about Omeprazole class, uses, side effects contraindications
Omeprazole
Short Description
Omeprazole is used to treat cases in which excessive amounts of acid are secreted in the stomach. It inhibits the action of some enzymes responsible for acid secretion, thus preventing acid production.
Category
Chemical class: Substituted benzimidazole
Therapeutic class: Antiulcer
Pregnancy category: C
Indications
To treat gastroesophageal reflux disease (GERD) without esophageal lesions, to prevent erosive esophagitis
Adults. 20 mg daily for 4 wk. To treat GERD with erosive esophagitis
Adults. 20 mg daily for 4 to 8 wk. To treat pediatric GERD and other acidrelated disorders Children age 2 and over weighing more than 20 kg. 20 mg daily. Children age 2 and over weighing 20 kg (44 lb) or less. 10 mg daily. To provide short-term treatment of active benign gastric ulcer
Adults. 40 mg daily for 4 to 8 wk.
Adults. 20 mg daily for 4 to 8 wk, increased to 40 mg daily, p.r.n. To treat duodenal or gastric ulcer associated with Helicobacter pylori
Adults. 40 mg daily with clarithromycin for 14 days, followed by 20 mg daily alone for another 14 days. Or, 20 mg b.i.d. with amoxicillin for 14 days. Or, 20 mg b.i.d. with amoxicillin and clarithromycin for 10 days.
Adults. 20 mg b.i.d. with clarithromycin and amoxicillin or metronidazole for 7 days, followed by 20 mg daily for up to 3 wk (for duodenal ulcer) or 20 to 40 mg daily for up to 12 wk (for gastric ulcer). To provide long-term treatment of gastric hypersecretory conditions, such as multiple endocrine adenoma syndrome, systemic mastocytosis, and Zollinger Ellison syndrome
Adults. 60 mg daily or in divided doses, as prescribed. Maximum: 120 mg t.i.d. Route Onset Peak Duration P.O. 1 hr In 2 hr 72–96 hr
Contraindications
Hypersensitivity to omeprazole, other proton pump inhibitors, or their components
Interactions
alprazolam, astemizole, carbamazepine, cisapride, cyclosporine, diazepam, diltiazem, erythromycin, felodipine, lidocaine, lovastatin, midazolam, quinidine, simvastatin, terfenadine, triazolam, verapamil, voriconazole: Decreased clearance and increased blood levels of these ampicillin, iron salts, itraconazole, ketoconazole, vitamin B12: Impaired absorption of these atazanavir, nelfinavir: Decreased plasma atazanavir or nelfinavir level cilostazol: Increased blood cilostazol level clarithromycin: Increased blood levels of omeprazole and clarithromycinl digoxin: Increased digoxin bioavailability, possibly digitalis toxicity levobupivacaine: Increased risk of levobupivacaine toxicity methotrexate: Possibly delayed methotrexate elimination nifedipine: Decreased nifedipine clearance, increased risk of hypotension
phenytoin: Decreased phenytoin clearance, increased risk of phenytoin toxicity saquinavir: Increased plasma saquinavir level sucralfate: Decreased omeprazole absorption tacrolimus: Possibly increased tacrolimus level
warfarin: Possibly increased risk of abnormal bleeding
Side Efect
CNS: Agitation, asthenia, dizziness, drowsiness, fatigue, headache, psychic disturbance, somnolence
CV: Chest pain, hypertension, peripheral edema
EENT: Anterior ischemic optic neuropathy, optic atrophy or neuritis, stomatitis
ENDO: Hypoglycemia
GI: Abdominal pain, constipation, diarrhea, dyspepsia, elevated liver function tests, flatulence, hepatic dysfunction or failure, indigestion, nausea, pancreatitis, vomiting
GU: Interstitial nephritis
HEME: Agranulocytosis, anemia, hemolytic anemia, leukopenia, leukocytosis, neutropenia, pancytopenia, thrombocytopenia
MS: Back pain
RESP: Cough
SKIN: Erythema multiforme, photosensitivity, pruritus, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria
Other: Anaphylaxis, angioedema, hyponatremia
Cautions
Give omeprazole before meals, preferably in the morning for once-daily dosing. If needed, also give an antacid, as prescribed. If needed, open capsule and sprinkle enteric-coated granules on applesauce or yogurt or mix with water or acidic fruit juice, such as apple or cranberry juice. Give immediately. To give drug via NG tube, mix granules in acidic juice because enteric coating dissolves in alkaline pH. Because drug can interfere with absorption of vitamin B12, monitor patient for macrocytic anemia. Be aware that long-term use of omeprazole may increase the risk of gastric carcinoma. PATIENT SAFTY
Tell patient to take drug before eating— usually before breakfast—and to swallow delayed-release capsules or tablets whole. If needed, patient may sprinkle contents of capsule onto 1 tablespoon of applesauce and swallow immediately without chewing pellets. Tell him to follow with a glass of cool water and not to keep any leftover mixture. If patient takes the oral suspension, tell K+ K+ H+ H+ ClClParietal cell Blocked proton pump Omeprazole Stomach lumen Parietal cell membrane Proton pump HCl K+ K+ H+ H+ ClClParietal cell Blocked proton pump Omeprazole Stomach lumen Parietal cell membrane Proton pump HCl Mechanism of Action
Omeprazole interferes with gastric acid secretion by inhibiting the hydrogenpotassium-adenosine triphosphatase (H+K+-ATPase) enzyme system, or proton pump, in gastric parietal cells. Normally, the proton pump uses energy from hydrolysis of adenosine triphosphate to drive hydrogen (H+) and chloride (Cl-) out of parietal cells and into the stomach lumen in exchange for potassium (K+), which leaves the stomach lumen and enters parietal cells. After this exchange, H+and Cl-combine in the stomach to form hydrochloric acid (HCl), as shown below left. Omeprazole irreversibly blocks the exchange of intracellular H+ and extracellular K+, as shown below right. By preventing H+from entering the stomach lumen, omeprazole keeps additional HCl from forming. him to empty package into a small cup containing 2 tablespoons of water (no other beverage should be used), stir the mixture well, drink it immediately, refill the cup with water, and drink again. Encourage patient to avoid alcohol, aspirin products, ibuprofen, and that may increase gastric secretions during therapy. Tell him to notify all prescribers about prescription drug use. Advise patient to notify prescriber immediately about abdominal pain or diarrhea. Urge female patient of childbearing age to use effective contraception during therapy and to inform prescriber immediately if she is or suspects she may be pregnant.
Trade Name & Company Name
effect of Omeprazole in Pregnancy, Fetal Health
and Breast feeding
Pregnancy
. Omeprazole is effective treatment for a number of hypersecretory disorders, and effective preoperative prophylaxis (20-40mg PO qd) against aspiration pneumonitis. While there are no adequate reports or well-controlled studies in pregnant women, omeprazole appears to retain its efficacy during pregnancy. Though it increases human myometrial contractility in isolated muscle strips, there are no reports of an increased prevalence of preterm delivery. Omeprazole is advocated to lower gastric pH prior to cesarean section, but the results of the randomized trials are inconsistent, perhaps reflecting dose and route of delivery. Further, it and similar agents require 20-30min to take effect. Thus, Bicitra (citric acid/sodium citrate solution), perhaps with metoclopramide to enhance lower esophageal sphincter tone, remain agents of choice for emergent procedures. Fetal Health
There are no adequate reports or well-controlled studies in human fetuses. It is unknown whether omeprazole crosses the human placenta. Proton pump inhibitors in general, and omeprazole specifically, are not associated with an increased risk of malformations. In the ewe, the F:M ratio approximates 0.5 and is strongly related to the rate of maternal clearance. Rodent studies are generally reassuring, revealing no evidence of teratogenicity despite the use of doses higher than those used clinically. However, embryo and fetal toxicity are noted in some models when multiples of the MRHD are used. Breastfeeding
There are no adequate reports or well-controlled studies in nursing women. Omeprazole enters human breast milk, but milk concentrations are less than 10% of the maternal serum level. Thus, the nursing infant is unlikely to ingest a clinically significant amount. Pregnancy
. Esomeprazole is the L-isomer of omeprazole. There are no adequate reports or well-controlled studies in pregnant women. Esomeprazole is cost-effective compared with omeprazole in the acute treatment of reflux esophagitis and GERD without esophagitis. These drugs are being used with increasing frequency during pregnancy, and there is a great need for additional study. Fetal Health
It is unknown whether esomeprazole crosses the human placenta. The F:M ratio of omeprazole at steady state in sheep is about 0.5. The findings of an epidemiologic study including 600 pregnancies is reassuring. In another study run by the European Network of Teratology Information Services, the rates of major anomalies was compared among pregnant women exposed to omeprazole, lanzoprazole, or pantoprazole and a control group. They followed 295 pregnancies exposed to omeprazole (233 in the 1st trimester [T1]), 62 to lansoprazole (55 in T1) and 53 to pantoprazole (47 in T1), along with 868 controls. The rates of major congenital anomalies did not differ between the exposed and control groups and there were no differences when exposure was limited to the 1st trimester after exclusion of genetic, cytogenetic, or infectious anomalies. Rodent studies are likewise reassuring, revealing no evidence of teratogenicity or IUGR despite the use of doses higher than those used clinically. Breastfeeding
There is no published experience in nursing women. It is unknown whether esomeprazole is excreted into breast milk. As esomeprazole is the L-isomer of omeprazole, the risks should be similar.
the follwing drugs will increse Omeprazole by inhepiting cyp450
amiodarone ; aprepitant ; armodafinil ; atomoxetine ; boceprevir ; ceritinib ; chloramphenicol ; chloramphenicol ; cimetidine ; cimetidine ; ciprofloxacin ; citalopram ; clarithromycin ; crizotinib ; delaviridine ; diethyl-dithiocarbamate ; diltiazem ; entrectinib ; erythromycin ; esomeprazole ; esomeprazole ; felbamate ; fluconazole ; fluconazole ; fluoxetine ; fluvoxamine ; fluvoxamine ; gestodene ; grapefruit juice ; idelalisib ; imatinib ; indinavir ; isoniazid ; itraconazole ; ivacaftor ; ketoconazole ; ketoconazole ; lesinurad ; letermovir ; luliconazole ; mibefradil ; mifepristone ; modafinil ; nefazodone ; nelfinavir ; netupitant/palonosetron ; norfloxacin ; norfluoxetine ; omeprazole ; oral contraceptives ; oritavancin ; pantoprazole ; pantoprazole ; perampanel ; quercetin ; quercetin ; regorafenib ; ribociclib ; ritonavir ; rucaparib ; saquinavir ; simeprevir ; starfruit ; telaprevir ; telithromycin ; ticagrelor ; ticlopidine ; topiramate ; tucatinib ; verapamil ; voriconazole ; voriconazole ;
the follwing drugs will decrease Omeprazole by inhancing cyp450
barbiturates ; brigatinib ; carbamazepine ; carbamazepine ; clobazam ; dabrafenib ; efavirenz ; efavirenz ; enzalutamide ; elagolix ; enzalutamide ; letermovir ; eslicarbazepine ; glucocorticoids ; letermovir ; lorlatinib ; modafinil ; nevirapine ; oxcarbazepine ; norethindrone ; perampanel ; prednisone ; rifampicin ; phenobarbital ; ritonavir ; phenytoin ; pioglitazone ; rifabutin ; rifampin ; St. John's Wort ; telotristat ; troglitazone ; vemurafenib ;
trad drugs based on Omeprazole
| Gen name | Trade name | Catagory name |
| amoxicillin / clarithromycin / omeprazole | Omeclamox-Pak | H2 antagonists |
| amoxicillin / omeprazole / rifabutin | Talicia | H2 antagonists |
| aspirin / omeprazole | Yosprala | Platelet aggregation inhibitors |
| esomeprazole | Nexium | Proton pump inhibitors |
| esomeprazole | Nexium 24HR | Proton pump inhibitors |
| esomeprazole | Nexium IV | Proton pump inhibitors |
| esomeprazole / naproxen | Vimovo | Nonsteroidal anti-inflammatory drugs |
| omeprazole | Prilosec | Proton pump inhibitors |
| omeprazole | Prilosec OTC | Proton pump inhibitors |
| omeprazole / sodium bicarbonate | Zegerid | Proton pump inhibitors |
| omeprazole / sodium bicarbonate | Zegerid OTC | Proton pump inhibitors |
| Omeprazole | EMILOK 20MG CAPSULES | |
| Omeprazole | GASEC 20MG GASTRO CAPS | |
| Omeprazole | GASEC 40MG GASTRO CAPSULES | |
| Omeprazole | LOSEC 40MG-10ML IV VIAL | |
| Omeprazole | LOSEC MUPS 10 MG TAB | |
| Omeprazole | LOSEC MUPS 20MG TAB | |
| Omeprazole | OMEPREX 20MG CAP | |
| Omeprazole | OMERAL 10MG CAPSULES | |
| Omeprazole | OMEZYN 20MG CAPSULES | |
| Omeprazole | OMIZ 10MG CAP | |
| Omeprazole | OMIZ 20MG CAP | |
| Omeprazole | OPRAZOLE 20MG ECTAB | |
| Omeprazole | OPRAZOLE 40MG- VIAL I.VI INFUSION | |
| Omeprazole | RISEK 10MG CAP | |
| Omeprazole | RISEK 20 MG CAPS | |
other drugs from same cataogory