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Omeprazole

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IDDRUG-OMEPRAZOLE
TipoFármaco
Alegais
PerdedoresOmezOrtanolPrilosecoОмепразол
Estadorevisto 2026-05-18
DoençasDIS-GASTRIC
FontesSRC-NCCN-BCELL-2025

Fatos sobre as drogas

ClasseInibidor da bomba de protão (IPP; benzimidazol substituído)
MecanismoProdrug 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.
Dose típicaH. 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.
Ucrânia registadaVerdade
NSZU reembolsadoFalso
Ucrânia verificada pela última vez2026-05-18

Notas

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.

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