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Omeprazole infusion

Updated 2 Feb 2023 | Proton pump inhibitors


Powder for solution for infusion containing omeprazole (as omeprazole sodium)

Drugs List

  • omeprazole 40mg powder for solution for infusion
  • Therapeutic Indications


    Benign gastric and duodenal ulceration
    Gastric and/or duodenal ulcer associated with NSAIDs
    Gastric ulcer associated with Helicobacter pylori (with other drugs)
    Gastro-oesophageal reflux disease
    Healed oesophagitis
    Prevention of duodenal or benign gastric ulcer recurrence
    Zollinger-Ellison syndrome (and other hypersecretory conditions)

    Unlicensed Uses

    Fat malabsorption despite pancreatic enzyme replacement in cystic fibrosis
    Severe peptic ulcer bleeding



    40mg once daily by intravenous infusion, where the use of oral medicinal products is inappropriate.

    Zollinger-Ellison syndrome
    Initial dose: 60mg daily intravenously.
    If a higher dose is needed it must be determined individually. Doses over 60mg daily must be divided and given twice daily.

    Severe peptic ulcer bleeding (unlicensed)
    Initial dose: 80mg by intravenous infusion over 40 to 60 minutes.
    Maintenance dose: By continuous intravenous infusion, 8 mg/hour for 72 hours. Change to oral therapy when appropriate.


    Acid-related dyspepsia; Fat malabsorption despite pancreatic enzyme replacement in cystic fibrosis (unlicensed use); Gastro-oesophageal reflux disease; Treatment of duodenal and benign gastric ulcers including those complicating NSAID therapy; Zollinger-Ellison syndrome.

    Children aged 12 to 18 years (unlicensed)
    40mg once daily.
    Children 1 month to 12 years (unlicensed)
    Initial dose: 500micrograms/kg (up to 20mg per dose) once daily. Increase to 2mg/kg (up to 40mg per dose) once daily if necessary.

    Patients with Hepatic Impairment

    A daily dose of 10mg to 20mg may be appropriate due to the increased half-life of omeprazole in patients with hepatic impairment.


    For intravenous administration only.

    Infusion should be administered over 20 to 30 minutes.


    Neonates under 1 month
    Long QT syndrome
    Torsade de pointes

    Precautions and Warnings

    Children 1 month to 18 years
    Family history of long QT syndrome
    Electrolyte imbalance
    Hepatic impairment
    History of torsade de pointes

    Advise patient dizziness may affect ability to drive or operate machinery
    Advise visual disturbances may affect ability to drive or operate machinery
    Exclude malignancy, if alarm symptoms develop and gastric ulcer suspected
    Exclude malignancy, if alarm symptoms develop in presence of gastric ulcer
    Measure magnesium levels before and periodically during prolonged treatment
    Consider monitoring ECG in patients at risk of QT prolongation
    Ensure adequate vitamin D & calcium in patients at risk of osteoporosis
    Consider discontinuing if subacute cutaneous lupus erythematosus occurs
    Increased risk of GI infection due to decreased gastric acidity
    May reduce absorption of vitamin B12
    Advise patient not to take St John's wort concurrently
    Advise patient to avoid sun exposure if subacute lupus erythematosus occurs

    Prolonged use (greater than 1 year) of proton pump inhibitors (PPIs) has been associated with hypomagnesaemia. Patient should seek medical advice if symptoms of hypomagnesaemia occur (e.g. muscle twitches, tremors, vomiting, tiredness, loss of appetite) while taking omeprazole.

    Prolonged use (greater than 1 year) of PPIs has been associated with an increased risk of hip, wrist and spine fracture, predominantly in the elderly or in the presence of other recognised risk factors.

    Rebound acid hypersecretion and protracted dyspepsia may occur after stopping prolonged treatment with a PPI.

    Very infrequent cases of subacute cutaneous lupus erythematosus (SCLE) have been reported in patients taking PPIs. Drug-induced SCLE can occur weeks, months or even years after exposure to the drug. The MHRA have issued the following advice if a patient treated with a PPI develops lesions, especially in sun-exposed areas of the skin and it is accompanied by arthralgia:
    Advise them to avoid exposing the skin to sunlight.
    Consider SCLE as a possible diagnosis.
    Consider stopping use of the PPI unless it is imperative for a serious acid-related condition; a patient who develops SCLE with a particular PPI may be at risk of the same reaction with another.
    In most cases, symptoms resolve on PPI withdrawal; topical or systemic steroids might be necessary for treatment of SCLE only if there are no signs of remission after a few weeks or months.

    Pregnancy and Lactation


    Omeprazole may be used in pregnancy.

    Animal studies do not indicate direct or indirect harmful effects with respect to reproduction. Results from epidemiological studies have not revealed any evidence of adverse events of omeprazole on pregnancy or on the health of the foetus/newborn child. Schaefer concludes that omeprazole is the drug of choice for reflux oesophagitis in pregnancy (Schaefer, 2007) and Briggs states that if omeprazole is required or if inadvertent exposure does occur early in gestation, the known risk to the embryo/foetus appears to be low (Briggs, 2011).

    The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( ) or if this is unavailable at the backup site ( ).


    Omeprazole should be used with caution in breastfeeding.

    Omeprazole is excreted in breast milk but limited information suggests that is not likely to cause any adverse effects in breastfed infants when therapeutic doses are used.

    Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
    Specialist advice is available from the UK Drugs in Lactation Advisory Service at


    Advise patient to seek medical advice if symptoms of hypomagnesaemia occur (e.g. muscle twitches, tremors, vomiting, tiredness, loss of appetite) while taking omeprazole.

    Side Effects

    Abdominal pain
    Anaphylactic shock
    Blurred vision
    Candidiasis (gastro-intestinal)
    Dry mouth
    Erythema multiforme
    Hepatic failure
    Hypersensitivity reactions
    Increased risk of fractures
    Increased sweating
    Increases in hepatic enzymes
    Interstitial nephritis
    Microscopic colitis
    Muscle weakness
    Peripheral oedema
    Stevens-Johnson syndrome
    Subacute cutaneous lupus erythematosus
    Taste disturbances
    Toxic epidermal necrolysis


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: February 2016

    Reference Sources

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 9th edition (2011) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.

    Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 2nd edition (2007) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

    Summary of Product Characteristics: Omeprazole 40mg Powder for Solution for Infusion. Sandoz Limited. Revised January 2016.

    MHRA Drug Safety Update April 2012. Proton pump inhibitors in long-term use: increased risk of fracture.
    Available at:
    Last accessed: 18 February 2016

    MHRA Drug Safety Update September 2015. Proton pump inhibitors: very low risk of subacute cutaneous lupus erythematosus.
    Available at:
    Last accessed: 18 February 2016

    NICE Evidence Services Available at: Last accessed: 15 September 2017

    UK Drugs in Lactation Advisory Service.
    Available at:
    Last accessed: 18 February 2016

    US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
    Available at:
    Omeprazole Last revised: 10 March 2015
    Last accessed: 18 February 2016

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    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

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    FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.