This medication can be taken with or without food and should be swallowed whole with water. When used to treat ulcers in the duodenum, the recommended adult dose is 20 mg taken once daily for 2 to 4 weeks. To treat ulcers in the stomach, reflux esophagitis, and ulcers associated with the use of NSAIDs, the recommended adult dose is 20 mg taken once daily for 4 to 8 weeks.
When used to treat stomach ulcers caused by H. Another dosing regimen for H. If your ulcer continues to bother you, your doctor may suggest that you continue taking omeprazole for a period of time to make sure that your ulcer is fully healed. When treating Zollinger-Ellison syndrome , the dose of omeprazole varies, but is often higher than the doses used to treat ulcers. Doses larger than 80 mg daily are often needed.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule.
If it is less than 12 hours until your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature, protect it from moisture, and keep it out of the reach of children. Do not dispose of medications in wastewater e. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor. Although, her diarrhea present at admittance probably contributed to her severe hypomagnesemia causing the arrhythmia.
She was discharged home after 14 days in hospital with daily oral supplements of magnesium. However, 3 months later she was again admitted to hospital with hypomagnesemia despite the daily supplementation.
The laboratory tests showed magnesium 0. Her kidney function had improved and her renal failure at the first admittance was probably secondary to the severe dehydration.
After a thorough examination, it was concluded that the hypomagnesemia was a side effect of the PPI omeprazole. She had taken PPI for the last 13 years and her serum magnesium was within the normal range at the last control 7 years before the first admittance. Her PPI treatment was stopped and she is now under surveillance in the outpatient clinic with stable normal serum magnesium levels for 5 months after last discharge.
The magnesium balance is maintained by renal regulation of magnesium reabsorption and hypomagnesemia can result from a variety of causes. However, it usually occurs secondary to other disease processes or drugs, and features of the primary disease process may complicate or mask magnesium deficiency.
Magnesium plays an important role in several biochemical and physiological processes, and is the fourth most abundant cation in the body. Hypomagnesemia therefore tends to cause symptoms from different tissues including the neuromuscular, central nervous system and the cardiovascular system [ 2 ]. The classic symptoms of severe hypomagnesemia include tetany, convulsions, bradycardia, hypotension and in worst case death.
Hypomagnesemia in critical ill patients is associated with increased mortality [ 6 ]. Unfortunately, there are no readily and easy methods to assess magnesium status, although serum magnesium and the magnesium tolerance test are the most widely used [ 2 ]. PPIs are extremely widely used, and during the last decades PPI-induced hypomagnesemia has become a well-established phenomenon [ 7—9 ].
Growing evidence suggest that PPI impair the intestinal magnesium absorption through molecular mechanism of magnesium transporters; probably influenced by a complicated interplay of molecular biology, pharmacology and genetic predisposition [ 10 ].
Our patient in the case report presented severe hypomagnesemia resulting in Torsade de pointe and cardiac arrest. She was successfully treated and widely investigated, searching for the cause of her hypomagnesemia which was found to be an adverse effect of PPI.
Her PPI was stopped and she then presented stable serum concentration of magnesium within the normal range in the following surveillance. Severe hypomagnesemia can cause life-threatening ventricular arrhythmias. Hypomagnesemia can be caused by many different conditions, e.
Serum concentration of magnesium should be analyzed in hospitalized patients especially when the patient presents with other electrolyte disturbances or when conditions affecting magnesium metabolism are present.
Hypomagnesemia: a clinical perspective. Int J Nephrol Renovasc Dis ; 7 : — Google Scholar. Swaminathan R. Treatment of hypomagnesemia generally requires magnesium supplements. Healthcare professionals should consider obtaining serum magnesium levels prior to initiation of prescription PPI treatment in patients expected to be on these drugs for long periods of time, as well as patients who take PPIs with medications such as digoxin, diuretics or drugs that may cause hypomagnesemia. For patients taking digoxin, a heart medicine, this is especially important because low magnesium can increase the likelihood of serious side effects.
Healthcare professionals should consider obtaining magnesium levels periodically in these patients. Today's communication is in keeping with FDA's commitment to inform the public about its ongoing safety review of drugs. Additional Information for Patients. Additional Information for Healthcare Professionals.
The cases from the literature included patients on diuretics when either a change in diuretic was not associated with an improvement in serum magnesium level, or b when increase in serum magnesium level occurred with documented PPI discontinuation. However, because hypomagnesemia is likely under-recognized and under-reported, the available data are insufficient to quantify an incidence rate for hypomagnesemia with PPI therapy.
Hypomagnesemia has been reported in adult patients taking PPIs for at least three months, but most cases occurred after a year of treatment. Approximately one-quarter of these cases required discontinuation of PPI treatment in addition to magnesium supplementation.
Some cases cited both positive dechallenge as well as positive rechallenge i. After discontinuing the PPI, the median time required for the magnesium to normalize was one week. After restarting the PPI, the median time to develop hypomagnesemia again was two weeks. In most cases reviewed the patients did not continue on PPIs after the hypomagnesemia was treated. Examples of positive dechallenge in two patients include a year-old woman and a year-old man who were both treated with PPIs for 6 and 11 years, respectively.
Both patients presented with seizures and hypomagnesemia. This problem may possibly be averted by drinking acidic juices when eating foods containing vitamin B However, all people taking omeprazole need to either supplement with vitamin B12 or have their vitamin B12 status checked on a yearly basis. Even relatively small amounts of vitamin B12 such as 10—50 mcg per day, are likely to protect against drug induced vitamin depletion. People taking omeprazole may increase absorption of dietary vitamin B12 by drinking cranberry Vaccinium marocarpon juice or other acidic liquids with vitamin Bcontaining foods.
In a study of healthy human volunteers, supplementing with St. John's wort greatly decreased omeprazole blood levels by accelerating the metabolism of the drug.
Use of St. John's wort may, therefore, interfere with the actions of omeprazole. Please read the disclaimer about the limitations of the information provided here. Do NOT rely solely on the information in this article. The TraceGains knowledgebase does not contain every possible interaction.
Learn more about TraceGains, the company. The information presented by TraceGains is for informational purposes only. It is based on scientific studies human, animal, or in vitro , clinical experience, or traditional usage as cited in each article.
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