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Omeprazole: Difference between revisions

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<!-- Pharmacokinetic data -->
| bioavailability= 35–76%<ref>{{cite web | title=Prilosec- omeprazole magnesium capsule, delayed release Prilosec- omeprazole magnesium granule, delayed release | website=DailyMed | date=22 December 2016 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a1b077e6-b070-43f2-a98e-380cc635419d | access-date=15 February 2020 | archive-date=27 December 2019 | archive-url=https://web.archive.org/web/20191227184048/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a1b077e6-b070-43f2-a98e-380cc635419d | url-status=live }}</ref><ref>{{cite journal | vauthors = Vaz-da-Silva M, Loureiro AI, Nunes T, Maia J, Tavares S, Falcão A, Silveira P, Almeida L, Soares-da-Silva P | display-authors = 6 | title = Bioavailability and bioequivalence of two enteric-coated formulations of omeprazole in fasting and fed conditions | journal = Clinical Drug Investigation | volume = 25 | issue = 6 | pages = 391–399 | year = 2005 | pmid = 17532679 | doi = 10.2165/00044011-200525060-00004 | url = http://www.medscape.com/viewarticle/508018 | url-status = live | access-date = 21 October 2018 | s2cid = 22082780 | archive-url = https://web.archive.org/web/20130313204630/http://www.medscape.com/viewarticle/508018 | archive-date = 13 March 2013 }}</ref>
| protein_bound = 95%
| metabolism = [[Liver]] ([[CYP2C19]], [[CYP3A4]])
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===Peptic ulcers===
Peptic ulcers may be treated with omeprazole. Infection with ''[[Helicobacter pylori]]'' can be treated by taking omeprazole, [[amoxicillin]], and [[clarithromycin]] together for 7–14 days.<ref>{{cite journal | vauthors = Fuccio L, Minardi ME, Zagari RM, Grilli D, Magrini N, Bazzoli F | title = Meta-analysis: duration of first-line proton-pump inhibitor based triple therapy for Helicobacter pylori eradication | journal = Annals of Internal Medicine | volume = 147 | issue = 8 | pages = 553–562 | date = October 2007 | pmid = 17938394 | doi = 10.7326/0003-4819-147-8-200710160-00008 | s2cid = 11644009 }}</ref> Amoxicillin may be replaced with [[metronidazole]] in patients who are allergic to penicillin.<ref name="Maastricht_2_Consensus_Report">{{cite journal | vauthors = Malfertheiner P, Megraud F, O'Morain C, Bazzoli F, El-Omar E, Graham D, Hunt R, Rokkas T, Vakil N, Kuipers EJ | display-authors = 6 | title = Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report | journal = Gut | volume = 56 | issue = 6 | pages = 772–781 | date = June 2007 | pmid = 17170018 | pmc = 1954853 | doi = 10.1136/gut.2006.101634 }}</ref>
 
==Adverse effects==
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There is a possible association between long term use and dementia which requires further study to confirm.<ref>{{cite journal | vauthors = Eusebi LH, Rabitti S, Artesiani ML, Gelli D, Montagnani M, Zagari RM, Bazzoli F | title = Proton pump inhibitors: Risks of long-term use | journal = Journal of Gastroenterology and Hepatology | volume = 32 | issue = 7 | pages = 1295–1302 | date = July 2017 | pmid = 28092694 | doi = 10.1111/jgh.13737 | doi-access = free }}</ref>
 
A review article in ''[[U.S. Pharmacist]]'' in 2013 states that long-term use of PPIs is associated with [[Hypocalcaemia|decreased calcium absorption]] (causing increased risk of [[osteoporosis]] and [[Bone fracture|fractures]]), [[Magnesium deficiency|decreased magnesium absorption]] (causing [[Electrolyte imbalance|electrolyte disturbances]]), and increased risk of certain infections such as ''[[C. difficile]]'' and [[community-acquired pneumonia]]. They hypothesize that this is due to decreased stomach acid production.<ref>{{Citecite journal | vauthors = O'Neill LW, Culpepper BL, Galdo JA |title=Long-Term Consequences of Chronic Proton Pump Inhibitor Use | journal = US Pharmacist | date = 2013 | volume = 38 | issue = 12 | pages = 38–42 |url= https://www.uspharmacist.com/article/longterm-consequences-of-chronic-proton-pump-inhibitor-use|access-date=28 December 2020 |archive-date=21 January 2021|archive-url=https://web.archive.org/web/20210121163435/https://www.uspharmacist.com/article/longterm-consequences-of-chronic-proton-pump-inhibitor-use|url-status=live}}</ref>
 
===Pregnancy and breastfeeding===
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==History==
{{main|Discovery and development of proton pump inhibitors }}
Omeprazole was first made in 1979 by Swedish AB Hässle, part of [[Astra AB]]. It was the first of the proton pump inhibitors (PPI).<ref>{{Citecite web|url=https://apps.who.int/medicinedocs/en/d/Js4915e/2.5.html|archive-url=https://web.archive.org/web/20101002080328/http://apps.who.int/medicinedocs/en/d/Js4915e/2.5.html|url-status=dead|archive-date=2 October 2010|title=Trends in Drug Patenting - Case Studies: THE CASES: 5. OMEPRAZOLE|website=apps.who.int|access-date=22 August 2019}}</ref><ref name="Fellenius 1981">{{cite journal | vauthors = Fellenius E, Berglindh T, Sachs G, Olbe L, Elander B, Sjöstrand SE, Wallmark B | title = Substituted benzimidazoles inhibit gastric acid secretion by blocking (H+ + K+)ATPase | journal = Nature | volume = 290 | issue = 5802 | pages = 159–161 | date = March 1981 | pmid = 6259537 | doi = 10.1038/290159a0 | s2cid = 4368190 | bibcode = 1981Natur.290..159F }}</ref> [[Astra AB]], now AstraZeneca, launched it as an ulcer medicine under the name Losec in Sweden. It was first sold in the United States in 1989 under the brand name Losec. In 1990, at the request of the [[Food and Drug Administration|U.S. Food and Drug Administration]], the brand name Losec was changed to Prilosec to avoid confusion with the [[diuretic]] Lasix ([[furosemide]]).<ref name=farley>{{cite journal | vauthors = Farley D | title = Making it easier to read prescriptions | journal = FDA Consumer | volume = 29 | issue = 6 | pages = 25–27 | date = July–August 1995 | pmid = 10143448 | url = http://www.thebody.com/content/art13913.html | url-status = dead | access-date = 26 January 2011 | archive-url = https://web.archive.org/web/20120315172345/http://www.thebody.com/content/art13913.html | archive-date = 15 March 2012 }}</ref> The new name led to confusion between omeprazole (Prilosec) and [[fluoxetine]] (Prozac), an [[antidepressant]].<ref name=farley />
 
==Society and culture==
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application of two different coatings to a drug in pill form to ensure, that the omeprazole did not disintegrate before reaching its intended site of action in stomach. Although the solution by means of two coating was obvious, the patent was found valid, because the source of the problem was non-obvious and was discovered by the patentee.<ref>{{cite web | url=https://scholar.google.com/scholar_case?case=12553883911671736992&q=+In+re+Omeprazole+Patent+Litigation&hl=en&as_sdt=40000003 | title=IN RE OMEPRAZOLE PATENT LITIGATION, Court of Appeals, Federal Circuit 2011 - Google Scholar }}</ref>
 
In September 2023, AstraZeneca announced it would pay $425 million to settle product liability litigations against Prilosec in the United States.<ref>{{Citecite news |date=3 October 2023 |title=AstraZeneca to pay $425 mln to settle Nexium, Prilosec litigation in US |work=Reuters |url=https://www.reuters.com/legal/astrazeneca-pay-425-mln-settle-nexium-prilosec-litigation-us-2023-10-03/ |access-date=3 October 2023}}</ref>
=== Brand names ===