Tips on the use of omeprazole

I believe that parents are familiar with omeprazole, a commonly used drug for digestive system diseases. Currently, the commonly used dosage forms for children are omeprazole enteric-coated tablets and omeprazole enteric-coated capsules. Let's learn about some basic knowledge about the use of omeprazole.

What kind of drug is omeprazole?

Omeprazole is a proton pump inhibitor that easily concentrates in an acidic environment and specifically acts on the proton pump (H+, K+-ATPase) of the gastric parietal cells, blocking the final step of gastric acid secretion, reducing the acid content in gastric juice and increasing the pH in the stomach. It has a strong inhibitory effect on both basal gastric acid and gastric acid secretion caused by stimulation.

Indications:

Omeprazole is mainly used to treat duodenal ulcers, gastroesophageal reflux, Zollinger-Ellison syndrome, and is used in combination with antibacterial drugs to eradicate Helicobacter pylori. It can also be used to relieve stomach acid-related symptoms such as acid reflux, heartburn, upper abdominal pain or discomfort.

Common usage and dosage for children : "Chinese National Formulary·Chemical Drugs and Biological Products Volume·Children's Edition" recommends: Oral dosage form once a day, take it in the early morning.

Newborns: 0.7 mg/kg once, increase to 1.4 mg/kg if necessary after 7 to 14 days; some newborns may require 2.8 mg/kg.

1 month to 2 years: 0.7 mg/kg once, increase to 3 mg/kg if necessary (maximum dose 20 mg).

Body weight 10-20kg: 10 mg, increase to 20 mg if necessary (in case of severe ulcerative reflux esophagitis, high doses can be used for up to 12 weeks).

Weight over 20 kg: 20 mg, increase to 40 mg if necessary (in case of severe ulcerative reflux esophagitis, high doses can be used for up to 12 weeks).

Eradication of Helicobacter pylori (needs to be used simultaneously with antibiotics):

1 to 12 years old, 1 to 2 mg/kg once (maximum 40 mg);

12 to 18 years old: 40 mg once.

Gastroesophageal reflux disease: Initial treatment: 1 mg/kg (maximum daily dose 40 mg), once a day, half an hour before breakfast. When effective, reduce the dose to 0.5 mg/kg and maintain for 4 to 8 weeks.

Peptic ulcer: 0.6-0.8 mg/kg per day (maximum daily dose 40 mg), once a day, in the early morning, for 2-4 weeks.

I would like to remind everyone in particular that enteric-coated tablets or capsules should not be broken or chewed before taking!

Precautions for long-term use of omeprazole:

① Long-term use of omeprazole can cause vitamin B12 deficiency. Vitamin B12 deficiency can lead to synthesis disorders of S-adenosylmethionine and methionine, which is likely to cause nervous system diseases. Therefore, long-term use of omeprazole requires attention to vitamin B12 supplementation.

② Long-term use of omeprazole can reduce calcium absorption, interfere with calcium-phosphorus metabolism, lead to calcium loss, and increase the risk of osteoporosis and fractures. Therefore, people who take omeprazole for a long time need to pay attention to calcium supplementation.

③ Long-term use of omeprazole can easily cause anemia, which will affect the absorption of iron supplements. Therefore, it is not recommended to take iron supplements while taking omeprazole.

④ Long-term use of omeprazole will cause a certain degree of damage to liver and kidney function, so attention should be paid to monitoring liver and kidney function during medication.

By learning about the basic knowledge of omeprazole usage, I believe parents and friends will have a new understanding of it and strengthen the rational use of medication for babies. Pharmacists will work with you to care for the healthy growth of your baby.

References:

［1］Chen Xinqian. New Edition of Pharmacology[M]. Beijing: People's Medical Publishing House, 2018: 546.

[2] Zhang Jing. Analysis of adverse reactions of omeprazole and its interactions with other drugs[J]. China Medical Guide, 2019, 17(1): 50.

[3] Li Jie, Tang Lei. Analysis of adverse reactions of omeprazole in the treatment of peptic ulcer[J]. Chinese Practical Medicine, 2021, 16(20): 131-133.

Academic authenticity, the author is responsible for the content

Source: Department of Pharmacy, Tianjin Children's Hospital

Author: Pharmacist Li Yan

Reviewer: Sun Yanyan, Chief Pharmacist

Yu He, Chief Pharmacist