Omeprazole

Introduction

Omeprazole acts by decreasing the amount of acid produced by the stomach and is indicated to treat certain conditions in which there is excess production of acid by the parietal cells of the stomach. It is used for the treatment of gastric (stomach) and duodenal (intestine) ulcers, and gastroesophageal reflux (when there is a return of gastric juice from the stomach to the esophagus).

About omeprazole

chemical molecule

Nome Químico: (RS) – 5 – methoxy – 2 – [ ( 4 – methoxy – 3,5 – dimethyl – pyridin – 2 – yl) methylsulfinyl] – 3 H – benzimidazole.

Molecule names : Omeprazole (PT-Bra); Omeprazole (ING)

Dose omeprazol

Omeprazole is commercialized in the form of gastro-resistant capsules, in dosages of 10, 20 or 40mg and in packs containing 7, 14, 28, 56 or 60 pills. Omeprazole can be associated with other active principles, for the treatment of specific diseases (such as, for example, the association with antibiotics for the treatment of peptic ulcers caused by H. Pylori).

The use of the gastro-resistant capsule is due to the fact that Omeprazole can be degraded when exposed to gastric acidity and the use of this formulation allows it to pass through the stomach without suffering acidic degradation, in order to be later absorbed in the intestine .

Dosage – Dosage and duration of treatment

Duodenal ulcers

The usual dosage to be administered for the treatment of duodenal ulcers is 20mg, once a day, for a period of 2 to 4 weeks. be given before breakfast. In poorly responsive patients (who do not respond adequately to treatment) with duodenal ulcer, a daily dose of 40 mg is recommended, to be administered once daily for a period of 4 weeks.

Gastric ulcer
The usual dosage to be administered for the treatment of gastric ulcers is 20mg, once a day, for a period of 4 to 8 weeks.
In poorly responsive patients (who do not respond adequately to treatment) with gastric ulcer, a daily dose of 40 mg is recommended, to be administered once daily for a total period of 4 weeks.

Reflux esophagitis
Adults
The usual dosage to be administered for the treatment of reflux esophagitis is 20mg, once a day, for a period of 4 to 8 weeks. be given before breakfast.
In patients with severe reflux esophagitis, a daily dose of 40 mg is recommended, to be administered once a day for a period of 4 weeks.

Children
The recommended dose in reflux esophagitis, for the treatment of children over 1 year of age, is 10 mg in a single dose administered in the morning with the aid of liquid.
If the child has difficulty swallowing the capsule, it can be opened and its contents can be mixed with liquid and ingested right away. If necessary, the dose may be increased, at the physician’s discretion, up to a maximum of 40 mg/day.

Zollinger-Ellison Syndrome
In patients with Zollinger-Ellison Syndrome (gastric hyperacidity due to increased release of the hormone gastrin), dosage and posology of Omeprazole must be individualized in order to administer the lowest dose capable of reducing gastric secretion acidic. The starting dose in these cases is usually 60 mg in a single dose. If it is necessary to use amounts greater than 80 mg/day, they must be administered divided into 2 intakes.

For more information, read the specific leaflet of the drug to be used for treatment.

omeprazole indications

Treatment of duodenal ulcer, gastric ulcer, reflux esophagitis, Zollinger-Ellison syndrome and patients refractory to other treatments.

In patients who make constant use of non-steroidal anti-inflammatory drugs (such as, for example, acetylsalicylic acid), there may be a higher incidence of stomach bleeding due to the inhibition of platelet aggregation caused by the anti-inflammatory drug. The use of Omeprazole, specifically in these cases, would have the purpose of preventing excessive gastric acidity from causing any type of more severe injury to the stomach epithelium already harmed by bleeding.

Omeprazole can be used together with antibiotics for the treatment of peptic ulcers caused by H. pylori, in order to avoid worsening of the patient’s clinical condition, caused by the acid attack on the stomach wall.

Effects (drug action)

Omeprazole is a specific inhibitor of the proton pump of the parietal cells of the stomach, and acts by inhibiting the H + K + -ATPase, an enzyme located specifically in these cells (parietal) and which are responsible for one of the final steps in the production mechanism of gastric acid.

Adverse effects

Adverse effects with the use of Omeprazole are not frequent and, when present, are generally of mild intensity, disappearing with the continuation of the treatment or after its suspension. Nausea, vomiting, gastroenteritis , flatulence, constipation, transient diarrhea  , headache, drowsiness, dizziness, weakness, insomnia , muscle pain and skin rash may occur during treatment.

When using Omeprazole for a long period of time, the appearance of gastric glandular cysts of a benign nature, of mild intensity, and reversible after discontinuation of treatment or its interruption may occur.

– According to a study published in late 2013, people who take proton pump inhibitors (PPIs) such as omeprazole and histamine H2 receptor antagonists such as ranitidine to treat heartburn or gastroesophageal reflux more often have a vitamin B12 deficiency than people who do not take these medications.

This study was performed by scientists from the research division of the Kaiser Permanente Institution of Oakland in California, it was published on December 11, 2013 in the Journal of the American Medical Association (JAMA).

contraindications

Omeprazole should not be used by patients with known sensitivity to this active ingredient.

Drug interactions

Omeprazole may slow the metabolism of phenytoin, diazepam, warfarin, and other drugs metabolized by hepatic oxidation. Omeprazole may interfere with the elimination of some drugs through inhibition of the hepatic cytochrome P-450 dependent system. It is recommended, therefore, that when Omeprazole is used simultaneously with drugs whose metabolism depends on such a system for its metabolization, the doses of such drugs are adjusted accordingly.

No type of interaction was observed between Omeprazole and other antacids when concomitantly administering such drugs.

For more information, read the specific leaflet of the drug and be used for treatment.

Pregnancy

Pregnancy risk category: C

Omeprazole should not be used by pregnant women without medical advice, as there are no adequate and well-controlled studies on its use during pregnancy.

Lactation

Omeprazole should not be used by nursing mothers without medical advice, due to the lack of adequate and well-controlled studies on its use during lactation. Omeprazole can be excreted in breast milk, therefore, its use during lactation should only be done under medical guidance.

pharmaceutical presentation omeprazole

Omeprazole is marketed in the form of gastro-resistant capsules and is not associated with other active ingredients.

The use of the gastro-resistant capsule is due to the fact that omeprazole can undergo degradation when subjected to gastric acidity and the use of this formulation allows it to pass through the stomach without suffering degradation, to be later absorbed in the intestine.

Clinical studies on omeprazole

Clinical trials carried out with animals, during a long period of use of omeprazole, showed the possibility of occurrence of achlorhydria and consequent elevation of serum concentrations of gastrin in these animals. However, the same is not observed during treatment with Omeprazole for a short period of time (around 2 to 4 weeks), generally indicated for treatment in humans.

Tips

– Omeprazole does not cause changes in liver and kidney function in normal subjects. However, it should be administered with adequate medical supervision in individuals with impaired liver or kidney function. In cases of hepatic impairment, dose adjustment should be considered;

– The use of alcohol and cigarettes can alter the metabolism and excretion of some drugs. Talk to your doctor and pharmacist about it and always inform him/her about the use of alcohol and alcoholic beverages when using any medication;

– The use of omeprazole is not indicated during pregnancy and lactation, except under medical guidance;

– Preferably use the medicine capsule without opening it. Consult the doctor or pharmacist if you have any difficulty in administering the medicine;

– Omeprazole may alter the metabolism and elimination of some therapeutically important drugs by inhibiting the hepatic metabolism system. It is therefore recommended to adjust the dose for drugs that are metabolized by this route and that need to be used concomitantly with Omeprazole;

– Omeprazole can be used by patients who make constant use of non-steroidal anti-inflammatory drugs, with the aim of preventing gastric acidity from causing any more severe injury to the stomach epithelium, already harmed by bleeding resulting from the use of anti-inflammatory drugs;

– Omeprazole can be used together with antibiotics for the treatment of peptic ulcers caused by Helicobacter pylori, with the aim of reducing the production of acid by the parietal cells, thus avoiding damage to the stomach mucosa, already injured by the microorganism.

Read also: Which drug is better: omeprazole, esomeprazole or ranitidine?

Warning

The information contained in this document is for information purposes only and does not replace, under any circumstances and situation, consultation with a medical professional.

 

Questions and Answers
“My 3 year old grandson has Kawasaki Syndrome and needs to take aspirin and omeprazole. Aspirin we managed to disguise, but omeprazole is very difficult because of its presentation, is there anything that can replace the capsules?”

Pharmacist’s response (by Adriana Sumi)
In cases of difficulty swallowing or administering omeprazole to children, it is possible to open the capsule in a glass, add some water and drink. You will see that inside the omeprazole capsule there are some white balls, it is very important that these balls are not crushed or bitten, they must be ingested whole! These balls have a coating that causes the medicine to be absorbed in the right place, ensuring the effect of the medicine, if the balls are undone the absorption is compromised and therefore the effect of the medicine as well.

Another alternative would be to change medication, but this alternative should be discussed beforehand with your grandson’s doctor, as only he can say whether it is safe and effective for your grandchild to change medication. A possible alternative, but depending on the type of stomach problem your grandchild has and the presence of other health problems, is the use of cimetidine. Cimetidine belongs to another class of antacid medication, H2 antagonists, but which must be used with follow-up in patients using anticoagulants such as warfarin.

Another alternative would be the use of espinheira-santa, an effective medicinal plant in cases of stomach gastritis, but which also has contraindications. So it’s also important to talk to your grandchild’s doctor to find out if it’s safe for him.

Find out more information at: espinheira-santa

Questions and Answers
“ How many hours should I fast before taking omeprazole?”

Pharmacist’s response (by Adriana Sumi)
To obtain a better effect from omeprazole, it is recommended that it be taken 20 minutes before breakfast, if you take two or more doses a day, we recommend that you take it 20 minutes before meals, with an interval of 3 hours of fasting before taking omeprazole and with an interval of 20 minutes after taking the medicine for the next meal.

Questions and Answers
“ When you finish taking omeprazole can you drink alcohol?”

Pharmacist’s response (by Adriana Sumi)
It is recommended to wait about 15 days after completing the treatment with omeprazole to find out if the treatment was effective or not, before going back to drinking alcoholic beverages, because if the treatment has not been effective, the drink alcohol will make symptoms worse. If you are taking antibiotics, do not drink alcohol, as it can decrease the effectiveness of the antibiotic and increase the risk of bacterial resistance to the antibiotic, which can lead to complications.

In addition, alcoholic beverage increases the risk of stomach problems such as burning in the stomach.

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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