Omeprazoleأوميبرازول

Omeprazole, sold under the brand name Losec, is a proton pump inhibitor (PPI) that reduces the amount of acid the stomach produces.

Omeprazole works by blocking the "proton pump" in the stomach lining that produces acid, which lowers overall stomach acidity.

• Frequent heartburn (occurring 2 or more days a week)
• Gastroesophageal reflux disease (GERD)
• Treatment and prevention of stomach and duodenal ulcers
• Helping heal erosive esophagitis
• As part of combination therapy (with antibiotics) to treat H. pylori infection
• Zollinger-Ellison syndrome

GERD, adults

• 20 mg once daily for 4–8 weeks

Stomach ulcer, adults

• 40 mg once daily for 4–8 weeks

Duodenal ulcer, adults

• 20 mg once daily for 4 weeks

H. pylori eradication, adults

• 20–40 mg twice daily, alongside antibiotics, for 10–14 days

Erosive esophagitis, adults

• 20 mg once daily for 4–8 weeks; up to 1 year for maintenance

Zollinger-Ellison syndrome, adults

• Starting dose 60 mg once daily, adjusted as needed up to 120 mg three times daily in some cases

Over-the-counter use for frequent heartburn

• Do not use for more than 14 days without a doctor's direction, and wait at least 4 months before repeating a 14-day course

See the special-populations section below for children's weight-based dosing.

This is educational background, not an individual prescription — your own doctor sets your exact dose and treatment length.

Symptoms usually start improving within 1–4 days of consistent use.

• Swallow capsules or tablets whole — do not crush or chew them
• Best taken in the morning before breakfast, on an empty stomach
• If taken twice daily, the second dose is usually in the evening
• If you have trouble swallowing, a capsule can be opened and its contents sprinkled on a spoonful of yogurt and swallowed right away, without chewing
• For the liquid form: shake well and measure the dose with the device provided
• For a powder packet: empty into water, let it dissolve for a few minutes, and drink right away

• Store at room temperature
• Keep away from moisture and light
• Keep out of children's reach

• Headache — reported in about 7%
• Abdominal pain — reported in about 5%
• Diarrhea — reported in about 4%
• Nausea — reported in about 4%
• Bloating or gas — reported in about 3%
• Vomiting — reported in about 3%
• Constipation — reported in about 2%
• Rash — reported in about 2%
• Weakness — reported in about 2%
• Dizziness — reported in about 2%
• Cold-like symptoms (stuffy nose, sneezing, sore throat) and fever, particularly in children

Rare but serious, potentially life-threatening skin reactions have been reported, including Stevens-Johnson syndrome and toxic epidermal necrolysis. Stop the medicine and seek medical attention immediately for skin blistering, peeling, or a widespread rash.

Seek medical attention immediately for signs of a serious allergic reaction: rash, difficulty breathing, or swelling of the face, lips, or tongue.

Rare serious blood-related effects have been reported, including a drop in certain white blood cells (neutropenia) and hemolytic anemia. Seek medical attention for unusual fatigue, easy bruising, or signs of infection such as fever or persistent sore throat.

Long-term use (generally 3 months or more) has been linked to low magnesium levels (hypomagnesemia), and use for a year or more has been linked to vitamin B12 deficiency.

Seek medical attention for dizziness, an irregular heartbeat, tremors, muscle cramps or spasms, cough, or a choking sensation (possible signs of low magnesium); or for severe fatigue, mouth ulcers, or tingling/numbness in the hands or feet (possible signs of B12 deficiency).

Like other acid-reducing medicines, omeprazole can increase the risk of a gut infection called C. difficile, which can cause diarrhea ranging from mild to serious. Long-term use (particularly beyond a year) has also been linked to stomach (gastric) polyps and to atrophic gastritis.

Seek medical attention immediately for watery or bloody diarrhea, or severe or persistent stomach pain.

Omeprazole has rarely been linked to kidney inflammation (acute interstitial nephritis), which can happen at any point during treatment. Seek medical attention for decreased urination, blood in the urine, unexplained weight gain, fever, rash, nausea, or loss of appetite.

Long-term use, especially at higher doses or for a year or more, has been linked to an increased risk of bone fractures, particularly of the hip, wrist, or spine. Seek medical attention for new or sudden pain in the wrist, hip, thigh, or back.

• Known hypersensitivity to omeprazole or other proton pump inhibitors (such as pantoprazole, lansoprazole, or esomeprazole)
• Taking rilpivirine (an HIV medicine) at the same time

Avoid combining

• Rilpivirine, nelfinavir, or atazanavir (HIV medicines)
• Clopidogrel (a blood thinner) — omeprazole can reduce its effectiveness
• Rifampin
• Mavacamten (a heart medicine)

Use with caution

• Azole antifungals (itraconazole, ketoconazole, voriconazole)
• Warfarin, cilostazol
• Citalopram (an antidepressant)
• Digoxin (a heart medicine)
• Immune-suppressing medicines (cyclosporine, tacrolimus)
• Certain cancer medicines (dasatinib, erlotinib, nilotinib)
• Disulfiram
• Certain diuretics
• Diazepam and similar anxiety/sleep medicines
• Certain seizure medicines (carbamazepine, phenobarbital, phenytoin)
• Methotrexate, mycophenolate mofetil
• St. John's Wort

Reduced absorption

• Vitamin B12 and iron supplements — omeprazole can reduce how well they're absorbed

Always tell your doctor and pharmacist about every other medicine you take.

No dose adjustment is needed based on kidney function alone.

In liver impairment, the dose is generally reduced to 10 mg once daily, and a doctor should be consulted before use.

Not used in children under 1 year except in special cases directed by a doctor.

GERD, ages 1 year and older

Erosive esophagitis

Duration: about 6 weeks for infants; 4–8 weeks for older children; up to 12 months when clinically needed.

H. pylori eradication

• About 1 mg/kg per day, combined with amoxicillin and clarithromycin

This is educational background, not an individual prescription — a doctor calculates the exact weight-based dose.

Omeprazole isn't usually a first-choice option during pregnancy — a doctor will often try other approaches to heartburn and indigestion first, since a risk to the developing baby can't be fully excluded. For breastfeeding, small amounts may pass into breast milk; a doctor should be consulted first.

• In elderly patients, guidance generally advises avoiding use beyond 8 weeks when possible, given the risks of C. difficile infection, bone loss, and fractures with prolonged use
• Periodic lab monitoring is generally advised with prolonged use
• Use with caution in liver disease, low calcium/magnesium/potassium levels, lupus, or osteoporosis — and be alert for lupus symptoms getting worse, such as joint pain or a rash on sun-exposed skin
• See a doctor if heartburn lasts more than 3 months, or comes with dizziness, sweating, or fainting, or if you have chest pain, vomiting blood or dark material, blood in the stool, unexplained weight loss, difficulty swallowing, or shortness of breath — these need evaluation, not self-treatment