Omeprazole is one kind of largely used PPI. It's available Tablet, Capsule, Suspension, Injection in the market.
Indication: Benign gastric & duodenal ulcer (including NSAID complicating), Zollinger-Ellison syndrome, reflux oesophagitis.
Side Efect: Diarrhoea, headache (both may be severe); also nausea, constipation, flatulence, dizziness, somnolence, malaise, insomnia and paraesthesia; rashes, urticaria, bullous eruption, erythema multiforme, angioedema, alopecia and photosensitivity reported; muscle and joint pain, blurred vision, peripheral oedema, gynecomastia and rarely impotence, loss of taste, stomatitis, gastro-intestinal candidiasis, leucopenia, thrombocytopenia, fever, bronchospasm, interstitial nephritis, liver enzyme changes and liver dysfunction also reported, reversible mental confusion, agitation, depression and hallucinations have been noted in the severely ill.
Cautions: Exclude gastric malignancy; severe liver disease, avoid in pregnancy and breastfeeding.
Pregnancy & lactation: There are no adequate and well-controlled studies on the use of omeprazole in pregnant women. Therapeutic doses during pregnancy are unlikely to cause a substantial teratogenic risk. Omeprazole should be used during pregnancy only if the potential benefit to pregnant women justifies the potential risk to the fetus.
Omeprazole is excreted in human milk. Thus, a decision should be taken to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Dosage & administration: By mouth (tablet, capsule, suspension): Benign gastric and duodenal ulcers (including those complicating NSAID therapy) 20mg daily for 4 weeks in duodenal ulceration or 8 weeks in gastric ulceration; in severe cases increase to 40mg daily; long-term use not recommended.
Zollinger-Ellison syndrome, initially 60mg once daily; usual ranger 20-120mg daily (above 80mg in 2 divided doses).
Reflux oesophagitis, 20mg daily for 4 weeks, followed by a further 4-8 weeks if not fully healed; 40mg daily has been given for 8 weeks in reflux oesophagitis refractory to other treatment; may be continued at 20mg daily.
Preparation of suspension: Whole contents of the packet should be taken into a small glass containing 2-3 tsf of water. Other liquids or foods should not be used. The mixer should be stirred well and drink immediately. The glass should be refilled with water and drink. If the suspension is to be administered through a nasogastric or orogastric tube, the suspension should be constituted with about 20ml of water, and an approximately sized syringe should be used to instill the suspension in the tube. The suspension should be washed through the tube with about 20ml of water.
By iv injection: In patients with duodenal ulcer, gastric ulcer or reflux oesophagitis where oral medication is inappropriate, omeprazole i.v 40mg once daily is recommended. In patients with Zollinger Ellison syndrome the recommended initial dose of omeprazole given i.v is 60mg daily.
Higher daily doses may be required and the dose should be adjusted individually. When doses exceed 60mg daily, the dose should be divided and given twice daily.
Impaired renal function: Dose adjustment is not needed in patients with impaired renal function.
Impaired hepatic function: As plasma half-life of omeprazole is increased in patients with impaired hepatic function a daily dose of 10 -20mg may be sufficient.
Elderly: Dose adjustment is not needed in the elderly.