Omeprazole
GERD, Peptic ulcer disease, H. pylori eradication (triple therapy), Stress ulcer prophylaxis, Zollinger-Ellison syndrome
Indications
- GERD
- Peptic ulcer disease
- H. pylori eradication (triple therapy)
- Stress ulcer prophylaxis
- Zollinger-Ellison syndrome
Adult dosing
- gerd: dose: 20; unit: mg; route: PO daily; interval: 20mg daily for 4-8 weeks; may increase to 40mg; fixed: true; gi bleed: dose: 80; unit: mg; route: IV bolus then 8mg/hr x72h; interval: After endoscopy for high-risk ulcers; fixed: true
Contraindications
- PPI allergy
Clinical pearls
- Take 30-60 min before first meal of the day for maximum efficacy
- Long-term use risks: C. difficile, hypomagnesemia, B12 deficiency, fractures, CKD
- Step-down therapy: aim to use lowest effective dose or switch to H2RA for long-term maintenance
- GI bleed: high-dose IV PPI after endoscopy for high-risk Forrest Ia/Ib/IIa ulcers
Source and review
- ACG Clinical Guidelines; NEJM 2019 (PPI safety review). Last reviewed: 2024-11-01