Mode of action
Irreversibly inactivate the hydrogen/potassium ATPase enzyme system (proton pump), suppressing both stimulated
and basal acid secretion. When PPIs are stopped, acid secretion is restored by synthesis of new hydrogen/potassium
ATPase.
Indications
Marketed: Peptic ulcer disease (PUD); Gastro-oesophageal reflux disease (GORD); Zollinger–Ellison syndrome;
H. pylori eradication as part of effective eradication regimen; Treatment and prevention of peptic ulcer and erosion
associated with NSAIDs.
Accepted: Scleroderma oesophagus; In selected patients for stress ulcer prophylaxis; acute upper GI bleeding;
Prevention of acid aspiration.
Specific considerations
Same as esomeprazole
Adverse effects
PPIs are generally well tolerated.
Common: headache, nausea, diarrhoea, abdominal pain, fatigue, dizziness
Infrequent: decreased absorption of cyanocobalamin (vitamin B12) may occur with long term use rash, itch,
flatulence, constipation.
Rare: paraesthesia, confusion, arthralgia, haemolytic anaemia, agranulocytosis, photosensitivity.
gynaecomastia, myalgia, interstitial nephritis, raised liver enzymes, hepatitis, jaundice, thrombocytopenia,
leucopenia, erythema multiforme, Stevens–Johnson syndrome, toxic epidermal necrolysis.
Dosage
PUD: Initially, oral 20–40 mg once daily for 4–8 weeks (gastric ulcer). Maintenance, oral 20 mg once daily.
GORD: Initially, oral 20–40 mg once daily (up to 80 mg daily can be used). Maintenance, reduce to minimum
required.
Zollinger–Ellison syndrome: Adjust dose according to gastric acid output. Initially, 60 mg once daily.. Maintenance,
oral 20–120 mg daily (give doses >80 mg daily as 2 divided doses).
H. pylori eradication: Oral, 20 mg twice daily for 1 week, with 2 antibiotics.
NSAID-associated PUD or erosion: Treatment, oral 20–40 mg once daily for 4–8 weeks. Prophylaxis, oral 20 mg
once daily.
Child: <10 kg, 5 mg once daily.
10–20 kg, 10 mg once daily (maximum 20 mg/day).
20 kg, 20 mg once daily (maximum 40 mg/day).
Patient counselling
Swallow tablet or capsule whole; do not crush or chew. Alternatively, omeprazole tablets may be dispersed in water,
orange juice or yoghurt; take within 30 minutes.
Tell your doctor if you develop symptoms such as black stools or coffee-coloured vomit.
Practice points
omeprazole tablets may be dispersed in water, orange juice or yogurt; give within 30 minutes
continuous IV administration for 72 hours following endoscopic therapy for bleeding ulcers has been used;
seek specialist advice.
Products
OMEPRAZOLE TABS OR CAPS 20 MG (LOSEC®, OMEDAR®, OPRAZOLE®)
OMEPRAZOLE TABS OR CAPS 10 MG (HYPOSEC®, GASEC®, LOPRAZ®, LOSEC®,
ODASOL®,OMEDAR®, OMEPREX®,OMISEC®, OPRAZOLE®, RISEK®, RYTHMOGASTRY®
OMEPREX®)
OMEPRAZOLE VIAL 40 MG (IPROTON®, LORDIN®, LOSEC®, ODASOL®, OPRAZOLE®, RISEC®)