prominent\u0103 sau senza\u021bie de plenitudine postprandial\u0103<\/li>\n<li>Gastroparezie diabetic\u0103 (tulburare func\u021bional\u0103 de motilitate)<\/li>\n<li>Dispepsie func\u021bional\u0103 (subtipul sindromului de detres\u0103 postprandial\u0103)<\/li>\n<li>Alinarea simptomatic\u0103 a gre\u021burilor induse de chimio- sau radioterapie (curs scurt)<\/li>\n<li>Simptome de reflux \u00een dismotilitatea esofagian\u0103 asociat\u0103 sclerodermiei<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Doza<\/h2>\n<p>O capsul\u0103 GR8-OD o dat\u0103 pe zi, cu 30\u201360 de minute \u00eenainte de micul dejun, de \u00eenghi\u021bit \u00eentreag\u0103. Durata tipic\u0103 este de 4\u20138 s\u0103pt\u0103m\u00e2ni pentru utilizarea orientat\u0103 pe simptome; dac\u0103 simptomele recidiveaz\u0103 la \u00eentrerupere, trece\u021bi la monoterapie cu PPI pentru \u00eentre\u021binere \u0219i p\u0103stra\u021bi domperidona pentru simptomele de exacerbare (regula EMA pentru cursuri scurte). Gastroparezia sever\u0103 poate necesita cursuri mai lungi sub supraveghere specializat\u0103 cu ECG periodic.<\/p>\n<h2 class=\"wp-block-heading\">Efecte secundare<\/h2>\n<ul>\n<li><strong>Frecvente (&gt; 1%):<\/strong> cefalee, gur\u0103 uscat\u0103, crampe abdominale, diaree, somnolen\u021b\u0103<\/li>\n<li><strong>PPI pe termen lung:<\/strong> nivel sc\u0103zut de B12, nivel sc\u0103zut de magneziu, risc de fractur\u0103, polipi glandulari gastrici, risc crescut de CDI<\/li>\n<li><strong>Specifice domperidon\u0103:<\/strong> hiperprolactinemie (galactoree, ginecomastie, tulbur\u0103ri menstruale), prelungire QT, aritmii rare<\/li>\n<li><strong>Rare:<\/strong> anafilaxie, sindrom Stevens-Johnson, nefrit\u0103 interstitial\u0103 acut\u0103 (efect de clas\u0103 PPI)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Interac\u021biuni medicamentoase<\/h2>\n<ul>\n<li><strong>Medicamente care prelungesc intervalul QT<\/strong> (azitromicin\u0103, fluoroquinolone, ondansetron, citalopram, metadon\u0103, hidroxiclorochin\u0103): evita\u021bi utilizarea concomitent\u0103.<\/li>\n<li><strong>Inhibitori puternici ai CYP3A4<\/strong> (ketoconazol, ritonavir, claritromicin\u0103, suc de grapefruit): cresc expunerea la domperidon\u0103 de 4\u20138 ori \u2014 evita\u021bi.<\/li>\n<li><strong>Levodopa, agonisti ai dopaminei:<\/strong> domperidona antagonizeaz\u0103 efectele periferice D2 (poate fi utilizat\u0103 inten\u021bionat pentru a controla greata indus\u0103 de levodopa).<\/li>\n<li><strong>Atazanavir, nelfinavir, posaconazol:<\/strong> necesit\u0103 acid pentru absorb\u021bie \u2014 PPI reduce semnificativ nivelurile sanguine.<\/li>\n<\/ul>\n<h2 id=\"faqs\">\u00centreb\u0103ri frecvente<\/h2>\n<h3 class=\"wp-block-heading\">Este GR8-OD sigur pentru utilizare pe termen lung?<\/h3>\n<p>Expunerea la PPI este \u00een general bine tolerat\u0103 timp de luni, dar riscurile se acumuleaz\u0103 (B12 \/ magneziu \/ fracturi \/ CDI). Frac\u021biunea de domperidon\u0103 ar trebui limitat\u0103 la tratamente scurte (de obicei \u2264 7 zile, maxim 30 mg\/zi conform EMA). Pentru men\u021binerea cronic\u0103 a GERD, trece\u021bi la monoterapie cu PPI.<\/p>\n<h3 class=\"wp-block-heading\">De ce s\u0103 o lua\u021bi \u00eenainte de mese?<\/h3>\n<p>PPI necesit\u0103 pompe de protoni active pentru a se lega. Pompele se activeaz\u0103 c\u00e2nd alimentele declan\u0219eaz\u0103 secre\u021bia acid\u0103. Luarea GR8-OD cu 30\u201360 de minute \u00eenainte de prima mas\u0103 asigur\u0103 ocuparea maxim\u0103 a pompelor.<\/p>\n<h3 class=\"wp-block-heading\">Va interac\u021biona cu medicamentul meu pentru inim\u0103?<\/h3>\n<p>Domperidona poate prelungi intervalul QT. Spune\u021bi prescriitorului despre fiecare medicament cardiac, antibiotic, antifungic, antidepresiv \u0219i antimalaric pe care \u00eel lua\u021bi. Un ECG de baz\u0103 este recomandat dac\u0103 ave\u021bi peste 60 de ani sau ave\u021bi boli cardiace cunoscute.<\/p>\n<h3 class=\"wp-block-heading\">Pot s\u0103 beau cafea sau alcool \u00een timp ce o iau?<\/h3>\n<p>Alcoolul \u0219i cafeaua pot agrava refluxul. Reduce\u021bi consumul \u00een timpul unei puse. Nu exist\u0103 o reac\u021bie de tip disulfiram cu aceast\u0103 combina\u021bie.<\/p>\n<h3 class=\"wp-block-heading\">Este sigur \u00een sarcin\u0103?<\/h3>\n<p>Inhibitorii de pomp\u0103 de protoni sunt clasifica\u021bi B\/C; datele privind utilizarea \u00een sarcin\u0103 sunt reconfortante pentru omeprazol, dar riscul nu este zero. Domperidonul are date limitate privind utilizarea \u00een sarcin\u0103 la om \u2014 evita\u021bi, cu excep\u021bia cazurilor \u00een care medicul consider\u0103 c\u0103 beneficiile dep\u0103\u0219esc riscurile. \u00cen timpul al\u0103pt\u0103rii: domperidonul este excretat \u00een laptele matern \u00een cantit\u0103\u021bi mici \u0219i este uneori utilizat off-label ca galactagog.<\/p>\n<h3 class=\"wp-block-heading\">Ce fac dac\u0103 uit o doz\u0103?<\/h3>\n<p>Lua\u021bi medicamentul imediat ce v\u0103 aminti\u021bi. Dac\u0103 este aproape de urm\u0103toarea doz\u0103, omite\u021bi \u0219i continua\u021bi conform programului. Nu lua\u021bi o doz\u0103 dubl\u0103 \u2014 acumularea de domperidon cre\u0219te riscul de prelungire a intervalului QT.<\/p>\n<h3 class=\"wp-block-heading\">Pot s\u0103 zdrobesc sau s\u0103 deschid capsula?<\/h3>\n<p>Nu. Peliculele cu eliberare prelungit\u0103 sunt concepute s\u0103 elibereze domperidonul treptat pe parcursul intervalului de dozare. Zdrobirea duce la eliberarea brusc\u0103 a \u00eentregii doze \u0219i produce un v\u00e2rf plasmatic ridicat, care este mai aritmogen.<\/p>\n<h3 class=\"wp-block-heading\">C\u00e2t de repede ac\u021bioneaz\u0103?<\/h3>\n<p>Suprimarea acidit\u0103\u021bii este detectabil\u0103 \u00een c\u00e2teva ore, dar maxim\u0103 la ziua 3\u20135. Accelerarea golirii gastrice indus\u0103 de domperidon se simte \u00een 30\u201360 de minute dup\u0103 prima doz\u0103.<\/p>\n<h3 class=\"wp-block-heading\">Ce se \u00eent\u00e2mpl\u0103 dac\u0103 simptomele mele nu se \u00eembun\u0103t\u0103\u021besc dup\u0103 4\u20138 s\u0103pt\u0103m\u00e2ni?<\/h3>\n<p>Reevalua\u021bi diagnosticul. Lua\u021bi \u00een considerare eradicarea H. pylori, manometria esofagian\u0103 pentru tulbur\u0103ri de motilitate sau trimiterea la endoscopie (simptome alarmante: pierdere \u00een greutate, disfagie, anemie, v\u0103rs\u0103turi s\u00e2ngeroase, v\u00e2rst\u0103 &gt; 55 cu simptome noi).<\/p>\n<h3 class=\"wp-block-heading\">Depozitare<\/h3>\n<p>Sub 30\u00b0C, proteja\u021bi de umiditate. P\u0103stra\u021bi departe de copii.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Alte Medicamente pentru S\u0103n\u0103tatea Gastrointestinal\u0103<\/h3>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/pantocid-dsr\/\">Pantocid DSR \u2014 Pantoprazol 40 + Domperidon 30 SR<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/famocid\/\">Famocid \u2014 Famotidin\u0103 (blocant H2)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/omez\/\">Omez \u2014 Omeprazol 20 mg (PPI mono)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/dompewal-tablet\/\">Dompewal \u2014 Domperidon 10 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/reglan\/\">Reglan \u2014 Metoclopramid\u0103 10 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/gastro-health\/\"><strong>Vede\u021bi toate Medicamentele pentru S\u0103n\u0103tatea Gastrointestinal\u0103<\/strong><\/a><\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\"><strong>\u2695 Dezaprobare medical\u0103.<\/strong> Aceast\u0103 pagin\u0103 are scop informativ \u0219i nu \u00eenlocuie\u0219te sfatul medical al unui profesionist calificat. GERD cu simptome alarmante (disfagie, pierdere \u00een greutate, anemie, v\u00e2rst\u0103 &gt; 55) necesit\u0103 endoscopie \u00een primul r\u00e2nd.<\/div>","protected":false},"excerpt":{"rendered":"<p>GR8-OD (Pantoprazole 40 mg + Domperidone 30 mg SR) capsule \u2014 combina\u021bie PPI + prokinetic pentru RGE cu regurgitare, gastroparez\u0103 \u0219i dispepsie func\u021bional\u0103. Produc\u0103tor certificat WHO-GMP. Livrare worldwide prin MedsBase.<\/p>","protected":false},"featured_media":58814,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3542,3342],"product_tag":[3609,4572,3611],"class_list":{"0":"post-58813","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-gastro-health","8":"product_cat-general-health","9":"product_tag-domperidone","10":"product_tag-gr8-od","11":"product_tag-pantoprazole","13":"first","14":"instock","15":"shipping-taxable","16":"purchasable","17":"product-type-variable","18":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product\/58813","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/comments?post=58813"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media\/58814"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media?parent=58813"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_brand?post=58813"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_cat?post=58813"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_tag?post=58813"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}