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Sompraz is a brand name for **omeprazole**, a proton pump inhibitor (PPI). ## Overview Omeprazole is a proton pump inhibitor that reduces gastric acid secretion. ## Primary Indications * Gastroesophageal reflux disease (GERD) * Healing of erosive esophagitis * Treatment of duodenal ulcers * Treatment of gastric ulcers * Eradication of *Helicobacter pylori* (in combination with antibiotics) * Prophylaxis of NSAID-induced gastric ulcers ## Adult Dosing * **GERD:** 20 mg once daily for 4 weeks. For more severe esophagitis, 20 mg once daily for up to 8 weeks. Maintenance: 10-20 mg once daily. * **Duodenal Ulcer:** 20 mg once daily for 4 weeks. * **Gastric Ulcer:** 20 mg once daily for 4-8 weeks. * ***H. pylori* Eradication (triple therapy):** Omeprazole 20 mg twice daily for 10 days with clarithromycin 500 mg twice daily and amoxicillin 1000 mg twice daily OR omeprazole 20 mg twice daily for 10 days with clarithromycin 500 mg twice daily and metronidazole 500 mg twice daily. (Specific regimen depends on local resistance patterns and guidelines). * **NSAID-induced Ulcers:** 20 mg once daily for 4-8 weeks. ## Pediatric Dosing * **GERD/Erosive Esophagitis:** * 1 to 16 years: 10 mg once daily for up to 8 weeks. * For more severe GERD or healing of erosive esophagitis, consider 20 mg once daily. Doses up to 20 mg twice daily have been used in some clinical trials for children 1-16 years, but these higher doses are not FDA-approved for all indications. * *H. pylori* eradication in pediatric patients is not well-established. ## Dose Adjustments * **Hepatic Impairment:** Maximum dose is 20 mg once daily. ## Contraindications * Known hypersensitivity to omeprazole, its substituted benzimidazoles, or any component of the formulation. ## Adverse Effects Common: Headache, diarrhea, nausea, abdominal pain, vomiting, constipation. Less Common: Rash, dizziness, fatigue. ## Key Drug Interactions * **Clopidogrel:** Omeprazole may decrease the antiplatelet effect of clopidogrel. Consider alternative PPIs or separate administration by 12 hours. * **CYP2C19 Substrates:** Omeprazole is a moderate inhibitor of CYP2C19 and can increase plasma concentrations of drugs metabolized by this enzyme (e.g., citalopram, escitalopram, diazepam, phenytoin). * **Ketoconazole, Itraconazole, Posaconazole:** Omeprazole decreases gastric pH, which can reduce absorption of these antifungals. * **Methotrexate:** Concurrent use may increase methotrexate levels. ## Monitoring * Monitor for efficacy in symptom relief and healing of mucosal lesions. * Long-term PPI use may be associated with an increased risk of *Clostridium difficile*-associated diarrhea, bone fractures, and vitamin B12 deficiency. ## Clinical Pearls * Administer capsules whole, do not chew or crush. * Administer orally disintegrating tablets (ODT) on the tongue and swallow. * For patients with difficulty swallowing, omeprazole can be mixed with applesauce or fruit juice. The mixture should be consumed within 30 minutes. * Omeprazole can be administered via nasogastric (NG) tube; suspend in a bicarbonate solution if necessary to prevent clogging. * Long-term use should be re-evaluated regularly. *** **Disclaimer:** This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always consult the current prescribing information and relevant clinical guidelines for the most up-to-date and comprehensive details regarding drug use.