page76
. Zollinger-Ellison syndrome (and other hypersecretory
conditions),
initially 60 mg once daily adjusted
according to response; daily doses of 120 mg or more
given in two divided doses
. Gastro-oesophageal reflux disease, 30 mg daily in the
morning for 4 weeks, continued for further 4 weeks if
not fully healed;
maintenance 15–30 mg daily
. Acid-related dyspepsia, 15–30 mg daily in the morn-
ing for 2–4 weeks
.
CHILD
under 18 years see
BNF for Children
Note
Lansoprazole doses in BNF may differ
from those in
product literature
Lansoprazole
(Non-proprietary) A
Capsules
,
enclosing e/c granules, lansoprazole
15 mg,
net price 28-cap pack = £1.44;
30 mg,
28-cap
pack = £2.23.
Label:
5,
22,
25
Dental prescribing on NHS
Lansoprazole capsules may be
prescribed
Zoton
c
(Wyeth) A
FasTab
c
(= orodispersible tablet),
lansoprazole
15 mg,
net price 28-tab pack = £2.99;
30 mg,
28-tab
pack = £5.50. Label: 5, 22, counselling, administration
Excipients
include aspartame (section 9.4.1)
Counselling
Tablets should be placed on the tongue,
allowed to
disperse and swallowed, or may be swallowed whole with a glass
of water. Alternatively, tablets can be dispersed in a small amount
of water and administered by an oral
syringe or nasogastric tube
OMEPRAZOLE
Indications
see under Dose
Cautions
see notes above; interactions: Appendix 1
(proton pump inhibitors)
Hepatic impairment
not more than 20 mg daily
should be needed
Pregnancy
not known to be harmful
Breast-feeding
present in milk but not known to be
harmful
Side-effects
see notes above;
also agitation and
impotence
Dose
. By mouth, benign gastric and duodenal ulcers, 20 mg
once daily for 4 weeks in duodenal ulceration or 8
weeks in gastric ulceration; in severe or recurrent
cases increase to 40 mg daily;
maintenance for
recurrent duodenal ulcer,
20 mg once daily; preven-
tion of relapse in duodenal ulcer,
10 mg daily
increasing to 20 mg once daily if symptoms return
NSAID-associated duodenal or gastric ulcer and gas-
troduodenal erosions,
20 mg once daily for 4 weeks,
continued for further 4 weeks if not fully healed;
prophylaxis in patients with a history of NSAID-
associated duodenal or gastric ulcers, gastroduodenal
lesions,
or dyspeptic symptoms who require contin-
ued NSAID treatment,
20 mg once daily
Duodenal or benign gastric ulcer associated with
Helicobacter pylori
,
see eradication regimens on
p.
50
Zollinger–Ellison syndrome, initially 60 mg once daily;
usual range 20–120 mg daily (above 80 mg in 2
divided doses)
Gastric acid reduction during general anaesthesia
(prophylaxis of acid aspiration),
40 mg on the pre-
ceding evening then 40 mg 2–6 hours before surgery
Gastro-oesophageal reflux disease,
20 mg once daily
for 4 weeks,
continued for further 4–8 weeks if not
fully healed; 40 mg once daily has been given for 8
weeks in gastro-oesophageal reflux disease refractory
to other treatment;
maintenance 20 mg once daily
Acid reflux disease (long-term management),
10 mg
daily increasing to 20 mg once daily if symptoms
return
Acid-related dyspepsia, 10–20 mg once daily for 2–4
weeks according to response
Severe ulcerating reflux oesophagitis,
CHILD
over 1
year,
body-weight 10–20 kg,
10 mg once daily
increased if necessary to 20 mg once daily for 4–12
weeks; body-weight over 20 kg,
20 mg once daily
increased if necessary to 40 mg once daily for 4–12
weeks; to be initiated by hospital paediatrician
. By intravenous injection over 5 minutes
or
by intra-
venous infusion over 20–30 minutes,
prophylaxis of
acid aspiration, 40 mg completed 1 hour before sur-
gery
Benign gastric ulcer,
duodenal ulcer and gastro-
oesophageal reflux,
40 mg once daily until oral
administration possible
. Major peptic ulcer bleeding (following endoscopic
treatment) [unlicensed indication],
initial intravenous
infusion of 80 mg over 40–60 minutes,
then by con-
tinuous intravenous infusion, 8 mg/hour for 72 hours
(then change to oral therapy)
Counselling
Swallow whole,
or
disperse
MUPS
c
tablets in
water,
or
mix capsule contents or
MUPS
c
tablets with fruit
juice or yoghurt. Preparations consisting of an e/c tablet within
a capsule should not be opened
Omeprazole
(Non-proprietary) A
Capsules
, enclosing e/c granules, omeprazole 10 mg,
net price 28-cap pack = £1.81;
20 mg,
28-cap pack =
£1.92;
40 mg,
7-cap pack = £1.95,
28-cap pack =
£21.65.
Counselling,
administration
Dental
prescribing on NHS
Gastro-resistant
omeprazole
capsules may be prescribed
Capsules
,
enclosing e/c tablet,
omeprazole 10 mg,
net price 28-cap pack = £1.81;
20 mg,
28-cap pack =
£1.92.
Counselling,
administration
Brands include
Mepradec
c
Dental
prescribing on NHS
Gastro-resistant
omeprazole
capsules may be prescribed
1
Tablets
,
e/c,
omeprazole 10 mg,
net price 28-tab
pack = £5.84; 20 mg, 28-tab pack = £5.71; 40 mg, 7-tab
pack = £5.15.
Label:
25
Intravenous infusion
,
powder for reconstitution,
omeprazole (as sodium salt),
net price 40-mg vial =
£5.18
1.
Omeprazole 10 mg tablets can be sold to the public for the
short-term relief of reflux-like symptoms (e.g.
heartburn) in
adults over 18 years,
max.
daily dose 20 mg for max.
4
weeks,
and a pack size of 28 tablets
Losec
c
(AstraZeneca) A
MUPS
c
(multiple-unit pellet system = dispersible
tablets),
f/c,
omeprazole 10 mg (light pink),
net price
28-tab pack = £7.75;
20 mg (pink), 28-tab pack =
£11.60;
40 mg (red-brown),
7-tab pack = £5.80.
Counselling,
administration
Capsules
, enclosing e/c granules, omeprazole 10 mg
(pink),
net price 28-cap pack = £7.75;
20 mg (pink/
brown),
28-cap pack = £11.60;
40 mg (brown),
7-cap
pack = £5.80.
Counselling,
administration
Intravenous infusion
,
powder for reconstitution,
omeprazole (as sodium salt),
net price 40-mg vial =
£5.41
Injection
,
powder for reconstitution,
omeprazole (as
sodium salt),
net price 40-mg vial (with solvent) =
£5.41
With ketoprofen
Section 10.1.1
56
1.3.5 Proton pump inhibitors
BNF 61
1
Gastro-intestinal system