Actions: potent proton pump inhibitor; suppresses gastric acid secretion by inhibiting the parietal cell H+/K+ ATP pump.
Indications: gastric acid hypersecretion conditions; gastritis; gastroesophageal reflux (GERD); erosive gastritis; peptic ulcer disease; prevention of acid aspiration pneumonitis during surgery. Dose (adult):
Duodenal ulcer: 20 mg/day PO for 4-8 weeks. GERD or severe erosive esophagitis: 20 mg/day for 4-8 weeks; maintenance therapy for erosive esophagitis: 20 mg/day. Gastric ulcer: 40 mg/day PO for 4-8 weeks. Pathological hypersecretory conditions: 60 mg PO once daily to start; doses up to 120 mg 3 times/day have been administered; administer daily doses >80 mg in divided doses. Dose (ped): 0.6-0.7 mg/kg/dose PO once daily; increase to 0.6-0.7 mg/kg/dose PO every 12 hrs if needed (effective range: 0.3-3.3 mg/kg/day). Clearance: extensive hepatic metabolism; 80% renal elimination.
Adverse effects: headache, diarrhea, nausea, vomiting.
Comments: induces some cytochrome P450 enzymes; increases half-life of diazepam, phenytoin, warfarin; may decrease absorption of itraconazole, ketoconazole, iron salts, ampicillin.; administer all doses before meals.
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