Buy Prilosec Online

Prilosec (omeprazole)

THERAPEUTIC CLASS

Proton pump inhibitor (PPI)

DEA CLASS

RX

INDICATIONS

Short-term treatment of active duodenal ulcer (DU) and active benign gastric ulcer in adults. Treatment of heartburn and other symptoms associated with GERD in adults and pediatric patients. Short-term treatment and maintenance of healing of erosive esophagitis in adults and pediatric patients. Long-term treatment of pathological hypersecretory conditions (eg, Zollinger-Ellison syndrome, multiple endocrine adenomas, systemic mastocytosis) in adults. Combination therapy with clarithromycin +/- amoxicillin in Helicobacter pylori infection and DU disease for H. pylori eradication in adults.

ADULT DOSAGE

Helicobacter pylori Eradication

Triple Therapy:
20mg + clarithromycin 500mg + amoxicillin 1000mg, each given bid x 10 days. Give additional 18 days of omeprazole 20mg qd if ulcer is present at the time of initiation of therapy

Dual Therapy:
40mg qd + clarithromycin 500mg tid x 14 days. Give additional 14 days of omeprazole 20mg qd if ulcer is present at the time of initiation of therapy

Active Duodenal Ulcer

20mg qd for 4-8 weeks

Gastroesophageal Reflux Disease

W/O Esophageal Lesions:
20mg qd for up to 4 weeks

W/ Erosive Esophagitis and Accompanying Symptoms:
20mg qd x 4-8 weeks

Erosive Esophagitis

Maint:
20mg qd

Gastric Ulcers

40mg qd x 4-8 weeks

Pathological Hypersecretory Conditions

Long-term Treatment:
Initial:
60mg qd
Titrate: Individualize and continue for as long as clinically indicated. Doses up to 120mg tid have been administered
Give >80mg/day in divided doses

PEDIATRIC DOSAGE

Erosive Esophagitis

Maint:
1-16 Years:
5-<10kg: 5mg/day
10-<20kg: 10mg/day
≥20kg: 20mg/day

Gastroesophageal Reflux Disease

1-16 Years:
5-<10kg: 5mg/day
10-<20kg: 10mg/day
≥20kg: 20mg/day

DOSING CONSIDERATIONS

Hepatic Impairment
Consider dose reduction, particularly for maint of healing of erosive esophagitis

Other Important Considerations
Asian Population:
Consider dose reduction, particularly for maint of healing of erosive esophagitis

ADMINISTRATION

Oral route

Take ac

Cap
Swallow whole or, alternatively, open cap and sprinkle all pellets on 1 tbsp of applesauce, then swallow immediately w/ a glass of cool water; do not chew or crush the pellets

Sus
Empty the contents of a 2.5mg pkt into 5mL of water or 10mg pkt into 15mL of water
Stir and leave 2-3 min to thicken
Drink w/in 30 min
If any material remains after drinking, add more water, stir and drink immediately
NG/Gastric Tube:
Add 5mL of water to a catheter-tipped syringe and then add the contents of a 2.5mg pkt (or 15mL of water for the 10mg pkt)
Immediately shake the syringe and leave 2-3 min to thicken
Shake the syringe and inject through the NG or gastric tube, French size 6 or larger, into the stomach w/in 30 min
Refill the syringe w/ an equal amount of water; shake and flush any remaining contents into the stomach

HOW SUPPLIED

Cap, Delayed-Release: 10mg, 20mg, 40mg; Sus, Delayed-Release: 2.5mg, 10mg (granules/pkt)

WARNINGS/PRECAUTIONS

Symptomatic response does not preclude the presence of gastric malignancy. Atrophic gastritis reported with long-term use. Acute interstitial nephritis reported; d/c if this develops. Cyanocobalamin (vitamin B12) deficiency may occur due to malabsorption with daily long-term treatment (eg, >3 yrs) with any acid-suppressing medications. May increase risk of Clostridium difficile-associated diarrhea (CDAD), especially in hospitalized patients. May increase risk for osteoporosis-related fractures of the hip, wrist, or spine, especially with high-dose and long-term therapy. Use lowest dose and shortest duration appropriate to the condition being treated. Hypomagnesemia reported and may require Mg2+ replacement and discontinuation of therapy. Drug-induced decrease in gastric acidity results in enterochromaffin-like cell hyperplasia and increased chromogranin A (CgA) levels, which may interfere with investigations for neuroendocrine tumors; temporarily d/c treatment at least 14 days before assessing CgA levels and consider repeating test if initial CgA levels are high.

ADVERSE REACTIONS

Headache, diarrhea, abdominal pain, N/V, flatulence.

DRUG INTERACTIONS

May reduce atazanavir and nelfinavir levels; concomitant use not recommended. May change absorption or levels of antiretrovirals. May reduce absorption of drugs where gastric pH is an important determinant of their bioavailability; ketoconazole, atazanavir, iron salts, erlotinib, and mycophenolate mofetil (MMF) absorption can decrease, while digoxin absorption can increase. Caution in transplant patients receiving MMF. May prolong elimination of drugs metabolized by oxidation in the liver (eg, diazepam, warfarin, phenytoin). Monitor patients taking drugs metabolized by CYP450 (eg, cyclosporine, disulfiram, benzodiazepines). Monitor for increases in INR and PT with warfarin. Voriconazole (a combined inhibitor of CYP2C19 and CYP3A4) may increase levels; consider dose adjustment with Zollinger-Ellison syndrome. Decreased levels with CYP2C19 or CYP3A4 inducers; avoid with St. John's wort or rifampin. Reduces pharmacological activity of clopidogrel; avoid concomitant use. May increase levels of saquinavir, cilostazol, and tacrolimus; consider saquinavir and cilostazol dose reduction. Caution with digoxin or other drugs that may cause hypomagnesemia (eg, diuretics). May elevate and prolong levels of MTX and/or its metabolite, possibly leading to toxicities; consider temporary withdrawal of therapy with high-dose MTX.

PREGNANCY AND LACTATION

Category C, caution in nursing.

MECHANISM OF ACTION

Proton pump inhibitor; substituted benzimidazole that suppresses gastric acid secretion by specific inhibition of the H+/K+ ATPase enzyme system at the secretory surface of the gastric parietal cell.

PHARMACOKINETICS

Absorption: Rapid. Absolute bioavailability (30-40%); Tmax=0.5-3.5 hrs. Distribution: Plasma protein binding (95%); found in breast milk. Metabolism: Extensive via CYP450. Elimination: Urine (77%, metabolites), feces; T1/2=0.5-1 hr.

ASSESSMENT

Assess for hypersensitivity to the drug or to substituted benzimidazoles, risk for osteoporosis-related fractures, hepatic impairment, pregnancy/nursing status, and possible drug interactions. Obtain baseline Mg2+ levels in patients expected to be on prolonged therapy.

MONITORING

Monitor for signs/symptoms of atrophic gastritis, acute interstitial nephritis, cyanocobalamin deficiency, bone fractures, hypersensitivity reactions, CDAD, and other adverse reactions. Monitor Mg2+ levels periodically in patients expected to be on prolonged therapy. Monitor INR and PT when given with warfarin.

PATIENT COUNSELING

Advise to immediately report and seek care for diarrhea that does not improve and for any cardiovascular/neurological symptoms. Inform of alternative administration options if patient has difficulty swallowing.

STORAGE

(Cap) 15-30°C (59-86°F). Protect from light and moisture. (Sus) 25°C (77°F); excursions permitted to 15-30°C (59-86°F).

TAGS

cheap prilosec, prilosec omeprazole 20 mg, buy omeprazole online uk, coupons for prilosec, omeprazole cost, prilosec otc coupons printable, order omeprazole online, prilosec otc ship to canada, prilosec coupons printable, 20 mg omeprazole, how much does prilosec otc cost, prilosec 20 mg, cheap prilosec from india, prilosec 20mg, what is prilosec otc used for, prilosec 40 india no prescription, 20 mg prilosec, prilosec otc printable coupon, what is prilosec for, coupon for prilosec otc, purchase prilosec, omeprazole capsule, prilosec coupon, omeprazole mg, printable prilosec coupons, omeprazole online, price of prilosec otc, printable coupon for prilosec, when to take prilosec otc, buy cheap prilosec, omeprazole 40 mg, cost of omeprazole, omeprazole otc, prilosec 20 mg otc, buy prilosec otc online, prilosec otc 20.6 mg, prilosec otc mg, prilosec otc coupon printable, buy prilosec online, where to buy prilosec, prilosec 10 mg, omeprazole 10 mg, coupon prilosec, prilosec otc coupons, prilosec cheap, prilosec australia, prilosec otc 20 mg, prilosec mg, prilosec and omeprazole, order prilosec, prilosec 40 mg, ranitidine omeprazole, omeprazole prices, omeprazole 40, otc omeprazole, omeprazole prilosec, order omeprazole, prilosec coupons, omeprazole tablet, what is prilosec otc, omeprazole cheap, online prilosec, buy omeprazole cheap, omeprazole buy online, prilosec from india, prilosec otc omeprazole, price of omeprazole, cheap omeprazole, what is prilosec good for, what is prilosec, buy cheap omeprazole, prilosec coupon printable, 40 mg prilosec, prilosec price, prilosec purchase, omeprazole to buy, prilosec buy, prilosec printable coupon, coupons for prilosec otc, coupons prilosec, online pharmacy prilosec, buy omeprazole, omeprazole 40mg, withdrawal symptoms of prilosec, prilosec without prescription, aciphex vs prilosec otc, omeprazole price, cost of prilosec otc, buy prilosec, prilosec otc canada, 40 mg omeprazole, order prilosec online, how to take prilosec otc, prilosec 10 mg otc, price of prilosec, omeprazole buy, prilosec, buy prilosec otc in canada, what is omeprazole, omeprazole tablets, prilosec 40 mg twice a day, prilosec otc cost, omeprazole online pharmacy, printable coupons for prilosec, printable coupons for prilosec otc, prilosec otc coupon, coupon for prilosec, prilosec otc price, prilosec otc prices, generic omeprazole, omeprazole and prilosec, prilosec otc, omeprazole 20 mg, purchase prilosec online, prilosec 20, purchase omeprazole online, prilosec online, lansoprazole omeprazole, prilosec non prescription drug, prilosec omeprazole, omeprazole order, omeprazole dr, otc prilosec, what is prilosec used for, purchase omeprazole, prilosec 40 mg otc, prilosec uk