Omeprazole (Gastric Antisecretory)

Question 1

What is the brand name of omeprazole?

Answer 1

Prilosec

Question 2

What are the available dosages of Prilosec in sustained release capsules?

Answer 2

10mg, 20mg, 40mg

Question 3

What is the available dosage of Omeprazole OTC?

Answer 3

20mg caps

Question 4

What dose of omeprazole is used when indicated for short-term treatment of active duodenal ulcer?

Answer 4

20mg QD for 4-8 weeks

Question 5

What dose of Prilosec is used when indicated for short-term treatment of erosive esophagitis or poorly responsive gastroesophageal reflux disease?

Answer 5

20mg QD for 4-8 weeks

Question 6

What dose of omeprazole is used when treating pathological hypersecretory conditions including Zollinger-Ellison syndrome, Multics endocrine adenomas, and systemic mastocytosis?

Answer 6

Initial dose is 60mg/day. Dose up to 120mg given TID have been administered. Some patients have been treated continuously for more than 5 years.

Question 7

What dose of Prilosec is used when for the maintenance therapy of healing erosive esophagitis?

Answer 7

20mg QD

Question 8

What dose of Omeprazole is used for the treatment of GERD or other acid-related disorders in pediatric patients over the age of 2 years?

Answer 8

<20kg give 10mg QD

>20kg give 20mg QD

Question 9

What is the dose of Prilosec when used as an adjunct in the treatment of H. Pylori?

Answer 9

Dual Therapy: Omeprazole 40mg QD w/ clarithromycin 500mg TID for 14 days. If an ulcer is present at initiation of treatment, follow with omeprazole 20mg QD for 14 days

Triple Therapy: Omeprazole 20mg with clarithromycin 500mg plus amoxicillin 1000mg given BID for 10 days. If an ulcer was present at initiation of treatment, follow with omeprazole 20mg QD for 18 days.

Question 10

What should the providers monitor when a patient is taking Prilosec?

Answer 10

Bone Mineral Density

Magnesium

Question 11

What is the mechanism of action of Prilosec?

Answer 11

Prilosec is a Proton Pump Inhibitor (PPI) that surpassed the H+/K+ ATPase enzyme system at the secretory surface of the gastric parietal cell.

Question 12

What are the drug interactions of Omeprazole?

Answer 12

• Increases plans levels of diazepam, phenytoin, and warfarin by inhibiting oxidative metabolism.
• May also interact with other drugs metabolized via the cytochrome P450 system (cyclosporine, disulfiram, benzodiazepines)
• This drug increases gastric pH, so drugs whose bioavailability depends on gastric pH may be affected (ketoconazole, digoxin, cyanocobalamin, ampicillin esters, iron salts)
• Antacids may be used concomitantly
• Voriconazole may increase the plasma levels of Prilosec
• Omeprazole inhibits metabolism of cilostazole
• Omeprazole prevents the conversion of clopidogrel to its active metabolite

Question 13

What are the contraindications of Prilosec?

Answer 13

Animal studies have shown a dose-related increased risk for gastric carcinoid tumors with long-term use. The levels f drug needed to produce tumors far exceeded the normal daily dose (up to 352 time the human dose)

Pregnancy Category C

Question 14

What are the adverse effects of Omeprazole?

Answer 14

Side effects are rare but may include back pain, cough, constipation, rash, and dizziness

Question 15

What should the RPh tell their patient about Prilosec/Omeprazole?

Answer 15

• Take 30 minutes prior to eating
• Antacids may be taken at the same times
• If a dose is missed, take it ASAP. If the time is closer to the next dose than the missed dose, skip the missed dose. Do NOT double doses
• For patients who have difficulty swallowing capsules, they can empty the contents of the capsule into 1 tsp of applesauce, swallowed immediately and follow with a glass of cool water. The contents of the capsule should not be crushed or chewed.