Indication & Dosage

Indication:
For the treatment of benign gastric and duodenal ulcers including NSAID induced gastric and duodenal ulcers or gastro-duodenal, erosions, gastroesophageal reflux disease (GERD), acid related dyspepsia or disorders associated with hyper secretion of gastric acld, such as the ZollingerEllison Syndrome. It is also used in cornbinatlon wlth antibiotics for eradication of Helicobacter pylori in peptic ulcer disease as triple therapy.

Dosage and Administration:
For the relief of acid-related dyspepsia, Omeprazole is given in usual doses of 10 or 20mg daily orally for 2 to 4 weeks. The usual dose for the treatment of gastrooesophageal reflux disease is 20mg orally once daily for 4 weeks, followed by further 4 to 8 weeks if not fully healed. In refractory oesophagitis, a dose of 40mg daily may be used. Maintenance therapy after healing of oesophagitis is 20mg once daily and for acid reflux is 10mg daily.

In the management of peptic ulcer disase, a single daily dose of 20mg daily, or 40mg in severe cases, is given. Treatment is continued for 4 weeks for duodenal ulcer and 8 weeks for gastric ulcer.

For the eradication of Helicobacter pylori in peptic ulceration, Omeprazole may be combined with antibactrials in dual or triple therapy. Effective triple therapy regimens include Omeprazole 20mg twice daily 40mg once daily combined with Amoxicillin 500mg and Metronidazole 400mg, both three times daily; Clarithromycin 250mg and Metronidazole 400mg (or Tinidazole 500mg) both twice daily; or with Amoxicillin 1g and Clarithromycln 500mg, both twice daily.

These regimens are given for 1 week. Dual therapy regimens such as Omeprazole 20mg twice daily or 40mg daily with either Amoxicillin 750mg to 1gtwice daily or Clarithromycin 500mg, three times daily, are less effective and must be given for 2 weeks. Omeprazole alone may be continued for further 4 to 8 weeks.

Doses of 20mg daily orally are used in the treatment of NSAID-associated ulceration; a dose of 20mg daily may also be used for prophylaxis in patients with a history of gastroduodenal lesions who require continued NSAID treatment.
The initial recommended dosage for patients with the Zollinger-Ellison syndrome is 60mg orally once daily, adjusted as-required. The majority of patients are effectively controlled by doses in the range 20 to 120mg, but doses up to 120mg three times daily have been used. Daily doses above 80mg should be given as divided doses (usually 2).

Omeprazole is also used for the prophylaxis of acid aspiration during general anaesthesia, in a dose of 40mg the evening before surgery and a further 40mg two to six hours before the procedure.
For the treatment of gastroesophageal reflux disease in children 1 year of age and over are determined by body-weight as follows: 10 to 20kg: 10mg once daily; over 20 kg: 20mg, once daily. These doses may be doubled if necessary.

Treatment may be given for 4 to 12 weeks.