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Omeprazole Dosage

Medically reviewed on June 25, 2018.

Applies to the following strengths: 20 mg; 10 mg; 40 mg; 2.5 mg; 2 mg/mL

Usual Adult Dose for Duodenal Ulcer

20 mg orally once a day
-Duration of therapy: 4 weeks

Comment: If patients are not fully healed after 4 weeks, treatment may continue for another 4 weeks.

Use: Short-term treatment of active duodenal ulcer

Usual Adult Dose for Helicobacter pylori Infection

Dual therapy: 40 mg orally once a day, taken concomitantly with clarithromycin
-Duration of therapy: 14 days

Triple therapy: 20 mg orally 2 times a day, taken concomitantly with amoxicillin and clarithromycin
-Duration of therapy: 10 days

Comments:
-Patients presenting with an ulcer at the time of treatment should continue treatment with a 20 mg dose orally once a day for 14 days (dual therapy) or 18 days (triple therapy).
-Antibiotic selection should be determined by local bacterial resistance, duration of treatment, and appropriate use.
-Refer to the manufacturer product information for dosing for amoxicillin and/or clarithromycin.
-Patients who failed therapy were more likely to develop clarithromycin resistance when they received dual therapy.
-Susceptibility testing should be performed in patients who fail treatment; alternative antimicrobial therapy should be used when clarithromycin resistance is demonstrated, or susceptibility testing is not possible.

Uses: Helicobacter pylori eradication to reduce the risk of duodenal ulcer recurrence
-TRIPLE THERAPY: In combination with clarithromycin and amoxicillin for the treatment of patients with H pylori infection and active or a history of duodenal ulcer disease (within 1 year) to eradicate H pylori
-DUAL THERAPY: In combination with clarithromycin for the treatment of patients with H pylori infection and duodenal ulcer disease to eradicate H pylori

Usual Adult Dose for Gastric Ulcer

40 mg orally once a day
-Duration of therapy: 4 to 8 weeks

Use: Short-term treatment of active benign gastric ulcer

Usual Adult Dose for Erosive Esophagitis

Treatment: 20 mg orally once a day
-Duration of therapy: 4 to 8 weeks

Maintenance: 20 mg orally once a day

Comments:
-Controlled studies for maintenance therapy did not extend past 12 months.
-Patients who do not respond after 8 weeks of treatment may continue for an additional 4 weeks.
-If there is a recurrence of erosive esophagitis (EE) or gastroesophageal reflux disease (GERD) symptoms, an additional 4 to 8-week course of treatment should be considered.

Uses:
-Short-term treatment of EE due to acid-mediated GERD that has been diagnosed by endoscopy
-Maintenance of healing of EE due to acid-mediated GERD

Usual Adult Dose for Multiple Endocrine Adenomas

Initial dose: 60 mg orally once a day
Maximum dose: 360 mg/day (as 120 mg orally 3 times a day)

Comments:
-Doses higher than 80 mg should be given in divided doses.
-The treatment duration should be for as long as clinically necessary. Some patients with Zollinger-Ellison Syndrome have been treated for longer than 5 years.

Use: Long-term treatment of pathological hypersecretory conditions (e.g., Zollinger-Ellison syndrome, multiple endocrine adenomas, systemic mastocytosis)

Usual Adult Dose for Systemic Mastocytosis

Initial dose: 60 mg orally once a day
Maximum dose: 360 mg/day (as 120 mg orally 3 times a day)

Comments:
-Doses higher than 80 mg should be given in divided doses.
-The treatment duration should be for as long as clinically necessary. Some patients with Zollinger-Ellison Syndrome have been treated for longer than 5 years.

Use: Long-term treatment of pathological hypersecretory conditions (e.g., Zollinger-Ellison syndrome, multiple endocrine adenomas, systemic mastocytosis)

Usual Adult Dose for Zollinger-Ellison Syndrome

Initial dose: 60 mg orally once a day
Maximum dose: 360 mg/day (as 120 mg orally 3 times a day)

Comments:
-Doses higher than 80 mg should be given in divided doses.
-The treatment duration should be for as long as clinically necessary. Some patients with Zollinger-Ellison Syndrome have been treated for longer than 5 years.

Use: Long-term treatment of pathological hypersecretory conditions (e.g., Zollinger-Ellison syndrome, multiple endocrine adenomas, systemic mastocytosis)

Usual Adult Dose for Hypersecretory Conditions

Initial dose: 60 mg orally once a day
Maximum dose: 360 mg/day (as 120 mg orally 3 times a day)

Comments:
-Doses higher than 80 mg should be given in divided doses.
-The treatment duration should be for as long as clinically necessary. Some patients with Zollinger-Ellison Syndrome have been treated for longer than 5 years.

Use: Long-term treatment of pathological hypersecretory conditions (e.g., Zollinger-Ellison syndrome, multiple endocrine adenomas, systemic mastocytosis)

Usual Adult Dose for Gastroesophageal Reflux Disease

20 mg orally once a day
-Duration of therapy: Up to 4 weeks

Use: Treatment of heartburn and other symptoms associated with GERD

Usual Adult Dose for Dyspepsia

Over-the-Counter (OTC) formulations: 20 mg orally once a day in the morning
-Duration of therapy: 14 days

Comments:
-A 14-day course of treatment may be repeated every 4 months.
-This drug should be taken with a full glass of water prior to eating.
-Some patients may experience symptom relief within 24 hours of taking the first dose.

Use: Treatment of frequent heartburn (occurring 2 or more days a week)

Usual Pediatric Dose for Gastroesophageal Reflux Disease

1 to 16 years:
-Weight 5 to less than 10 kg: 5 mg orally once a day
-Weight 10 to less than 20 kg: 10 mg orally once a day
-Weight 20 kg and greater: 20 mg orally once a day
Duration of therapy: Up to 4 weeks

16 to 18 years: 20 mg orally once a day
-Duration of therapy: Up to 4 weeks

Use: Treatment of heartburn and other symptoms associated with GERD

Usual Pediatric Dose for Erosive Esophagitis

TREATMENT:
1 month to less than 1 year:
-Weight 3 to less than 5 kg: 2.5 mg orally once a day
-Weight 5 to less than 10 kg: 5 mg orally once a day
-Weight 10 kg and greater: 10 mg orally once a day
Duration of therapy: Up to 6 weeks

1 to 16 years:
-Weight 5 to less than 10 kg: 5 mg orally once a day
-Weight 10 to less than 20 kg: 10 mg orally once a day
-Weight 20 kg and greater: 20 mg orally once a day
Duration of therapy: 4 to 8 weeks

16 to 18 years: 20 mg orally once a day
-Duration of therapy: 4 to 8 weeks

MAINTENANCE:
1 to 16 years:
-Weight 5 to less than 10 kg: 5 mg orally once a day
-Weight 10 to less than 20 kg: 10 mg orally once a day
-Weight 20 kg and greater: 20 mg orally once a day

16 to 18 years: 20 mg orally once a day

Comments:
-Patients who do not respond after 8 weeks of treatment may continue for an additional 4 weeks.
-If there is a recurrence of EE or GERD symptoms, an additional 4 to 8-week course of treatment should be considered.
-Controlled studies for the treatment EE did not extend past 8 weeks, and maintenance studies did not extend beyond 12 months.

Uses:
-Short-term treatment of EE due to acid-mediated GERD that has been diagnosed by endoscopy
-Short-term treatment of EE due to acid-mediated GERD
-Maintenance of healing of EE due to acid-mediated GERD

Renal Dose Adjustments

No adjustment recommended.

Liver Dose Adjustments

Maintenance of healing of EE: 10 mg orally once a day

Dose Adjustments

Maintenance of healing of EE in Asian patients: 10 mg orally once a day

Precautions

CONTRAINDICATIONS:
-Hypersensitivity to the active component, substituted benzimidazoles, or any of the ingredients
-The concomitant use with rilpivirine-containing products

For the treatment of H pylori (as combination therapy): Refer to the contraindications section of the other antibacterial agents for further information.

Safety and efficacy of prescription formulations have not been established in patients younger than 1 month (prescription formulations) or 18 years (OTC formulations).

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-Tablet and capsule formulations should be swallowed whole, without crushing/chewing.
-The delayed-release capsule may be opened and sprinkled onto a tablespoon of applesauce and swallowed immediately. Do not chew or crush granules.
-The delayed-release oral suspension may be emptied into a small volume of water, allowed to thicken (approximately 2 to 3 minutes), and swallowed within 30 minutes. Remaining material should be mixed with more water and swallowed immediately.
-The suspension may be mixed with water and administered via nasogastric tube.

Storage requirements: The manufacturer product information should be consulted.

Reconstitution/preparation techniques: The manufacturer product information should be consulted.

IV compatibility: The manufacturer product information should be consulted.

General:
-The IV formulation should be used when oral formulations are inappropriate; IV use should be discontinued as soon as treatment with an oral formulation is possible. A single 10 mg IV dose was shown to be equivalent to a single 20 mg oral tablet dose.
-Antacids may be used concomitantly during treatment.

Monitoring:
-METABOLIC: Magnesium levels, especially in patients taking other drugs that could result in hypomagnesemia or those on long-term therapy; Vitamin B12 levels, especially in patients on long-term therapy
-MUSCULOSKELETAL: Bone fractures, especially in patients at high risk for osteoporosis-related events

Patient advice:
-Patients should be advised that use is not intended for immediate relief. Patients may not experience full effects for up to 4 days.
-If using this drug to treat H pylori, tell patients that it is important to complete the full regimen.
-Instruct patients to seek medical attention if signs/symptoms of hypersensitivity, Clostridium difficile, or systemic cutaneous lupus erythematosus occur.
-Inform patients that this drug may cause drowsiness, dizziness, vertigo, and/or visual disturbances. They should avoid driving or operating machinery until the full effects of the drug are seen.
-Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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