omeprazole (redirected from Losec)

omeprazole /omep·ra·zole/ (o-mep´ra-zōl) an inhibitor of gastric acid secretion used in the treatment of dyspepsia , gastroesophageal reflux disease, disorders of gastric hypersecretion, and peptic ulcer, including that associated with Helicobacter pylori infection.

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o·mep·ra·zole (-mpr-zl)

n.

A drug of the proton pump inhibitor class.

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omeprazole (ōmep´rzōl´),

n brand name: Prilosec;
drug class: antisecretory compound;
action: suppresses gastric secretion by inhibiting hydrogen/potassium ATPase enzyme system in the gastric parietal cell;
uses: gastroesophageal reflux disease (GERD), severe erosive esophagitis, pathologic hypersecretory conditions (Zollinger-Ellison syndrome, mastocytosis, multiple endocrine adenomas).

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omeprazole

a substituted benzimidazole that is a long-acting inhibitor of gastric ATPase; used in the treatment of gastric ulcers.

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omeprazole

Losec (CA) (UK), Heartburn Relief (UK), Prilosec, Prilosec OTC, Zegerid, Zanprol (UK)

Pharmacologic class: Proton pump inhibitor

Therapeutic class: Antiulcer drug

Pregnancy risk category C

Action

Reduces gastric acid secretion and increases gastric mucus and bicarbonate production, creating protective coating on gastric mucosa and easing discomfort from excess gastric acid

Availability

Capsules (delayed-release): 10 mg, 20 mg, 40 mg

Powder for oral suspension: 20 mg

Tablets (delayed-release): 20 mg

⊘Indications and dosages

➣ Gastroesophageal reflux disease

Adults: 20 mg P.O. (capsules, powder) daily for 4 weeks

➣ Erosive esophagitis

Adults: 20 mg P.O. (capsules, powder) daily for 4 to 8 weeks

➣ Short-term treatment of active duodenal ulcer

Adults: 20 mg P.O. (capsules, powder) daily for 4 weeks. Some patients may need 4 additional weeks of therapy.

➣ To reduce risk of duodenal ulcers caused by Helicobacter pylori

Adults: 40 mg P.O. (capsules) daily in morning, given with clarithromycin t.i.d. for 2 weeks; then 20 mg daily for 2 weeks

➣ Gastric ulcers

Adults: 40 mg P.O. (capsules) daily for 4 to 8 weeks

➣ Pathologic hypersecretory conditions, including Zollinger-Ellison syndrome

Adults: Initially, 60 mg P.O. (capsules) daily; may increase up to 120 mg t.i.d. Divide daily dosages above 80 mg.

➣ Frequent heartburn (two or more episodes a week)

Adults ages 18 and older: 20 mg P.O. (OTC tablets) daily for 14 days

Off-label uses

• Posterior laryngitis
• To enhance pancreatin efficacy in treating steatorrhea in cystic fibrosis patients

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:
• hepatic disease
• pregnant or breastfeeding patients
• children (safety not established).

Administration

• Give 30 to 60 minutes before a meal, preferably in morning.
• If desired, give concurrently with antacids.
• Know that if patient has ulcer at start of therapy, treatment may be extended.
• When giving through nasogastric tube, use powder for oral suspension, or separate capsule and mix pellets with water. Agitate syringe while injecting. After administration, flush with 30 to 60 ml of water.
• Don't crush capsules.
• Be aware that symptomatic response doesn't rule out gastric cancer.

Route	Onset	Peak	Duration
P.O.	Within 1 hr	Within 2 hr	72-96 hr
P.O. (delayed)	Unknown	10-90 min	Unknown

Adverse reactions

CNS: dizziness, headache, asthenia

GI: nausea, vomiting, diarrhea, constipation, abdominal pain

Musculoskeletal: back pain

Respiratory: cough, upper respiratory tract infection

Skin: rash

Interactions

Drug-drug. Ampicillin, cyanocobalamin, iron salts, ketoconazole: reduced absorption of these drugs

Clarithromycin: increased omeprazole blood level

Diazepam, phenytoin, warfarin: prolonged elimination and increased effects of these drugs

Digoxin: increased digoxin absorption and blood level, possible digoxin toxicity

Drugs metabolized by CYP450 system: competitive metabolism

Drug-diagnostic tests. Alanine phosphatase, alkaline aminotransferase, aspartate aminotransferase, bilirubin: increased levels

Gastrin: increased level during first 1 to 2 weeks of therapy

Patient monitoring

• Assess vital signs.
• Check for abdominal pain, emesis, diarrhea, or constipation.
• Evaluate fluid intake and output.
• Watch for elevated liver function test results (rare).

Patient teaching

• Tell patient to take 30 to 60 minutes before a meal, preferably in morning.
• Instruct patient to swallow capsules or tablets whole and not to chew or crush them. If he can't swallow capsule, tell him he may open it, carefully sprinkle and mix entire contents into 1 tbsp of cool applesauce, and swallow immediately with glass of water.
• Inform patient taking OTC delayed-release tablets for heartburn that full effect may take 1 to 4 days. Advise him not to take tablets for more than 14 days without consulting healthcare professional.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

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omeprazole

Prilosec^® Therapeutics A proton pump inhibitor used to manage GERD; heartburn; erosive esophagitis; maintenance of healed erosive esophagitis; short-term management of active duodenal ulcer and active benign gastric ulcer, and for certain hypersecretory conditions; combined with clarithromycin to eradicate H pylori associated with duodenal ulcers. See GERD, Helicobacter pylori. Cf H2 blockers.