The usual recommended dose of omeprazole is 10 mg to 40 mg once daily.

The dose and length of

treatment depends on the condition being treated. This medication can be taken with or without food.

To treat ulcers in the stomach, reflux esophagitis, and ulcers associated with the use of
NSAIDs, the recommended adult dose is 20 mg taken once daily for 4 to 8 weeks.

When used to treat stomach ulcers caused by H. pylori in adults, the dose of omeprazole is 20 mg
twice daily taken with amoxicillin 1,000 mg twice daily and clarithromycin 500 mg twice daily, all for 7
days. Another dosing regimen for H. pylori infections is omeprazole 20 mg, metronidazole 500 mg, and
clarithromycin 250 mg, all twice daily for 7 days.

Are any nutrients depleted by this medication?

Some medications can affect vitamin and nutrient levels in the body. Below is a list of nutrient depletions
associated with this medication. Talk to your doctor or pharmacist about whether taking a supplement is
recommended or if you have any questions or concerns.

Losec may deplete vitamin B12

How can this nutrient deficiency impact me?

Vitamin B12, also known as cyancobalamin or cobalamin, is involved in the body's metabolism, DNA
synthesis, and red blood cells. It also helps maintain the nervous system. Vitamin B12 deficiency is most
common in people on meatless diets since it is not found in grains, fruits, or vegetables. Talk to your
Rexall Pharmacist about vitamin B12 deficiency. Vitamin B12 is available as a supplement, such as Be
Better Vitamin B12. Before starting any nutrient supplement, always talk with your Rexall Pharmacist.

Losec may deplete magnesium

How can this nutrient deficiency impact me?

Magnesium is a nutrient important to the body's metabolism, energy production, and detoxification. It also
is involved in the production of some hormones as well as healthy bones and teeth. Magnesium helps to
control blood pressure and maintain heart health. Magnesium deficiency can increase the risk of stomach
disorders, osteoporosis, high blood pressure, stroke, and heart attack. Magnesium is available in
supplements such as Rexall Magnesium Citrate. Before starting any nutrient supplement, always talk
with your Rexall Pharmacist.
Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or
allergies you may have, any medications you are taking, whether you are pregnant or breast-
feeding, and any other significant facts about your health. These factors may affect how you
should use this medication.

Diarrhea: When gastric acid is decreased, the number of bacteria normally in the digestive system
increases. Occasionally, this can cause serious infection in the digestive tract. If you experience watery,
foul-smelling bowel movements after starting to take omeprazole, contact your doctor as soon as
possible.

Fluid and electrolyte balance: Omeprazole, like other PPIs, may cause the levels of electrolytes such
as potassium, sodium, magnesium, chloride, and calcium in the blood to change while taking this
medication. If you experience symptoms of fluid and electrolyte imbalance such as muscle pains or
cramps; dry mouth; numb hands, feet, or lips; or racing heartbeat, contact your doctor as soon as
possible. Your doctor will do blood tests regularly to monitor the levels of these electrolytes in your blood
while you are taking this medication.

Liver disease: People with severe liver disease should generally not take more than 20 mg of
omeprazole daily.

Methotrexate interaction: Omeprazole, like other medications in this group, may interact with
methotrexate when the two medications are used at the same time. This combination may lead to higher
than expected amounts of methotrexate in the body and can cause serious side effects, including kidney
damage, irregular heartbeat, anemia, or infection. If you take omeprazole and are also going to receive a
dose of methotrexate, discuss with your doctor how this medication may affect your medical condition,
how your medical condition may affect the dosing and effectiveness of this medication, and whether any
special monitoring is needed.

Osteoporosis-related fractures: Studies suggest that the use of omeprazole, like other PPIs may be
related to an increase risk of fractures, particularly for people who take this medication for a year or
longer. The lowest dose of this medication to control the symptoms, taken for the shortest period of time is
less likely to cause these problems.

Severe stomach problems: If you have recurrent vomiting, difficulty swallowing, blood in the stool,
coughing up of blood, or significant unintentional weight loss, check with your doctor immediately.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks.
If you become pregnant while taking this medication, call your doctor immediately.

Breast-feeding: It is not known if omeprazole passes into breast milk. If you are a breast-feeding mother
and are taking this medication, it may affect your baby. Talk to your doctor about whether you should
continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

Seniors: Using the same dosage, seniors reach higher blood levels of omeprazole than younger people.
Therefore, seniors may need to take reduced doses and should generally not take more than 20 mg of
omeprazole daily.

What other drugs could interact with this medication?

There may be an interaction between omeprazole and any of the following:

amphetamines (e.g., dextroamphetamine, mesalamine

lisdexamphetamine)
methotrexate
"azole" antifungals (e.g., itraconazole,
ketoconazole, voriconazole) methylphenidate

benzodiazepines (e.g., alprazolam, moclobemide

diazepam, lorazepam)
multivitamins with iron, folate
bisphosphonates (e.g., alendronate,
etidronate) mycophenolate

bortezomib nelfinavir

bosutinib nilotinib

carbamazepine other proton pump inhibitors (e.g.,

esomeprazole, lansoprazole)
carvedilol
peginterferon Alfa-2b
citalopram
pentamidine
clopidogrel
 clozapine phenobarbital

cyclosporine phenytoin

dabigatran pimozide

dabrafenib ponatinib

dasatinib progesterone

desogestrel raltegravir

delavirdine rifampin

dexmethylphenidate "statin" anti-cholesterol medications (e.g.,

atorvastatin, lovastatin, simvastatin)
erlotinib
St. John's wort
escitalopram
tacrolimus
HIV protease inhibitors (e.g., atazanavir,
indinavir, ritonavir, saquinavir) tricyclic antidepressasnts (e.g., amitriptyline,
clomipramine, desipramine, trimipramine)
ifosfamide
vismodegib
iron salts (e.g., ferrous fumarate, ferrous
sulphate) warfarin