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Pharmacological Effects and Toxicogenetic Impacts of RISEK

Pharmacological Effects and Toxicogenetic Impacts of RISEK

What is the composition of Risek tablet?

Risek tablet is composed of Omeprazole (OME) and sodium bicarbonate. Omeprazole is 5-methoxy-2- [[(4-methoxy-3, 5-dimethyl-2-pyridinyl) methyl] sulfinyl]-1H-benzimidazole. The molecular formula is C17H19N3O3S. Each 20 mg/1680 mg sachet contains omeprazole 20 mg and sodium bicarbonate (as buffer) 1680 mg. Omeprazole fits in a class of drugs known as proton pump inhibitors (PPIs) [stops the receptors that activate the acid release]. It is stored at room temperature away from light and moisture.


What are pharmacological Risek uses?

Omeprazole (OME) is frequently used to treat gastrointestinal disorders such as acid reflux and ulcers. It reduces the amount of acid produced by the stomach. It eases symptoms such as heartburn, difficulty in swallowing, and persistent cough. OME cures acid damage to the stomach and esophagus, prevents ulcers, and help prevent esophagus cancer. OME protective uses, related to proton pump blockade and anti-inflammatory activity, are reported abundantly. This is achieved via an increase in gastric flow, anti-inflammatory markers (COX-2 and interleukins), glycoprotein expression, and neutrophil infiltration reduction.

What are pharmacological side effects of Risek?

Risek tablet can cause headache or abdominal pain. However, complications of side effects can vary from person to person. Symptoms can include low magnesium blood level resulting in unusually irregular heartbeats, persistent muscle cramps, seizures), rash on nose and cheeks and joint pain. It rarely causes severe intestinal condition, complication due to a bacteria called C. difficile, resulting in diarrhea, abdominal pain, fever, and blood in stools. PPIs (such as OME) rarely causes vitamin B-12 deficiency. The risk is enhanced if they are taken every day for longer time period. B-12 deficiency leads to  unusual weakness, sore tongue, numbness of the hands or feet. Rarely, serious allergic reaction can occur including rash, itching or swelling of the face, tongue or throat, dizziness, difficulty, breathing, kidney problems. There are other possible side effects too. Overdose may cause confusion, unusual sweating, blurred vision, fast heartbeat. Long-term use of OME can increase the risk of gastric cancer.


What are toxicogenetic impacts of Risek?

Many findings suggest that long-term use of OME can promote genomic instability and increase risk for different cancers. The reported adverse and toxic effects were atrophic gastritis, cobalamin deficiencies, homeostasis disorders, polyp development, hepatotoxicity, cytotoxicity, and genotoxicity. Therefore, appropriate precautions should be taken. Genomic instability induces genetic variations resulting in resistance to treatment. For therapy of gastrointestinal disorders, discontinuous or long-term OME is administered. Hence, genotoxic risks must be assessed. OME can induce DNA damage by oxidative damage, genotoxicity, and mutagenicity.


Oxidative stress is an important factor in assessment. Radical oxidative species (ROS) are continuously produced in cells. ROS can also promote genomic instability and tumorigenesis through increased glucose metabolism, hypoxia adaptations and mutations, leading to abnormal cell growth, angiogenesis, and apoptosis resistance. OME amplifies oxidative stress in gastritis and damages the gastric mucosa rather than healing it.


Genomic instability caused by Risek can be related to genotoxicity induction. Studies indicate that OME does not promote carcinogenesis, but it may enhance the effects of environmental carcinogens. Reports showed that OME can cause genotoxicity and mutagenicity through the formation of chromosomal and micronuclei aberrations.


OME induces hepatotoxicity in pregnant women. Hepatotoxic and nephrotoxic effects, thrombocytopenia, acute interstitial nephritis, anaphylactic reactions, gynecomastia, and impotence have been seen in the long-term OME use. Hepatic toxicity leads to hepatic lesions that disappear when drug intake is discontinued. PPIs can induce cytotoxicity through autophagic mechanisms and alterations in pH homeostasis. More recent studies indicate that OME has antitumor activity against multiple myeloma. Risek presented antitumor effects together with chemotherapy in rectal cancer patients and also reduced side effects of the treatment. Similar effects were noticed in colon cancer cells. These remarkable results suggest that Risek tablet uses combined with anticancer drugs can be a promising therapy against malignant tumor. OME antitumor effects in clinical studies are rare, but some have shown collaborative effects with antitumor drugs on regulating tumor, acidity and apoptosis.


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