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OMEPRAZOLE ENTERIC-COATED PASTE

Posted on Feb 02, 2019

INDICATIONS

Omeprazole is useful in gastric and duodenal ulcer disease. It also shows efficiacy against gastric erosions caused by ulcer prone drugs such as NSAIDs.

PHARMACOLOGY

In the stomach omeprazole is activated to a form that binds irreversibly at the surface of parietal cells to the enzym H/K ATPase. It thereby inhibits the transport of hydrogen ions into the stomach. The net effects is that omeprazole reduces acide secretion during both basal and stimulated conditions.


PHARMACOKINETICS

OMP is rapidly absorbed from the gut; the human commercial product is an enteric coated granule form as the drug is rapidly degraded by acid. The commercial oral pastes consist of some enteric coated options and some uncoated options.

OMP is extensively metabolised in the liver to at least six different metabolites. These are excreted principally in the urine.

OMP in dogs has an average serum half life of about 1 one hour, however, due to the nature of its effects as an irreversible inhibitor the therapeutic effect may last between 24-72 hours.

CONTRA-INDICATIONS

OMP is contraindicated in hypersensitive cases.


Care should be exercised in patients who have hepatic and/or renal disease

ADVERSE EFFECTS

When used at therapeutic doses adverse reactions are rare. However, hypersensitivity reactions theoretically may occur at any dose level. The most common adverse effects are listed below:


Frequent:

  • GI distress (anorexia, colic, nausea, vomiting, flatulence, diarrhoea)


Infrequent

  • hematologic abnormalities
  • urinary tract infections, proteinuria, or CNS disturbances.
  • chronic high doses can cause enterochromaffin-like cell hyperplasia
  • gastric carcinoid tumours


DRUG INTERACTIONS
The following drug interactions have either been reported or theoretical:

  • Benzodiazepines
  • Clarithromycin
  • Cynacobalamin
  • Cyclosporin
  • Drugs requiring decreased gastric pH for optimal absorption
  • Sucrafate
  • Warfarin


DOSES
Horses:

  • 4mg/kg twice daily for 5 days for treatment of gastric ulcer
  • 2mg/kg daily for prevention