Omeprazole belongs to a class of antisecretory compounds, the substituted benzimidazoles, that suppress gastric acid secretion by 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 characterized as a gastric acid-pump inhibitor, in that it blocks the final step of acid production. This effect is dose-related and leads to inhibition of both basal and stimulated acid secretion irrespective of the stimulus.
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Duodenal Ulcer: 20 mg once daily for 4 weeks. In severe cases, 40 mg once daily for 4 weeks.
Gastric Ulcer: 20 mg once daily for 8 weeks. In severe cases, 40 mg once daily for 8 weeks.
Erosive Reflux Oesophagitis: 20 mg once daily for 4 weeks. For those not fully healed, to be continued for 4 more weeks. Refractory Reflux Oesophagitis: 40 mg once daily for 8 weeks. Zollinger-Ellison Syndrome: 60 mg once daily, adjusted individually and continued as long as necessary.
Most patients will be effectively controlled with 20-120 mg daily. Dosage above 80 mg should be divided and given twice daily. Long-term maintenance treatment with Omeprazole is not recommended.
Impaired Renal or Hepatic Function: Adjustment is not required. Patients with severe liver disease should not require more than 20 mg Omeprazole daily
Prophylaxis of acid aspiration: Omeprazole 40 mg to be given slowly (over a period of 5 minutes) as an intravenous injection, one hour before surgery.
Duodenal ulcer, gastric ulcer or reflux oesophagitis: In patients with duodenal ulcer, gastric ulcer or reflux oesophagitis where oral medication is inappropriate, Omeprazole IV 40 mg once daily is recommended.
Zollinger- Ellison syndrome (ZES): In patients with Zollinger-Ellison Syndrome the recommended initial dose of Omeprazole given intravenously is 60 mg daily. Higher daily doses may be required and the dose should be adjusted individually. When doses exceed 60 mg daily, the dose should be divided & given twice daily.