Fat malabsorption despite pancreatic enzyme
replacement therapy in cystic fibrosis
▶BY MOUTH
▶Neonate: 700 micrograms/kg once daily for 7 – 14 days,
then increased if necessary to 1. 4 – 2. 8 mg/kg once daily.▶Child 1 month–1 year: 700 micrograms/kg once daily,
increased if necessary to 3 mg/kg once daily (max. per
dose 20 mg)
▶Child 2–17 years (body-weight 10–19 kg): 10 mg once daily,
increased if necessary to 20 mg once daily
▶Child 2–17 years (body-weight 20 kg and above): 20 mg
once daily, increased if necessary to 40 mg once daily
▶BY INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION
▶Child 1 month–11 years:Initially 500 micrograms/kg once
daily (max. per dose 20 mg), increased if necessary to
2 mg/kg once daily (max. per dose 40 mg), injection to
be given over 5 minutes
▶Child 12–17 years: 40 mg once daily, injection to be given
over 5 minuteslUNLICENSED USECapsules and tabletsnot licensed for use
in children except for severe ulcerating reflux oesophagitis
in children over 1 year.Injectionnot licensed for use in
children under 12 years.
lINTERACTIONS→Appendix 1 : proton pump inhibitors
lSIDE-EFFECTS
▶Rare or very rareAggression.agitation.bronchospasm.
encephalopathy.gastrointestinal candidiasis.muscle
weakness
lPREGNANCYNot known to be harmful.
lBREAST FEEDINGPresent in milk but not known to be
harmful.
lHEPATIC IMPAIRMENT
Dose adjustmentsNo more than 700 micrograms/kg (max.
20 mg) once daily.
lDIRECTIONS FOR ADMINISTRATIONFor administration by
mouth, swallow whole, or disperseLosec MUPS®tablets in
water,ormix capsule contents orLosec MUPS®tablets
with fruit juice or yoghurt. Preparations consisting of an
e/c tablet within a capsule shouldnotbe opened.
For administration through anenteral feeding tube,use
Losec MUPS®or the contents of a capsule containing
omeprazole dispersed in a large volume of water, or in
10 mL Sodium Bicarbonate 8. 4 %( 1 mmol Na+/mL). Allow
to stand for 10 minutes before administration.
Forintermittent intravenous infusion, dilute reconstituted
solution to a concentration of 400 micrograms/mL with
Glucose 5 % or Sodium Chloride 0. 9 %; give over
20 – 30 minutes.
lPRESCRIBING AND DISPENSING INFORMATIONThe RCPCH
and NPPG recommend that, when a liquid special of
omeprazole is required, the following strength is used:
20 mg/ 5 mL.
lPATIENT AND CARER ADVICE
▶With oral useCounselling on administration advised.
Medicines for Children leaflet: Omeprazole for gastro-oesophageal
reflux disease (GORD)www.medicinesforchildren.org.uk/
omeprazole-for-gord
lPROFESSION SPECIFIC INFORMATION
Dental practitioners’formulary
Gastro-resistant omeprazole capsules may be prescribed.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension, oral solution
Gastro-resistant capsule
▶Omeprazole (Non-proprietary)
Omeprazole 10 mgOmeprazole 10 mg gastro-resistant capsules|
28 capsuleP£ 9. 30 DT = £ 0. 59
Omeprazole 20 mgOmeprazole 20 mg gastro-resistant capsules|
28 capsuleP£ 13. 50 DT = £ 0. 60
Omeprazole 40 mgOmeprazole 40 mg gastro-resistant capsules|
7 capsuleP£ 6. 96 DT = £ 0. 36 | 28 capsuleP£ 1. 44 – £ 19. 72
▶Losec(AstraZeneca UK Ltd)
Omeprazole 10 mgLosec 10 mg gastro-resistant capsules|
28 capsuleP£ 11. 16 DT = £ 0. 59
Omeprazole 20 mgLosec 20 mg gastro-resistant capsules|
28 capsuleP£ 16. 70 DT = £ 0. 60
Omeprazole 40 mgLosec 40 mg gastro-resistant capsules|
7 capsuleP£ 8. 35 DT = £ 0. 36
▶Mepradec(Discovery Pharmaceuticals)
Omeprazole 10 mgMepradec 10 mg gastro-resistant capsules|
28 capsuleP£ 0. 58 DT = £ 0. 59
Omeprazole 20 mgMepradec 20 mg gastro-resistant capsules|
28 capsuleP£ 0. 59 DT = £ 0. 60
Gastro-resistant tablet
CAUTIONARY AND ADVISORY LABELS 25
▶Omeprazole (Non-proprietary)
Omeprazole 10 mgOmeprazole 10 mg gastro-resistant tablets|
28 tabletP£ 18. 91 DT = £ 7. 90
Omeprazole (as Omeprazole magnesium) 10 mgOmeprazole
10 mg dispersible gastro-resistant tablets| 28 tabletP£ 9. 30 DT =
£ 9. 30
Omeprazole 20 mgOmeprazole 20 mg gastro-resistant tablets|
28 tabletP£ 28. 56 DT = £ 6. 39
Omeprazole (as Omeprazole magnesium) 20 mgOmeprazole
20 mg dispersible gastro-resistant tablets| 28 tabletP£ 13. 92 DT
=£ 13. 92
Omeprazole 40 mgOmeprazole 40 mg gastro-resistant tablets|
7 tabletP£ 14. 28 DT = £ 6. 42
Omeprazole (as Omeprazole magnesium) 40 mgOmeprazole
40 mg dispersible gastro-resistant tablets| 7 tabletP£ 6. 96 DT =
£ 6. 96
▶Losec MUPS(AstraZeneca UK Ltd)
Omeprazole (as Omeprazole magnesium) 10 mgLosec MUPS
10 mg gastro-resistant tablets| 28 tabletP£ 9. 30 DT = £ 9. 30
Omeprazole (as Omeprazole magnesium) 20 mgLosec MUPS
20 mg gastro-resistant tablets| 28 tabletP£ 13. 92 DT = £ 13. 92
Omeprazole (as Omeprazole magnesium) 40 mgLosec MUPS
40 mg gastro-resistant tablets| 7 tabletP£ 6. 96 DT = £ 6. 96
▶Mezzopram(Sandoz Ltd)
Omeprazole (as Omeprazole magnesium) 10 mgMezzopram 10 mg
dispersible gastro-resistant tablets| 28 tabletP£ 6. 58 DT = £ 9. 30
Omeprazole (as Omeprazole magnesium) 20 mgMezzopram
20 mg dispersible gastro-resistant tablets| 28 tabletP£ 9. 86 DT =
£ 13. 92
Omeprazole (as Omeprazole magnesium) 40 mgMezzopram
40 mg dispersible gastro-resistant tablets| 7 tabletP£ 4. 93 DT =
£ 6. 96
Powder for solution for infusion
▶Omeprazole (Non-proprietary)
Omeprazole (as Omeprazole sodium) 40 mgOmeprazole 40 mg
powder for solution for infusion vials| 5 vialP£ 32. 45 (Hospital
only)| 5 vialP£ 26. 004.3 Gastro-oesophageal reflux
disease
Gastro-oesophageal reflux disease
Management
Gastro-oesophageal reflux disease includes non-erosive
gastro-oesophageal reflux and erosive oesophagitis.
Uncomplicated gastro-oesophageal reflux is common in
infancy and most symptoms, such as intermittent vomiting
or repeated, effortless regurgitation, resolve without
treatment between 12 and 18 months of age. Older children
with gastro-oesophageal reflux disease may have heartburn,
acid regurgitation and dysphagia. Oesophageal
inflammation (oesophagitis), ulceration or stricture
formation may develop in early childhood; gastro-
oesophageal reflux disease may also be associated with
chronic respiratory disorders including asthma.BNFC 2018 – 2019 Gastro-oesophageal reflux disease 59
Gastro-intestinal system1