Diseases such as inflammation of the gastric mucosa, gastric ulcer or the use of drugs that are harmful to the stomach can make it necessary to take a stomach-protecting, acid-inhibiting agent. Modern medicine has a number of corresponding drugs available that are effective and gentle. One of the most commonly prescribed active ingredients 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 known as antacids (acid inhibitors) or ulcer therapeutic agents (drugs used to treat ulcers). Proton pump inhibitors have a gastric protective effect because they prevent the formation of stomach acid in the parietal cells of the stomach.
The best-known trade names include Omep® and Antra MUPS®. Omeprazole is meanwhile also sold 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 the dose of 20 mg or 40 mg per tablet or capsule. The attending physician will decide on the exact dosage in each individual case. With 13 million packs, omeprazole is one of the drugs most frequently prescribed in Germany each year.
Pharmacological effect
Pharmacokinetically (how the body handles the drug), it should be noted that omeprazole is an acid-sensitive active ingredient, which is why the drug is always administered in an enteric form. In most cases, gastric juice-resistant agents must not be ground in a mortar or halved, as the active ingredient of the drug can otherwise be digested by the stomach acid and not absorbed in the intestine.
It enters the bloodstream via the intestine and only then reaches the parietal cells of the stomach. The effect in the body reaches its peak after 1-3 hours; omeprazole reaches its half-life after approx. 45 minutes. As with most drugs, the active ingredient is excreted via the liver.
Pharmacodynamically (how the drug works in the body) it can be said that omeprazole acts directly on the acid-producing parietal cells of the stomach and in this way inhibits proton potassium ATPase. For best results, omeprazole is usually taken on an empty stomach with a sip of water.
Medical application & use
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 illnesses. These include gastritis, often caused by the bacterium Helicobacter pylori, gastric ulcer (Ulcus ventriculi), duodenal ulcer (Ulcus duodeni), inflammation of the esophagus due to permanent heartburn (reflux esophagitis) and Zollinger-Ellison syndrome, a which stimulates the stomach to produce excessive salt.
Some medications, for example pain relievers (non-steroidal anti-inflammatory drugs) such as paracetamol or acetylsalicylic acid (ASS® / Aspirin®), cortisone and numerous antibiotics, can damage the gastric mucosa. Here omeprazole is often administered prophylactically.
Omeprazole is usually given in the form of capsules, tablets and infusions are also used. Omeprazole should not be taken for more than 14 days.
Risks & side effects
As with all prescription drugs, omeprazole can be associated with risks and side effects. For this reason, omeprazole should never be taken without express medical advice. The active ingredient is generally very well tolerated, which is why there are seldom side effects. However, changes in liver function, tiredness and fatigue, joint pain, dizziness, sleep disorders, hair loss, skin reactions, constipation, forgetfulness and a vitamin B12 deficiency can occur.
Disorders of the gastrointestinal tract can also occur. Serious side effects such as hepatitis, Stevens-Johnson syndrome or inflammation of the pancreas (pancreatitis) are very rare.
Due to undesirable interactions with other active substances, omeprazole must not be taken together with clopidogrel, atazanavir, astemizole, carbamazepine, cisapride or clarithromycin. Vitamin K antagonists and benzodiazepines also interact with omeprazole.
In case of hypersensitivity to the active substance, use is contraindicated. The thesis currently under discussion is 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, as proton pump inhibitors can reduce calcium absorption.
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