Losec

What is it?

A proton pump inhibitor (limits the enzyme responsible for the final stage of stomach acid secretion), available as film-coated, oblong tablets in 3 different strengths, all containing enteric coated pellets and marked with strength. Light pink tablets contain 10mg of omeprazole, darker pink tablets contain 20mg of omeprazole and brown-red tablets contain 40mg of omeprazole. Also, LOSEC CAPSULES, available in 3 different strengths, all containing enteric-coated granules. Pink capsules, marked A/OS and 10, contain 10mg of omeprazole; brown/pink capsules marked AIOM and 20, contain 20mg of omeprazole; brown capsules, marked AIOL and 40, contain 40mg of omeprazole. Also, LOSEC INFUSION, available as a powder in vials for reconstitution containing 40mg of omeprazole. Also, LOSEC INJECTION, available as a powder in vials with solvent containing 40mg of omeprazole.

Medical Uses

Tablets and capsules, GORD (oesophageal reflux disease), reflux oesophagitis, duodenal and benign gastric ulcers, prevention and treatment of ulcers caused by NSAIDs in susceptible patients, relief of symptoms of acid indigestion, additional treatment with antibiotics to eliminate H. pylori in duodenal and stomach ulcers, Zollinger-Ellison (ZE) syndrome, in patients undergoing general anaesthesia, to prevent acid aspiration. Infusion and injection, prevention of aspiration of acid in patients undergoing general anaesthesia, short-term treatment of duodenal or stomach ulcers and reflux oesophagitis in patients unable to take tablets or capsules.

Dosage

Adults, tablets or capsules: CORD, 20mg once each day for 4 weeks in first instance, then for further 4 to 8 weeks, if necessary, until completely healed. In cases that do not respond, 40mg can be taken. Acid-reflux, 10mg once each day for longterm treatment, increasing to 20mg once each day if flare-up occurs. Ulcers associated with NSAIDs, 20mg once each day. Acid indigestion, 10 to 20mg once each day for 2 to 4 weeks at first and then evaluate/investigate if response is poor. To heal a duodenal ulcer, usually 20mg (40mg in severe cases) once each day for 4 weeks; prevention of relapse, 10mg once each day, increasing to 20mg if relapse occurs. As component of triple therapy in duodenal ulcer to eliminate H. pylori, 40mg once each day or 20mg twice each day with 500mg of amoxycillin and 400mg of metronidazole, both 3 times each day for 1 week. Or, with 250mg of clarithromycin and 400mg of metronidazole twice each day for 1 week. Or, lg of amoxycillin and 500mg of clarithromycin 3 times each day for 2 weeks. As component of dual therapy in duodenal ulcer for elimination of H. pylori, 20mg twice each day or 40mg once each day with 750mg to lg of amoxycillin twice each day for 2 weeks, or with 500mg of clarithromycin 3 times each day for 2 weeks. Treatment of stomach ulcer, usually 20mg (40mg in severe cases) once each day for 8 weeks. As component of dual therapy in stomach ulcer to eliminate H. pylori, 20mg twice each day or 40mg once each day with 750mg to 1 g of amoxycillin twice each day for2 weeks. Z-E syndrome, 60mg onceeach day at first then adjusted according to response. Usual maintenance is in order of 20 to 120mg each day with higher doses over 80mg given as 2 divided doses. Prevention of acid aspiration in anaesthesia, 40mg on the night before surgery then 40mg 6 to 2 hours before operation. Children over 2 years, for treatment of severe GORD with ulceration only, 0.7 to 1.4mg per kg of body weight each day for 1 to 3 months with a maximum daily dose of 40mg. Adults, infusion or injection, prevention of acid aspiration in patients undergoing anaesthesia, 40mg by slow intravenous injection or infusion 1 hour before operation. Other conditions, 40mg once each day in same way for a maximum of 5 days. Not for children.

Special Care

Liver disease, in suspected stomach ulcer, malignancy must be excluded prior to treatment.

Avoid Use

Children (except for GORD), pregnancy, breastfeeding.

Possible Drug and Food Interactions

Warfarin, ketoeonazole, digoxin, phenytoin, itraconazole, diazepam.

Known Side Effects

Dizziness, headache, skin rashes, gastrointestinal upset, muscle and joint pains, sleepiness, numbness/tingling/'pins and needles' extremities, raised liver enzymes, risk of infections in gastrointestinal tract. Any adverse side effects with infusion must be reported to the Committee on the Safety of Medicines (CSM).