| Name | Compounded + Branded Omeprazole (e.g., Prilosec) |
| Uses | Treatment of gastroesophageal reflux disease (GERD), erosive esophagitis, gastric ulcers, and Zollinger-Ellison syndrome. |
| Route Of Administration | Oral (capsule, tablet, suspension) |
| Frequency Of Use | Once daily, preferably in the morning before meals; may be increased to twice daily in severe cases under provider supervision. |
| Concentration(s) | • Standard capsules/tablets: 10 mg, 20 mg, 40 mg • Compounded liquid suspension: 2 mg/mL, 4 mg/mL (customized based on patient needs) |
| Maximum Dosage (Day, Wk) | • Maximum standard dose: 40 mg per day (unless prescribed otherwise for Zollinger-Ellison syndrome) • Do not exceed 80 mg per day without physician supervision. |
| Contraindications | • Known hypersensitivity to omeprazole or proton pump inhibitors (PPIs) • Severe hepatic impairment (require dose adjustment) • Concurrent use of drugs requiring gastric acidity for absorption (e.g., ketoconazole, atazanavir) • Long-term use caution in osteoporosis or kidney disease. |
| Possible Side Effects | • Common: Nausea, headache, abdominal pain, diarrhea, constipation • Rare: Vitamin B12 deficiency, magnesium depletion, bone fractures (long-term use) • Severe: Clostridioides difficile infection, acute interstitial nephritis, rebound acid hypersecretion upon discontinuation. |
| Compatibility With Other Treatments/Drugs | • Avoid concomitant use with clopidogrel (reduces efficacy) • Caution with warfarin (may increase bleeding risk) • May decrease absorption of calcium, iron, and vitamin B12 supplements. |
| Allergies | Assess for prior allergic reactions to omeprazole or other PPIs (pantoprazole, lansoprazole, esomeprazole). |
| Administration Time | • Once daily, 30-60 minutes before breakfast. • If taken twice daily, second dose should be before dinner. |
| Dosing/Settings | • GERD/Erosive Esophagitis: 20 mg to 40 mg once daily for 4-8 weeks • Maintenance therapy: 20 mg daily • Zollinger-Ellison Syndrome: 60 mg/day, adjusted as needed. |
| Test Spot Requirement | Not applicable for oral medications. |
| Pre-Treatment Guidelines | - Assess for symptoms requiring omeprazole therapy. - Rule out H. pylori infection if peptic ulcer disease is suspected. - Educate patients on potential long-term risks of PPI therapy. |
| Provider Clearance Guidelines | - Evaluate renal and hepatic function for high-risk patients. - Consider alternative therapies for patients with osteoporosis or chronic kidney disease. |
| Pre-Treatment Screening Workflow | - Confirm indication for use. - Review drug interactions and allergy history. - Assess risk factors for long-term complications (osteoporosis, kidney disease, B12 deficiency). |
| What To Do If Adverse Reaction Occurs | - For mild symptoms (nausea, headache), monitor and adjust dosing if necessary. - If severe reaction occurs (acute kidney injury, C. difficile infection), discontinue and refer for specialist evaluation. - If rebound acid hypersecretion occurs, consider step-down approach instead of abrupt discontinuation. |
| Clinic Implementation Guidelines | - Provide education on proper administration and duration of therapy. - Document baseline symptoms and monitor response. - Recommend lifestyle modifications (diet, weight loss, avoiding trigger foods) alongside medication. |
| Photographic Documentation Protocol | Not applicable for oral medications. |
| Post-Treatment Care | - Reassess need for continued therapy after 4-8 weeks. - Encourage tapering off therapy when clinically appropriate to avoid rebound acid hypersecretion. - Monitor for signs of long-term complications if chronic use is required. |
| Additional Documentation Requirements | - Prescription details and dosage instructions. - Patient education documentation on PPI risks and benefits. - Adverse event documentation (if applicable). |