Omeprazole

Omeprazole Brand Names

First-Omeprazole | Prilosec | Prilosec OTC

What is Omeprazole

Omeprazole is a proton pump inhibitor (PPI) that has a long duration of action and is very potent, allowing for once-daily administration.

It is indicated for short term therapy of gastroesophageal reflux disease, gastric and duodenal ulcers, and gastric hypersecretory conditions including Zollinger-Ellison syndrome, systemic mastocytosis, and multiple endocrine adenoma.

It is also approved for use in combination with antibiotics in the eradication of Helicobacter pylori (H. pylori) infection for the reduction of the risk of duodenal ulcer recurrence.

Clinicians should test for H. pylori infection in patients presenting with non-ulcer dyspepsia; patients found to be H. pylori positive should be started on combination eradication therapy.

Eradication of H. pylori offers modest, but significant, symptom relief in non-ulcer dyspepsia and reduces the risk of developing peptic ulcer disease, atrophic gastritis, and gastric cancer.

For populations with a low prevalence of H. pylori infection (< 10%), starting a 2 to 4 week empiric trial of a PPI is an alternate approach.

On the basis of available research, no clear advantage has been demonstrated for the use of one PPI over another in the treatment of GERD. Instead, a key to optimizing effectiveness is tailoring dosage timing and considering twice daily dosing; traditional delayed release PPIs should be administered 30 to 60 min before a meal for maximal pH control.

A one-time switch to a different PPI in a refractory patient may be useful.

Indications

1. duodenal ulcer
2. dyspepsia
3. eosinophilic esophagitis
4. esophagitis
5. gastric ulcer
6. gastroesophageal reflux disease (GERD)
7. Helicobacter pylori (H. pylori) eradication
8. multiple endocrine adenoma syndrome
9. NSAID-induced ulcer prophylaxis
10. pyrosis (heartburn)
11. stress gastritis prophylaxis
12. systemic mastocytosis
13. Zollinger-Ellison syndrome

For the short-term, self-treatment of frequent dyspepsia or pyrosis (heartburn) that occurs 2 or more times per week

Side Effects

1. abdominal pain
2. agitation
3. agranulocytosis
4. alopecia
5. anaphylactic shock
6. anaphylactoid reactions
7. anemia
8. angina
9. angioedema
10. anorexia
11. anxiety
12. arthralgia
13. asthenia
14. back pain
15. blurred vision
16. bone fractures
17. bradycardia
18. bronchospasm
19. candidiasis
20. chest pain (unspecified)
21. cholestasis
22. colitis
23. confusion
24. constipation
25. cough
26. depression
27. diarrhea
28. diplopia
29. dizziness
30. drowsiness
31. dysgeusia
32. elevated hepatic enzymes
33. epistaxis
34. erythema multiforme
35. fatigue
36. fever
37. flatulence
38. glycosuria
39. gynecomastia
40. hallucinations
41. headache
42. hematuria
43. hemolytic anemia
44. hepatic encephalopathy
45. hepatic failure
46. hepatic necrosis
47. hepatitis
48. hyperbilirubinemia
49. hyperhidrosis
50. hypertension
51. hypocalcemia
52. hypoglycemia
53. hypokalemia
54. hypomagnesemia
55. hyponatremia
56. increased urinary frequency
57. infection
58. insomnia
59. interstitial nephritis
60. jaundice
61. leukocytosis
62. leukopenia
63. lupus-like symptoms
64. malaise
65. muscle cramps
66. myalgia
67. myasthenia
68. nausea
69. neutropenia
70. ocular irritation
71. optic atrophy
72. optic neuritis
73. palpitations
74. pancreatitis
75. pancytopenia
76. paresthesias
77. peripheral edema
78. pernicious anemia
79. petechiae
80. photosensitivity
81. proteinuria
82. pruritus
83. pseudomembranous colitis
84. purpura
85. pyuria
86. rash
87. renal failure (unspecified)
88. sinus tachycardia
89. Stevens-Johnson syndrome
90. stomatitis
91. stool discoloration
92. testicular pain
93. thrombocytopenia
94. tinnitus
95. toxic epidermal necrolysis
96. tremor
97. urticaria
98. vertigo
99. vitamin B12 deficiency
100. vomiting
101. weight gain
102. xerophthalmia
103. xerosis
104. xerostomia

Monitoring Parameters

• LFTs
• serum magnesium

Contraindications

• abdominal pain
• Asian patients
• bone fractures
• breast-feeding
• diarrhea
• dysphagia
• gastric cancer
• geriatric
• GI bleeding
• hepatic disease
• hypomagnesemia
• laboratory test interference
• long QT syndrome
• osteopenia
• osteoporosis
• poor metabolizers
• pregnancy
• proton pump inhibitors (PPIs) hypersensitivity
• pseudomembranous colitis
• rebound acid hypersecretion
• systemic lupus erythematosus (SLE)
• vitamin B12 deficiency
• vomiting

Interactions

• Acalabrutinib
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Alendronate
• Alendronate; Cholecalciferol
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Alprazolam
• Amiloride; Hydrochlorothiazide, HCTZ
• Amitriptyline; Chlordiazepoxide
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amobarbital
• Amphetamine
• Amphetamine; Dextroamphetamine
• Amphetamine; Dextroamphetamine Salts
• Ampicillin
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• Anticholinergics
• Apalutamide
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• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Atazanavir
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• Atropine; Difenoxin
• Atropine; Diphenoxylate
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• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Avanafil
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• Barbiturates
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Belladonna; Opium
• Benazepril; Hydrochlorothiazide, HCTZ
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• Benztropine
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• Bosentan
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