Omeprazole indicated for gastroesophageal reflux disease including reflux esophagitis, acid reflux disease, duodenal & benign gastric ulcers, Helicobacter pylori eradication regimens in peptic ulcer disease, prophylaxis of acid aspiration, Zollinger-Ellison Syndrome & for the treatment of NSAID-associated gastric ulcers, duodenal ulcers or gastroduodenal erosions. Seclo IV is indicated primarily for the treatment of Zollinger-Ellison syndrome, & may also be used for the treatment of gastric ulcer, duodenal ulcer & reflux esophagitis.
Proton Pump Inhibitor; Antacid, Antiulcer
Omeprazole, a substituted benzimidazole, is an inhibitor of gastric acid secretion. It inhibits gastric acid secretion by blocking hydrogen-potassium-adenosine triphosphatase (H+/K+ ATPase) enzyme system in the gastric parietal cell. After oral administration, the onset of the antisecretory effect occurs within one hour, with the maximum effect occurring within two hours and inhibition of secretion lasts up to 72 hours. When the drug is discontinued, secretory activity returns gradually, over 3 to 5 days.
Omeprazole should be taken 30 minutes before meal.
Due to the decreased intragastric acidity the absorption of ketoconazole may be reduced during omeprazole treatment as it is during treatment with other acid secretion inhibitors. As omeprazole is metabolised in the liver through cytochrome P450 it can delay the elimination of diazepam, phenytoin and warfarin. Monitoring of patients receiving warfarin or pheytoin is recommended and a reduction of warfarin or phenytoin dose may be necessary. However concomitant treatment with omeprazole 20mg daily did not change the blood concentration of phenytoin in patients on continuous treatment with phenytoin. Similarly concomitant treatment with omeprazole 20mg daily did not change coagulation time in patients on continuous treatment with warfarin. Plasma concentrations of omeprazole and clarithromycin are increased during concomitant administration. This is considered to be a useful interaction during H. pylori eardication. There is no evidence of an interaction with phenacetin, theophylline, caffeine, propranolol, metoprolol, cyclosporin, lidocaine, quinidine, estradiol, amoxycillin or antacids. The absorption of omeprazole is not affected by alcohol or food. There is no evidence of an interaction with piroxicam, diclofenac or naproxen. This is considered useful when patients are required to continue these treatments. Simultaneous treatment with omeprazole and digoxin in healthy subjects lead to a 10% increase in the bioavailability of digoxin as a consequence of the increased intragastric pH.
There are no known contraindications to the use of Omeprazole. When gastric ulcer is suspected, the possibility of malignancy should be excluded before treatment with Omeprazole is instituted as treatment may alleviate symptoms & delay diagnosis.
Omeprazole is well tolerated. Nausea, diarrhoea, abdominal colic, paresthesia, dizziness & headache have been stated to be generally mild & transient & not requiring a reduction in dosage.
US FDA pregnancy category C. Omeprazole is excreted in breast milk but is not likely to influence the child when therapeutic doses are used.
Keep in a dry place away from light and heat. Keep out of the reach of children.
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