OMEPRAZOLE

Proton-pump inhibitor (PPI). Inhibits gastric acid secretion

Dosage Forms

Tablet

20 mg

Uses

  • Peptic ulcer
  • Duodenal ulcer
  • Gastro-oesophageal reflux disease
  • Prevention and treatment of NSAID-induced ulcers
  • Helicobacter pylori eradication
  • Zollinger-Ellison syndrome (specialist)

Dose and Duration

Peptic ulcer

Adult: 20 mg every 12 hours for 4 weeks; increase dose to 40 mg in severe or recurrent case

Gastric ulcer

Adult: 20 mg once daily for 8 weeks; increase dose to 40 mg in severe or recurrent case

NSAID- induced ulcers, gastro-oesophageal reflux disease

Adult and child > 20kg: 20 mg once daily for 4 weeks, continue for 8 weeks if not fully healed

Child > 1 year (10–20 kg): 10 mg once daily increased if necessary to 20 mg

H.pylori eradication (in combination with two antibiotics)

20 mg every 12 hours for 1 week

Zollinger-Ellison syndrome (specialist use only)

Adult: initially 60 mg once daily. Usual dose range, 20–120 mg daily. Uses above 80 mg should be given in 2 divided doses

Contraindications

  • Allergy to omeprazole

Side Effects

  • Stomach upset, flatulence
  • Headache, agitation
  • Impotence

Interactions

  • Warfarin (enhanced anticoagulant effect)
  • Atazanavir (reduced plasma concentration of atazanavir)
  • Nelfinavir (reduced plasma concentration of nelfinavir)
  • Raltegravir (increased plasma concentration of raltegravir)
  • Saquinavir (increased plasma concentration saquinavir)
  • Clopidogrel (reduced antiplatelet effect of clopidogrel)

Pregnancy

  • Can be used

Breast-feeding

  • Can be used

⚠️ Caution

  • Omeprazole is used in combination with antibacterials in Helicobacter pylori eradication
  • Use the lowest effective dose for the shortest possible duration
  • May mask symptoms of gastric cancer; thorough investigations need to be carried out
  • Rebound acid hypersecretion and dyspepsia may occur after stopping prolonged treatment with omeprazole
  • Use in children should be initiated by paediatrician only
  • Use in Zollinger-Ellison syndrome should be initiated by specialist only