OMEPRAZOLE

Omeprazole is a proton pump inhibitor (PPI) which inhibits gastric acid production by the gastric parietal cells.Following endoscopic treatment of bleeding peptic ulcers, omeprazole given intravenous for 72 hours has been shown to reduce the risk of rebleeding.

USES

• Bleeding peptic ulcers, after endoscopic treatment of bleeding (unlicensed)
• Continuation of PPI therapy when the PO/NG route is unavailable.
• Helicobacter pylori eradication.

ADMINISTRATION

• Bleeding peptic ulcers, after endoscopic treatment of bleeding

IV: Initial 80 mg IV loading dose given over 1 hour, followed by 8 mg/h
IV infusion for 72 hours
Reconstitute with either sodium chloride 0.9% or glucose 5%

• Continuation of PPI therapy when the PO/NG route is unavailable
IV bolus: 40 mg daily. Reconstitute 40 mg vial with the solvent provided and administer over 5 min
• Eradication of Helicobacter pylori

ADVERSE EFFECT

• GI disturbances (nausea, vomiting, abdominal pain, diarrhoea and constipation)
• Paraesthesia
• Agitation
• Liver dysfunction
• Hyponatraemia
• Leukopenia and thrombocytopenia rarely

CAUTIONS

• Severe hepatic disease (risk of encephalopathy)
• Pregnancy (toxic in animal studies)
• May mask symptoms of gastric cancer
• Omeprazole may enhance anticoagulant effect ofwarfarin – monitor INR and may increase phenytoin levels
• Omeprazole may reduce the effectiveness of clopidogrel

ORGAN FAILURE

Hepatic: reduce dose