Omeprazole is a drug that inhibits stomach acid secretion. It is used to treat dyspepsia, peptic ulcer, Zollinger-Ellison syndrome, and gastroesophageal reflux conditions. This drug, whose commercial name can be varied in the market, acts on the cells of the gastric mucosa, inhibiting up to 80% the secretion of hydrochloric acids (HCl) through the cancellation of the output of the protons in the pump electrogenic H + / K +.
What is Omeprazole
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Omeprazole (in English) belongs to the group of proton pump inhibitors, which are also known as those medicines that reduce the acid produced by the stomach in gastric juices in a pronounced and lasting way. It acts on the gastric parietal cell, producing a control through the reversible inhibition of the acid secretion of the stomach with only one daily dose.
Mechanism of action of omeprazole
It is indicated for the treatment of duodenal ulcer and benign gastric ulcer, including those that complicate NSAID treatments, for the eradication of Helicobacter pylori in peptic ulcer, for the treatment of severe reflux esophagitis, for the symptomatic treatment of Reflux and in the treatment of Zollinger - Elison Syndrome, it should be taken when the doctor considers it appropriate or if one has occasional gastroesophageal reflux. It is indicated whenever the patient has stomach problems or is over 55 years old.
Omeprazole indications
This medicine is indicated with medical restriction for the following treatments:
- Burning and acid regurgitation.
- Ulcers of the upper part of the intestine.
- Stomach and duodenal ulcers.
- Gastroesophageal reflux.
- Presence of gastroduodenal ulcer.
- Gastric ulcer.
- Chronic erosive esophagitis.
- Pathological hypersecretory conditions.
- Ulcers caused by Helicobacter pylori infection.
Presentations
It comes in the form of capsules that contain a gastro-resistant coating at a dose of 20 mg.
It is also available as a 40 mg injectable dose as a solid powder for extemporaneous reconstitution. Its stability is a function of pH and, when mixed with acidic vehicles for oral ingestion, it guarantees a maximum shelf life of seven days. This presentation is used only if the patient is unable to ingest it.
All preparations should be protected from light and kept between 15 and 30 ° C maximum. The usual doses for adults are 20 or 40 mg / day. in periods of two, four and up to eight weeks in short treatments.
In prolonged treatments, the dose is 20 mg / day. The maximum dose is 360 mg daily, although higher doses have occasionally been administered. Doses greater than 80 mg / day should be administered in a fractional manner because the mechanism of action of the substance causes the amounts to be wasted more than indicated by the saturation of the cell membrane.
On the other hand, some presentations of Omeprazole on the market can be obtained under the names of Arapride, Aulce, Ceprandal, Elgam, Losec, Nivel, Nuclosina, Omapren, Zimor, Prysma, Ompranyt, among others, or cheaper generic presentations. Also in powder to be diluted in water, in compressed tablets or capsules.
The latter normally has a delayed release, so that the drug in each capsule is not destroyed by stomach acids, but is released into the walls of the esophagus.
Dose
- Omeprazole Injection: for patients with gastric duodenal ulcer or reflux esophagitis, the dose is 40 mg daily.
- In Zollinger-Ellison syndrome, the starting amount is 60 mg.
- Omeprazole suspension: heartburn and acid indigestion: 1 capsule of 20 mg per day.
- For gastric and duodenal ulcers: take 1 capsule of 20 mg a day, for 2 or 3 continuous weeks.
- In patients with ulcers refractory to other treatment regimens, healing is achieved in most cases with a dose of omeprazole 40 mg once daily.
- Reflux esophagitis: 1 capsule of 20 mg. Once a day for 4 weeks.
- Zollinger-Ellison syndrome: the first dose should be 60 mg once a day.
- Most patients are controlled with omeprazole doses of 20 to 120 mg per day. If the dose exceeds 80 mg daily, it should be divided and given in two doses a day.
- In geriatric patients or in patients with renal or hepatic impairment, no dose adjustment is necessary.
On the other hand, it is an inexpensive product, and the price of Omeprazole, especially in Mexico, can vary according to the amount of product that your pharmaceutical company has and its presentation. For example, the price of Omeprazole in 20 mg capsules in generic brands, the presentation of 120 tablets ranges between $ 120 and $ 150.
Omeprazole side effects
The side effects that may exist for this drug vary from constipation, gas vomiting, headache, nausea, to more serious effects, such as heart damage due to magnesium deficiency, osteoporosis, diarrhea associated with Clostridium difficile or even neurological damage., pernicious anemia and dementia due to lack of vitamin B12.
However, this drug should be used with caution during pregnancy and lactation.
Omeprazole in pregnant women
Women who are in condition should take precautions, however, if heartburn occurs during pregnancy, there is the possibility of resorting to medications to treat this condition, previously consulting the doctor so that he is in charge of giving the indications regarding its administration.
On the other hand, the conclusion of three prospective epidemiological practices (which involved the pregnancy outcome of more than 1,000 women), do not present adverse drug reports in pregnancy or the health of the fetus or newborn, that is, it can be used during pregnancy as it is excreted in breast milk, but is not likely to affect the child when doses are used.
Contraindications
It should be taken 30 minutes before food. The pills should not be chopped or pulverized, as the natural pH of the esophagus and mouth would break down the microencapsulation, and the drug would be exposed to its degradation by gastric juice.
This drug is contraindicated in patients who have previously had hypersensitivity reactions to the drug. Its use is not recommended for long periods of more than 8 weeks, less in Zollinger-Ellison syndrome and Barrett's esophagus under medical supervision, as it can cause osteoporosis in the long term.
