Omeprazole

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`DRUG-OMEPRAZOLE`
Type	Drug
Aliases	LosecOmezOrtanolPrilosecОмепразол
Status	reviewed 2026-05-18
Diseases	`DIS-GASTRIC`
Sources	`SRC-NCCN-BCELL-2025`

Drug Facts

Class	Proton-pump inhibitor (PPI; substituted benzimidazole)
Mechanism	Prodrug that is acid-activated in the parietal cell secretory canaliculus to a sulfenamide cation, which forms a covalent disulfide bond with cysteine residues of the H+/K+-ATPase (proton pump) and irreversibly inhibits gastric acid secretion. New pump synthesis is required for recovery (≥24 h half-life of effect despite ~1 h plasma half-life). Cancer-prevention relevance: profound gastric acid suppression is required for H. pylori antimicrobial efficacy (clarithromycin and amoxicillin both require near-neutral gastric pH for stability and bactericidal activity) — PPI is the linchpin of triple / quadruple H. pylori eradication regimens.
Typical dosing	H. pylori eradication (component of triple therapy, adult): 20 mg PO BID × 14 days, taken 30-60 min before breakfast and dinner, with clarithromycin 500 mg BID + amoxicillin 1 g BID (or metronidazole 500 mg BID if penicillin-allergic). H. pylori quadruple (PBMT) therapy: 20 mg PO BID × 10-14 days with bismuth subcitrate + metronidazole + tetracycline. GERD / erosive esophagitis: 20-40 mg PO daily × 4-8 weeks. Duodenal ulcer: 20 mg PO daily × 4 weeks. Renal: no adjustment. Hepatic: reduce dose 50% in severe hepatic impairment (clearance ~⅓ normal). Long-term use carries risks (bone loss, B12 deficiency, hypomagnesemia, AKI, C. difficile) — limit duration where possible.
Ukraine registered	True
NSZU reimbursed	False
Ukraine last verified	2026-05-18

Notes

STUB — v0.2 prevention-workstream authoring; pending two-Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode. PPI is the linchpin of H. pylori triple and quadruple eradication therapy — without near-neutral gastric pH, clarithromycin is unstable and amoxicillin/tetracycline are less bactericidal. Standard 20 mg BID dose for 14 days in both triple and quadruple PBMT regimens. Critical interactions: clopidogrel (use pantoprazole instead), rilpivirine (contraindicated), high-dose methotrexate (hold), pH-dependent TKIs in oncology context (erlotinib, dasatinib, etc.). CYP2C19 poor metabolizer status (esp. Asian patients) → higher exposure and better H. pylori cure rates with standard doses; some experts dose PPI by genotype. Ukraine: cheap, OTC, ubiquitous, out-of-pocket. Long-term safety concerns (bone, B12, Mg, AKI, CDI, pneumonia) are largely irrelevant for a 14-day eradication course. Two-Co-Lead signoff queued for v0.2-A clinical review.

Used By

Access Pathways

AP-HP-ERADICATION-PHARMACY-OOP - H. pylori eradication (PPI + amox/clarithromycin / bismuth quadruple) — pharmacy out-of-p...

Regimens

REG-HP-BISMUTH-QUADRUPLE - Bismuth quadruple therapy (PBMT) — 14 days
REG-HP-PPI-CLAR-AMOX - PPI-clarithromycin-amoxicillin triple therapy — 14 days