omeprazole.txt

CLINICAL USE

Gastric acid suppression

DOSE IN NORMAL RENAL FUNCTION

Oral: 10–120 mg daily IV: 40 mg once daily for up to 5 days Patients with recent bleeding on endoscopy: 80 mg stat followed by 8 mg/hour for 72 hours (British Society of Gastroenterology)

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :345.4

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :95

%Excreted unchanged in urine &nbsp &nbsp : Minimal

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.3

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :0.5–3/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : Dose as in normal renal function

10 to 20 &nbsp &nbsp : Dose as in normal renal function

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in normal renal function

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in normal renal function

HDF/high flux &nbsp :Unknown dialysability. Dose as in normal renal function

CAV/VVHD &nbsp &nbsp &nbsp:Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anticoagulants: effect of coumarins possibly enhanced

Anti-epileptics: effects of phenytoin possibly enhanced

Antivirals: reduced atazanavir concentration – avoid concomitant use; AUC of saquinavir increased by 82% (increased risk of toxicity)

Ciclosporin: variable response; mostly increase in ciclosporin levelCilostazol: increased cilostazol concentration – avoid concomitant use

Tacrolimus: may increase tacrolimus concentration

ADMINISTRATION

Reconstition

5 mL solvent provided per 40 mg vial

Route

Oral, IV

Rate of Administration

Bolus: over 5 minutes Infusion: 40 mg over 20–30 minutes Continuous infusion: 8 mg/hour

Comments

Add to 100 mL sodium chloride 0.9% or glucose 5%Once diluted stable for 12 hours in sodium chloride 0.9% and 3 hours in glucose 5%Use oral as soon as possible 200 mg in 50 mL for 8 mg/hour infusion. (UK Critical Care Group, Minimum Infusion Volumes for fluid restricted critically ill patients, 3rd Edition, 2006)

OTHER INFORMATION

Omeprazole clearance is not limited by renal disease.

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