Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Omeprazole is in a class of drugs called
proton pump inhibitors (PPI) that block the production of acid by the stomach.
Other drugs in the class include lansoprazole (Prevacid), rabeprazole (Aciphex),
pantoprazole (Protonix), and esomeprazole (Nexium). Proton pump inhibitors are
used for the treatment of conditions such as ulcers, gastroesophageal reflux
disease (GERD) and the Zollinger-Ellison
syndrome, which are all caused by
stomach acid. Omeprazole, like other proton-pump inhibitors, blocks the enzyme
in the wall of the stomach that produces acid. By blocking the enzyme, the
production of acid is decreased, and this allows the stomach and esophagus to
heal. Zegerid contains omeprazole and an antacid (sodium bicarbonate). The FDA
approved omeprazole in September 1989.
GENERIC AVAILABLE: Yes (Prilosec)
PRESCRIPTION: Yes; No (Prilosec OTC, Zegerid OTC)
PREPARATIONS: Capsules: 10, 20 and 40 mg. Tablets: 20 mg (Prilosec
OTC). Powder for oral suspension: 20 and 40 mg
STORAGE: Capsules should be stored at 15 to 30 C (59 to 86 F) and tablets at
20 to 25 C (68 to 77 F). They should be kept away from moisture and light.
PRESCRIBED FOR: Omeprazole is used for treating acid-induced inflammation and
ulcers of the stomach and duodenum; gastroesophageal reflux disease (GERD);
erosive esophagitis, heartburn; prevention of upper gastrointestinal bleeding in
critically ill patients; and Zollinger-Ellison Syndrome. It also is used in
combination with antibiotics for eradicating
H. pylori infection of the stomach.
DOSING: For ulcers, GERD, erosive esophagitis and eradication of H. pylori
the recommended dose for adults is 20-40 mg daily. Ulcer healing usually occurs
within 4-8 weeks.
H. pylori infections are treated for 10-28 days.
The usual
dose for prevention of upper gastrointestinal bleeding in critically ill
patients is 40 mg daily for 14 days.
Prilosec OTC is used for treating heartburn
for up to two weeks, and the usual dose is 20 mg daily.
For the management of Zollinger-Ellison Syndrome the starting dose for adults
is 60 mg daily, and the dose is adjusted based on either the response of
symptoms or the actual measurement of acid production. Doses greater than 80 mg
should be divided. Doses up to 120 mg three times a day have been used in the
treatment of Zollinger-Ellison Syndrome.
For maximal efficacy, omeprazole tablets should be taken before meals,
swallowed whole and should not be crushed, chewed or opened.
DRUG INTERACTIONS: Omeprazole potentially can increase the concentrations in
blood of diazepam (Valium), warfarin (Coumadin), and phenytoin (Dilantin) by
decreasing the elimination of these drugs by the liver.
The absorption of certain drugs may be affected by stomach acidity.
Therefore, omeprazole as well as other PPIs reduce the absorption and
concentration in blood of ketoconazole (Nizoral) and increase the absorption and
concentration in blood of digoxin (Lanoxin). This may reduce the effectiveness
of ketoconazole or increase digoxin toxicity.
Through unknown mechanisms, omeprazole may increase blood levels of
saquinavir and reduce blood levels of nelfinavir and atazanavir, drugs that are
used for treating patients with infection caused by the
human immunodeficiency
virus (HIV). Accordingly, the dose of saquinavir may need to be
reduced to avoid toxicity, and the doses of nelfinavir and atazanavir may need
to be increased to maintain efficacy.
GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid
contents of the stomach backs up into the esophagus. The symptoms of uncomplicated GERD are heartburn,
regurgitation, and nausea. Effective treatment is available for most patients with GERD.
Helicobacter pylori (H. pylori) is a bacterium that causes chronic inflammation (gastritis) of the inner lining of the stomach in humans. This bacteria also is the most common cause of ulcers worldwide.
A peptic ulcer is an ulcer in the lining of the stomach, duodenum, or esophagus. Ulcer formation is related to Helicobacter pylori bacteria in the stomach, use of anti-inflammatory medications, and cigarette smoking.
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body, leading to thickness and firmness of involved areas. Scleroderma is also referred to as systemic sclerosis, and the cause is unknown. Treatment of scleroderma is directed toward the individual features that are most troubling to the patient.
Eosinophilic esophagitis is an inflammation of the esophagus. Eosinophilic esophagitis has many causes including acid reflux, heartburn, viruses, medications that become stuck in the esophagus, allergy, asthma, hay fever, allergic rhinitis, and atopic dermatitis. Eosinophilic esophagitis symptoms include difficulty swallowing food, abdominal pain, chest pain, and heartburn.
Gastritis is an inflammation of the stomach lining. Causes of gastritis include drinking too much alcohol, medications such as NSAIDs, ibuprofen, aspirin, H. pylori infection, severe infections, burns, anemia, and autoimmune disorders. Gastritis is diagnosed with endoscopy, blood tests, or stool tests. Treatment depends upon the cause of gastritis.
Barrett's esophagus occurs as a complication of chronic gastroesophageal reflux disease (GERD), primarily in white males. GERD refers to the reflux of acidic fluid from the stomach into the esophagus (the swallowing tube), and is classically associated with heartburn.
Heartburn is a burning sensation experienced from acid reflux (GERD). Symptoms of heartburn include chest pain, burning in the throat, difficulty swallowing, the feeling of food sticking in the throat, and a burning feeling in the chest. Causes of heartburn include dietary habits, lifestyle habits, and medical causes. Treatments for heartburn include lifestyle changes, OTC medication, prescription medication, and surgery.
Acid backing up into the larynx (voice box), it causes reflux laryngitis. Irritation of the lining of the esophagus, larynx, and throat can lead to esophagitis, sinusitis, strictures, hoarseness, throat clearing, swallowing problems, asthma, chronic cough, and more. Typical symptoms of reflux laryngitis include heartburn, hoarseness, or a sensation of a foreign body in the throat. Reflux laryngitis can be treated with OTC medication, prescription medication, and lifestyle changes.
Gastritis is a condition in which the stomach lining—known as the mucosa—is inflamed. The stomach lining contains special cells that produce acid and enzymes, which help break down food for digestion, and mucus, which protects the stomach lining from acid. When the stomach lining is inflamed, it produces less acid, enzymes, and mucus.
Gastritis may be acute or chronic. Sudden, severe inflammation of the stomach lining is called acute gastritis. Inflammation that lasts for a long time is called chronic gastritis. If chronic gastritis is not treated, it may last for years or even a lifetime.
Erosive gastritis is a type of gastritis that often does not cause significant inflammation but can wear away the stomach lining. Erosive gastritis can cause bleeding, erosions, or ulcers. Erosive gastritis may be acute or chronic.
The relationship between gastritis and symptoms is not clear. The term gastritis refers specifically to abnor...
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