o-MEP-ra-zole 
OTC:
twice/wk.Absorption: Rapidly absorbed following oral administration; immediate release formulation contains bicarbonate to prevent acid degradation.
Distribution: Good distribution into gastric parietal cells.
Protein Binding: 95%.
Metabolism/Excretion: Mostly metabolized by the liver via the cytochrome P450 (CYP) system (primarily CYP2C19 isoenzyme, but also the CYP3A4 isoenzyme); the CYP2C19 enzyme system exhibits genetic polymorphism (15–20% of Asian patients and 3–5% of Caucasian and Black patients may be poor metabolizers and may have significantly ↑ omeprazole concentrations and an ↑ risk of adverse effects); inactive metabolites are excreted in urine (77%) and feces.
Half-life: 0.5–1 hr (↑ in liver disease to 3 hr).
Contraindicated in:
Use Cautiously in:
CV: chest pain.
Derm: cutaneous lupus erythematosus, itching, rash.
F and E: hypomagnesemia (especially if treatment duration 3 mo).
GI: CLOSTRIDIOIDES DIFFICILE-ASSOCIATED DIARRHEA (CDAD), abdominal pain, acid regurgitation, constipation, diarrhea, flatulence, fundic gland polyps, nausea, vomiting.
GU: acute tubulointerstitial nephritis.
Hemat: vitamin B12 deficiency.
MS: bone fracture.
Neuro: dizziness, drowsiness, fatigue, headache, weakness.
Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS, ANGIOEDEMA, OR TUBULOINTERSTITIAL NEPHRITIS), systemic lupus erythematosus.
Drug-Drug:
Drug-Natural Products:
20 kg): GERD/erosive esophagitis — 20 mg once daily for 4–8 wk.10 kg): Erosive esophagitis — 10 mg once daily for up to 6 wk.(Generic available)
NDC Code*
