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Omeprazole offers significant therapeutic gains in the treatment of acid related diseases. Healing rates are high in duodenal ulcer, gastric ulcer and erosive reflux oesophagitis; acid production is controlled effectively in Zollinger-Ellison Syndrome and symptom relief is prompt and sustained in all indications. Less clear-cut indications where benefit might be expected but where data are limited include:

• Prevention of stress ulceration
• Prevention of the acid aspiration syndrome
• Treatment of upper gastro-intestinal bleeding

NOTE: In comparative studies, Omeprazole has been found to produce faster symptom relief and higher healing rates in a greater percentage of patients than either Cimetidine or Ranitidine, confirming the ‘therapeutic gains’ achievable with Omeprazole over existing therapies.

Dosage: 

Oral-

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

IV Injection-

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.

Side effects: Side effects reported with Omeprazole in clinical studies have included nausea, diarrhoea, constipation, flatulence, abdominal colic, paresthesia, dizziness and headache but are rare. Skin rashes, leukopenia and transient elevation of plasma activation of hepatic amino-transferases have been observed occasionally in few patients and there has been no consistent relationship with treatment.