Pharm
Omeprazole
search
Omeprazole
, Prilosec, Zegerid
See Also
Proton Pump Inhibitor
Lansoprazole
Esomeprazole
Pantoprazole
Rabeprazole
Dexlansoprazole
Indications
Peptic Ulcer Disease
Gastroesophageal Reflux
Erosive
Esophagitis
Zollinger-Ellison Syndrome
Contraindications
Hypersensitivity
to
Proton Pump Inhibitor
s
Use with caution in severe liver disease
Medications
Omeprazole (Prilosec)
Gene
ric 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)
Gene
ric 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
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
Dosing
Children
Indicated in
GERD
, erosive
Esophagitis
, and off-label use for
Peptic Ulcer
s
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
Baird (2015) Am Fam Physician 92(8): 705-14 [PubMed]
Pharmacokinetics
All PPIs have short plasma half life of 1-2 hours
Effect is delayed 5-7 days until proton pumps are fully blocked
Metabolized by
CYP2C19
and
CYP3A4
Inhibits
CYP2C19
Induces
CYP1A2
Mechanism
See
Proton Pump Inhibitor
Adverse Effects
See
Proton Pump Inhibitor
Precautions
See
Proton Pump Inhibitor
Safety
Pregnancy Category C (other PPIs are category B)
Unknown safety in
Lactation
Efficacy
See
Proton Pump Inhibitor
Drug Interactions
See
Proton Pump Inhibitor
Voriconazole
Doubles the serum levels of Omeprazole
Drug level increases specific to Omeprazole
Carbamazepine
(
Tegretol
)
Diazepam
(
Valium
)
Phenytoin
(
Dilantin
)
Warfarin
(
Coumadin
)
Methotrexate
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
Juurlink (2009) CMAJ 180(7): 713-8 [PubMed]
Avoid Omeprazole following
PTCA
and coronary stenting
Consider
H2 Blocker
or
Pantoprazole
instead
As of 2015, no consistent
Drug Interaction
between
Proton Pump Inhibitor
s and
Clopidogrel
Melloni (2015) Circ Cardiovasc Qual Outcomes 8(1): 47-55 +PMID: 25587094 [PubMed]
Resources
Omeprazole Delayed Release Capsule (DailyMed)
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5a09ce48-7139-4fc7-9b6e-439459c8e866
References
(2022) Comparison of
Proton Pump Inhibitor
s, Presc Lett, #380327
(2012) Prescr Lett 19(3): 14 [PubMed]
(2013) Prescr Lett 20(5): 30 [PubMed]
(2001) Med Lett Drugs Ther 43(1103):36-7 [PubMed]
Ament (2012) Am Fam Physician 86(1): 66-70 [PubMed]
Vanderhoff (2002) Am Fam Physician 66(2):273-80 [PubMed]
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