Omeprazole: Effects, Uses & Risks

Diseases such as gastritis, peptic ulcer, or the use of medications that are harmful to the stomach may require the use of a stomach-protecting, acid-inhibiting agent. Modern medicine has a number of appropriate drugs available that work effectively and gently. One of the most commonly prescribed agents is omeprazole.

What is omeprazole?

The active ingredient omeprazole belongs to the group of proton pump inhibitors. Preparations made from this active ingredient are also called antacids (acid inhibitors) or ulcer therapeutics (medications used to treat ulcers). Proton pump inhibitors have a stomach-protecting effect because they prevent the formation of gastric acid in the stomach’s gastric cells. The best-known trade names include Omep and Antra MUPS. Omeprazole is now also marketed under its active ingredient name. It was first approved in 1989 by the pharmaceutical company AstraZeneca. Omeprazole is most commonly prescribed for oral use in adults in doses of 20mg or 40mg per tablet or capsule. The exact dosage is decided by the treating physician on a case-by-case basis. Omeprazole is one of the most commonly prescribed medications in Germany, with 13 million packs prescribed annually.

Pharmacologic effect

Pharmacokinetically (how the body handles the drug), it should be noted that omeprazole is an acid-sensitive agent, which is why the drug is always administered in enteric-coated form. In most cases, enteric-coated drugs must not be crushed or halved, as the active ingredient of the drug would otherwise be digested by gastric acid and could not be absorbed in the intestine. Through the intestine, it enters the bloodstream and only then reaches the gastric vestibular cells. After 1-3 hours, the effect in the body reaches its peak; omeprazole has reached its half-life after about 45 minutes. As with most medications, excretion of the active ingredient occurs via the liver. Pharmacodynamically (mode of action of the drug in the body), it can be said that omeprazole acts directly on the acid-producing occupancy cells of the stomach and in this way inhibits the proton potassium ATPase. For optimal effect, omeprazole is usually taken on an empty stomach along with a sip of water.

Medicinal use and application

As an effective drug with few side effects, omeprazole is used in the treatment of numerous inflammatory or ulcerative diseases of the gastrointestinal tract or even for prophylaxis. It is used for both chronic and acute disease processes. These include inflammation of the gastric mucosa (gastritis), often caused by the bacterium Helicobacter pylori, gastric ulcer (ulcus ventriculi), duodenal ulcer (ulcus duodeni), inflammation of the esophagus caused by persistent heartburn (reflux esophagitis), and Zollinger-Ellison syndrome, a hormonal disorder that stimulates the stomach to produce excessive amounts of salt. Some medications, for example painkillers (non-steroidal anti-inflammatory drugs) such as paracetamol or acetylsalicylic acid (ASA/Aspirin), cortisone and numerous antibiotics, can damage the stomach lining. Here, omeprazole is often administered prophylactically. Omeprazole is usually administered in the form of capsules, tablets and infusions are also used. Omeprazole should not be taken for more than 14 days.

Risks and side effects

Like all prescription medications, taking omeprazole may be associated with risks and side effects. For this reason, omeprazole should never be taken without an explicit doctor’s instructions. The active ingredient is generally considered to be very well tolerated, which is why side effects are rare. Nevertheless, changes in liver function, fatigue and exhaustion, joint pain, dizziness, sleep disturbances, hair loss, skin reactions, constipation, forgetfulness, and vitamin B12 deficiency may occur. Further, gastrointestinal tract disorders may occur. Serious side effects such as hepatitis, Stevens-Johnson syndrome or pancreatitis occur very rarely. Due to adverse drug interactions, omeprazole should not be taken with clopidogrel, atazanavir, astemizole, carbamazepine, cisapride, or clarithromycin. Vitamin K antagonists and benzodiazepines also interact with omeprazole.Use is contraindicated in cases of hypersensitivity to the active ingredient. It is currently under discussion whether omeprazole promotes bacterial diseases such as pneumonia, which has not yet been clearly proven. Long-term use has been shown to increase the risk of bone fractures because proton pump inhibitors can decrease calcium absorption.