Drug Lesson #2: Omeprazole
It’s time for another drug lesson! This medication is pretty standard in the pharmacy world; at least 53.4 million prescriptions of omeprazole are prescribed yearly. Today, I will provide all the information you need to know about this drug, including helpful counseling points!
What is omeprazole?
Omeprazole belongs to a class of medications called proton pump inhibitors (PPIs). Another name for a proton pump is H+/K+ ATPase. Let’s break this down: an ATPase is a type of enzyme that uses ATP (adenosine triphosphate) to do its job. An H+/K+ ATPase is an enzyme that uses ATP to transport H+ (hydrogen) out of the cell and K+ (potassium) into the cell.
The proton pump will transport H+ from the parietal cell to the stomach lumen. Since hydrogen is technically a single proton, a whole bunch of hydrogens in one place can create a very acidic environment. The pH of the stomach is between 1 and 3, which makes it one of the most acidic environments in your body. Omeprazole inhibits this enzyme, so no H+ is getting into the stomach.
When do we use it?
The FDA approved omeprazole for conditions such as GERD (gastroesophageal reflux disease), ulcers, and Helicobacter pylori infections.
GERD is a disease where the contents of your stomach reflux into your esophagus. This causes burning in your chest, regurgitation, and an acid taste in the mouth. Omeprazole works by reducing the amount of acid in the stomach to relieve GERD symptoms and prevent damage to the esophagus.
Ulcers are breaks in the protective lining of your GI tract that causes stomach pain and possible bleeding. Omeprazole also works to treat a GI ulcer by the exact mechanisms stated above.
Infections like Helicobacter pylori are one of the most common causes of GI ulcers. Physicians treat these infections with a triple or quadruple therapy regimen, and omeprazole is a component of both.
What about the side effects?
The side effects of medications like omeprazole include mostly GI effects like nausea, flatulence, and diarrhea. The concerns become more serious when taking long term. Patients who are on PPIs for years can develop vitamin B12 deficiency as well as osteoporosis.
PPI can interfere with calcium absorption in the GI tract, which leads to osteoporosis, possible pneumonia, and Clostridium difficule infections. Monitoring calcium and vitamin B12 levels are essential for patients on long-term PPI use. Additionally, PPIs like omeprazole can lower Magnesium (Mg) levels in the blood, so monitoring those levels are crucial.
When should a patient not be taking omeprazole?
The first rule which accompanies all drugs is a possible allergic reaction. Stop the medication immediately if you notice swelling, hives, or difficulty breathing. Adding onto that, omeprazole is contraindicated for use with any medicinal products containing rilpivirine. Rilpivirine is an antiviral medication that prevents HIV from traveling in the body.
Can pregnant people take omeprazole?
Omeprazole is considered a pregnancy Category C medication. That means that there were some risks associated with the mother/fetus in animal trials, but there hasn’t been any official clinical evidence of safety in human trials. Prescribing omeprazole for a pregnant patient would be at the discretion of the provider and the patient.
Extra Tips!
- make sure to take omeprazole before meals for the best absorption
- if taking delayed-release capsules, do not crush or chew
- please get in touch with your physician as soon as you experience diarrhea for more than a week
- Monitor vitamin B12, Mg, and Ca levels periodically