Omeprazole

A to Z Drug Facts

Omeprazole

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(oh-MEH-pray-ZAHL)

Prilosec

Capsules, delayed-release: 10 mg

Capsules, delayed-release: 20 mg

Capsules, delayed-release: 40 mg

Losec

Class: GI

Action Suppresses gastric acid secretion by blocking “acid (proton) pump” within gastric parietal cell.

Indications Short-term treatment of active duodenal ulcer, gastroesophageal reflux disease (GERD), including erosive esophagitis and symptomatic GERD; long-term treatment of pathologic hypersecretory conditions (eg, Zollinger-Ellison syndrome, multiple endocrine adenomas, systemic mastocytosis); to maintain healing of erosive esophagitis; in combination with clarithromycin to eradicate H. pylori, use clarithromycin and amoxicillin in combination with omeprazole in patients with a 1-yr history of duodenal ulcers or active duodenal ulcers to eradicate H. pylori ; short-term treatment of active benign gastric ulcer.

Posterior laryngitis; enhanced efficacy of pancreatin for treatment of steatorrhea in cystic fibrosis.

Contraindications Standard considerations.

Route/Dosage

Active Duodenal Ulcer

Adults: PO 20 mg/day for 4 to 8 wk.

Erosive Esophagitis

Adults: PO 20 mg/day for 4 to 8 wk. Maintenance: 20 mg/day.

Pathologic Hypersecretory Conditions

Adults: PO Initial dose: 60 mg/day. Doses up to 120 mg tid have been given. Divide daily doses more then 80 mg.

H. pylori

Adults (triple therapy): PO 20 mg omeprazole plus clarithromycin 500 mg plus amoxicillin 1000 mg each given bid for 10 days; continue omeprazole 20 mg/day for an additional 18 days if an ulcer is present at start of therapy. Adults (dual therapy): PO 40 mg omeprazole once daily plus clarithromycin 500 mg tid for 14 days; continue omeprazole 20 mg/day for an additional 14 days if an ulcer is present at start of therapy.

Gastric ulcer

Adults: PO 40 mg once daily for 4 to 8 wk.

GERD

Adults (without esophageal lesions): PO 20 mg/day for 4 wk. Adults (with erosive esophagitis): PO 20 mg/day for 4 to 8 wk.

Interactions

Benzodiazepines: Clearance of benzodiazepines may be decreased. Cilostazol: Plasma levels may be increased by omeprazole, increasing the therapeutic and adverse effects. Clarithromycin: Serum concentrations of clarithromycin and omeprazole may be increased. Drugs depending on gastric pH for bioavailability (eg, ketoconazole, iron salts, ampicillin): Absorption of these drugs may be affected. Phenytoin: Decreased plasma clearance and increased phenytoin half-life. Warfarin: Prolonged warfarin elimination.

Lab Test Interferences None well documented.

Adverse Reactions

CARDIOVASCULAR: Angina; tachycardia; bradycardia; palpitation. CNS: Headache; dizziness. DERMATOLOGIC: Rash. GI: Diarrhea; abdominal pain; acid regurgitation; nausea; vomiting; constipation; flatulence. RESPIRATORY: Cough; upper respiratory tract infection. OTHER: Asthenia; back pain.

Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy in children not established.

PATIENT CARE CONSIDERATIONS

Administration/Storage

Do not open, chew, or crush capsule. Instruct patient to swallow capsule whole.
Divide daily doses greater than 80 mg.
Give before meals or as one-time daily dose. If medication is administered once daily, give before dinner.
Store at room temperature in original container tightly closed and protected from light.

Assessment/Interventions

Obtain patient history, including drug history and any known allergies.
Review baseline CBC and LFT results, and monitor as indicated.
Assess for coffee ground emesis, tarry stools, or constipation.
Assess for any symptoms of hyperacidity (eg, dyspepsia, nausea, vomiting).
Monitor elimination patterns and document any problems such as constipation.
Assess skin for rashes or hives.
Encourage adequate fluid intake and roughage in diet.

OVERDOSAGE: SIGNS & SYMPTOMS
	Confusion, drowsiness, blurred vision, tachycardia, nausea, diaphoresis, flushing, headache, dry mouth

Patient/Family Education

Advise patient not to chew or crush medication, and to swallow medication whole.
Remind patient to take medication before meals.
Inform patient that antacids may be taken concurrently with omeprazole.
Advise patient to avoid tasks requiring alertness until response to medication is established.
Caution patient to report the following symptoms to health care provider: cramping, diarrhea, rash, hives.