II. Indications
- Peptic Ulcer Disease
- Gastroesophageal Reflux
- Erosive Esophagitis
- Zollinger-Ellison Syndrome
III. Contraindications
- Hypersensitivity to Proton Pump Inhibitors
- Use with caution in severe liver disease
IV. Medications
- Omeprazole (Prilosec)
- Generic in 2002, OTC
- Capsules may be opened and sprinkled on apple sauce
- Suspension may be given via Nasogastric Tube or G-Tube
- Take at least 30 minutes prior to a meal
- Omeprazole with Bicarbonate (Zegerid)
- Generic and OTC
- May offer benefit in the first week of use, until Omeprazole has reached full effect
- Capsules contain 1100 mg Sodium Bicarbonate (300 mg Sodium)
- Powders contain 1680 mg Sodium Bicarbonate (460 mg Sodium)
- Take on an empty Stomach at least one hour before meals
- Capsules must be taken intact with meals
- Suspension may be given via Nasogastric Tube
V. Dosing: Adults
- See Helicobacter Pylori Treatment
- Background
- Take 30 to 60 minutes prior to a meal
-
Duodenal Ulcer or erosive Esophagitis
- Take 20 mg orally daily
-
Gastroesophageal Reflux
- Take 20 mg orally daily
-
Gastric Ulcer
- Take 40 mg orally daily
- Zollinger Ellison Syndrome
- Take 60 mg orally daily
VI. Dosing: Children
- Indicated in GERD, erosive Esophagitis, and off-label use for Peptic Ulcers
- Background
- May sprinkle opened capsule onto applesauce or acidic liquid
- Infants
- Give 0.7 mg/kg orally daily
- Weight 5-10 kg (and age >1 year old)
- Give 5 mg orally daily
- Weight 10-20 kg
- Give 10 mg orally daily
- Weight >20 kg
- Give 20 mg orally daily
- References
VII. Pharmacokinetics
VIII. Mechanism
IX. Adverse Effects:
X. Precautions
XI. Safety
- Pregnancy Category C (other PPIs are category B)
- Unknown safety in Lactation
XII. Efficacy
XIII. Drug Interactions
- See Proton Pump Inhibitor
-
Voriconazole
- Doubles the serum levels of Omeprazole
- Drug level increases specific to Omeprazole
-
Clopidogrel (Plavix)
- Omeprazole lowers Clopidogrel efficacy
- Increased major coronary events occurred within one year of PTCA
- Attributed to Omeprazole's interaction with Clopidogrel
- Gaglia (2010) Am J Cardiol 105(6): 833-8 [PubMed]
- Pantoprazole (Protonix) does not lower Clopidogrel efficacy
- Avoid Omeprazole following PTCA and coronary stenting
- Consider H2 Blocker or Pantoprazole instead
- As of 2015, no consistent Drug Interaction between Proton Pump Inhibitors and Clopidogrel
XIV. Resources
- Omeprazole Delayed Release Capsule (DailyMed)
XV. References
Images: Related links to external sites (from Bing)
Related Studies
omeprazole (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
OMEPRAZOLE DR 10 MG CAPSULE | Generic | $0.09 each |
OMEPRAZOLE DR 20 MG CAPSULE | Generic | $0.03 each |
OMEPRAZOLE DR 20 MG ODT | Generic OTC | $0.41 each |
OMEPRAZOLE DR 20 MG TABLET | Generic OTC | $0.44 each |
OMEPRAZOLE DR 40 MG CAPSULE | Generic | $0.06 each |
OMEPRAZOLE MAG DR 20 MG CAP | Generic OTC | $0.34 each |
OMEPRAZOLE MAG DR 20 MG TABLET | Generic OTC | $0.49 each |
OMEPRAZOLE MAG DR 20.6 MG CAP | Generic OTC | $0.32 each |
OMEPRAZOLE-BICARB 20-1,100 CAP | Generic | $1.11 each |
OMEPRAZOLE-BICARB 40-1,100 CAP | Generic | $0.89 each |
OMEPRAZOLE-BICARB 40-1,680 PKT | Generic | $13.18 each |
prilosec (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
PRILOSEC DR 10 MG SUSPENSION | $13.19 each | |
PRILOSEC DR 2.5 MG SUSPENSION | $13.29 each |
Ontology: Omeprazole (C0028978)
Definition (MSH) | A 4-methoxy-3,5-dimethylpyridyl, 5-methoxybenzimidazole derivative of timoprazole that is used in the therapy of STOMACH ULCERS and ZOLLINGER-ELLISON SYNDROME. The drug inhibits an H(+)-K(+)-EXCHANGING ATPASE which is found in GASTRIC PARIETAL CELLS. |
Definition (NCI) | A benzimidazole with selective and irreversible proton pump inhibition activity. Omeprazole forms a stable disulfide bond with the sulfhydryl group of the hydrogen-potassium (H+ - K+) ATPase found on the secretory surface of parietal cells, thereby inhibiting the final transport of hydrogen ions (via exchange with potassium ions) into the gastric lumen and suppressing gastric acid secretion. This agent exhibits no anticholinergic activities and does not antagonize histamine H2 receptors. |
Definition (NCI_NCI-GLOSS) | A drug that inhibits gastric acid secretion. |
Definition (CSP) | substituted benzimidazole used as a gastric acid secretion inhibitor. |
Definition (PDQ) | A benzimidazole with selective and irreversible proton pump inhibition activity. Omeprazole forms a stable disulfide bond with the sulfhydryl group of the hydrogen-potassium (H+ - K+) ATPase found on the secretory surface of parietal cells, thereby inhibiting the final transport of hydrogen ions (via exchange with potassium ions) into the gastric lumen and suppressing gastric acid secretion. This agent exhibits no anticholinergic properties and does not antagonize histamine H2 receptors. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42309&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42309&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C716" NCI Thesaurus) |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D009853 |
SnomedCT | 25673006, 387137007 |
LNC | LP18586-5, MTHU004701 |
English | Omeprazole, 1H-Benzimidazole, 5-methoxy-2-(((4-methoxy-3,5-dimethyl-2-pyridinyl)methyl)sulfinyl)-, OMEP, 5-Methoxy-2-(((4-methoxy-3,5-dimethyl-2-pyridinyl)methyl)sulfinyl)-1H-benzimidazole, omeprazole, omeprazole (medication), OMEPRAZOLE, Omeprazole [Chemical/Ingredient], omeprazole product, Omeprazole (product), Omeprazole (substance) |
Swedish | Omeprazol |
Czech | omeprazol |
Finnish | Omepratsoli |
Russian | OMEPRAZOL, ОМЕПРАЗОЛ |
Croatian | OMEPRAZOL |
Polish | Omeprazol |
Japanese | オメプラゾール, オメプラール |
Spanish | omeprazol (producto), omeprazol (sustancia), omeprazol, Omeprazol |
French | Oméprazole |
German | Omeprazol |
Italian | Omeprazolo |
Portuguese | Omeprazol |
Ontology: Prilosec (C0700777)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D009853 |
German | Prilosec |
English | prilosec, PriLOSEC, Prilosec |