ADMINISTRATION ROUTES:
PO, IV
ALTERNATIVE NAMES:
Dr Reddy’s Omeprazole, Losec, Omezol
ICU INDICATIONS:
- Ulcer prophylaxis
- Upper gastrointestinal bleeding
PRESENTATION AND ADMINISTRATION:
IV:
Omeprazole 40 mg vial (powder)
- Reconstitute the powder with 5mL compatible fluid (Sodium Chloride 0.9% or Glucose 5%)
- Dilute to 100ml Sodium Chloride 0.9% or Glucose 5%
- Administer the diluted solution over at least 20-30 minutes
Store at room temperature. Protect from light
Prepare immediately before use. Discard unused portion immediately.
PO / NG:
Capsules:
Dr Reddys Omeprazole Capsules 10 mg (purple / yellow), 20 mg (purple / light grey), 40 mg (yellow / purple)
Losec Capsules 10 mg (pink), 20 mg (pink / reddish-brown), 40 mg (reddish-brown) Omezol Capsules 10 mg (pale pink / white), 20 mg (pink / white), 40 mg (pink / beige)
Suspension:
10 mg/5 mL
Note: Tablets can be dispersed in water and given via NG immediately following dispersion but only if NG tubes larger than 8 French diameter. For NG tubes less than this size liquid should be used to prevent the tube blocking.
DOSAGE:
IV:
Ulcer Prophylaxis:
20 - 40 mg OD
Change to oral as soon as possible
High dose (for upper GI bleed):
40 mg BD to QID
PO:
Ulcer Prophylaxis:
20 - 40 mg OD
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:
Dose as in normal renal function
DOSAGE IN PAEDIATRICS:
0.4 - 0.8 mg/kg BD to OD
CLINICAL PHARMACOLOGY:
Omeprazole is a specific inhibition of the H+/K+ ATPase enzyme system at the secretory surface of the gastric parietal cell. Because this enzyme system is regarded as the acid (proton) pump within the gastric mucosa, omeprazole has been characterised as a gastric acid-pump inhibitor, in that it blocks the final step of acid production.
CONTRAINDICATIONS:
- Hypersensitivity to omeprazole
WARNINGS:
Nil
PRECAUTIONS:
General:
Nil
Laboratory Tests:
No tests additional to routine ICU tests are indicated
Drug/Laboratory Test Interactions:
None reported
IMPORTANT DRUG INTERACTIONS IN ICU:
Omeprazole can prolong the elimination of diazepam, warfarin and phenytoin, drugs that are metabolised by oxidation in the liver. There have been reports of increased INR and prothrombin time in patients receiving proton pump inhibitors, including omeprazole, and warfarin concomitantly.
ADVERSE REACTIONS:
Body as a Whole:
Allergic reactions
Gastrointestinal:
Abdominal pain, constipation, diarrhoea, flatulence, nausea, vomiting, elevated liver function tests
Renal:
Interstitial nephritis
Nervous System:
Headache, somnolence