Omeprazole

Omeprazole is a proton pump inhibitor (ppi) medicine available in Bangladesh under many brand names. Below are its uses, side effects and precautions — and every brand with its current price.

• Gastric and duodenal (peptic) ulcers
• Gastro-oesophageal reflux disease (GERD) and reflux oesophagitis
• Heartburn, acidity and acid regurgitation
• Helicobacter pylori eradication with antibiotics, as prescribed
• Prevention and treatment of NSAID-associated ulcers
• Zollinger-Ellison syndrome and other hypersecretory conditions
• Acid-related dyspepsia, when advised by a doctor

Omeprazole is generally well tolerated. The most common side effects are headache, abdominal pain, nausea, vomiting, flatulence, diarrhoea and constipation. These are usually mild and often improve as treatment continues.

Less frequently, people may notice dizziness, skin rash, itching or sleep disturbance. Prolonged use (usually more than a year) has been associated with low magnesium, vitamin B12 deficiency, slightly increased fracture risk and a higher chance of gut infections such as Clostridioides difficile. Stopping abruptly after long use can cause temporary rebound acid symptoms. Get urgent help for swelling of the face or throat, severe skin reactions or persistent watery diarrhoea.

Tell your doctor before starting omeprazole if you have liver disease, low magnesium, osteoporosis or previous gut infections. Alarm symptoms such as unintentional weight loss, repeated vomiting, vomiting blood, black stools or difficulty swallowing should be investigated before or during treatment, because acid suppression can hide serious stomach conditions including malignancy.

Use the lowest dose that controls symptoms for the shortest necessary time, and review any long-term use with your doctor. Long courses may need periodic checks of magnesium and vitamin B12. Avoid stopping a long course suddenly. Supporting habits help: eat on time, avoid late heavy meals, limit smoking, and reduce excessive tea, coffee and spicy oily food.

Omeprazole interacts with a number of medicines. It can reduce the effectiveness of clopidogrel, so this combination is generally avoided. By reducing stomach acid it lowers absorption of ketoconazole, itraconazole, iron salts and some HIV medicines such as atazanavir and nelfinavir.

It can raise blood levels of diazepam, phenytoin, warfarin (increasing bleeding risk), methotrexate, digoxin and tacrolimus, sometimes requiring dose adjustment or monitoring. Rifampicin and St John's Wort can reduce omeprazole's effect and should be avoided with it. Always give your doctor and pharmacist a complete list of your medicines, including over-the-counter products and supplements.

Omeprazole is contraindicated in people with known hypersensitivity to omeprazole, other proton pump inhibitors or any component of the formulation. A previous allergic reaction such as rash, facial swelling or breathing difficulty after any PPI means it should not be taken again without specialist advice.

It must not be used with rilpivirine-containing HIV regimens, and combining it with atazanavir or nelfinavir is not recommended. Concomitant use with clopidogrel is generally avoided. In severe liver impairment, lower doses and medical supervision are required. Confirm with your doctor that omeprazole is appropriate for you before starting.

Pregnancy: Omeprazole has been used in pregnancy for many years and available data do not show clear harm to the baby. Even so, it should only be taken when a doctor considers it necessary, at the lowest effective dose. Lifestyle measures and antacids are usually preferred first for heartburn in pregnancy.

Lactation: Omeprazole passes into breast milk in small amounts and is generally considered compatible with breastfeeding, but it should still be used under medical advice. Tell your doctor if your breastfed baby seems unusually sleepy or feeds poorly while you are taking it.

Store below 30°C in a dry place away from direct sunlight, heat and moisture. Keep the in its original blister or container until you take it, as the coating is sensitive to humidity. Keep out of the reach and sight of children. Do not use beyond the expiry date on the packaging, and dispose of unused medicine safely, preferably through a pharmacy.