Omeprazole is used to treat certain stomach and esophagus problems (such as acid reflux , ulcers). Reports have been received of overdosage with Omeprazole in humans. Doses ranged up to 2400 mg (120 times the usual recommended clinical dose). Manifestations were variable, but included confusion, drowsiness, blurred vision, tachycardia, nausea, vomiting, diaphoresis, flushing, headache, dry mouth, and other adverse reactions similar to those seen in normal clinical experience see Adverse Reactions ( 6 ). Symptoms were transient, and no serious clinical outcome has been reported when Omeprazole Delayed-Release Capsules was taken alone. No specific antidote for Omeprazole overdosage is known. Omeprazole is extensively protein bound and is, therefore, not readily dialyzable. In the event of overdosage, treatment should be symptomatic and supportive.
In this study, the 40 mg dose was not superior to the 20 mg dose of Omeprazole Delayed-Release Capsules in the percentage healing rate. Other controlled clinical trials have also shown that Omeprazole Delayed-Release Capsules is effective in severe GERD. In comparisons with histamine H2-receptor antagonists in patients with erosive esophagitis, grade the advantage 2 or above, Omeprazole Delayed-Release Capsules in a dose of 20 mg was significantly more effective than the active controls. Complete daytime and nighttime heartburn relief occurred significantly faster (p < 0.01) in patients treated with Omeprazole Delayed-Release Capsules than in those taking placebo or histamine H2- receptor antagonists.
In a foreign multinational randomized, double-blind study of 105 patients with endoscopically documented duodenal ulcer, 20 mg and 40 mg of Omeprazole Delayed-Release Capsules were compared with 150 mg b.i.d. of ranitidine at 2, 4 and 8 weeks. At 2 and 4 weeks both doses of Omeprazole Delayed-Release Capsules were statistically superior (per protocol) to ranitidine, but 40 mg was not superior to 20 mg of Omeprazole Delayed-Release Capsules, and at 8 weeks there was no significant difference between any of the active drugs.
Inactive ingredients in Omeprazole Delayed-Release Capsules: (including the capsule shells): crospovidone, glyceryl dibehenate, hypromellose, lactose monohydrate, methacrylic acid copolymer dispersion, silicon dioxide, talc, titanium dioxide and triethyl citrate. The capsule shells also contain gelatin and may contain sodium lauryl sulfate. In addition, the 20 mg and 40 mg capsule shells also contain yellow iron oxide. The imprinting ink also contains ammonium hydroxide, butyl alcohol, black iron oxide, isopropyl alcohol, propylene glycol and shellac glaze. The ink may also contain dehydrated alcohol.
Following single dose oral administration of a buffered solution of Omeprazole, little if any unchanged drug was excreted in urine. The majority of the dose (about 77%) was eliminated in urine as at least six metabolites. Two were identified as hydroxyOmeprazole and the corresponding carboxylic acid. The remainder of the dose was recoverable in feces. This implies a significant biliary excretion of the metabolites of Omeprazole. Three metabolites have been identified in plasma the sulfide and sulfone derivatives of Omeprazole, and hydroxyOmeprazole. These metabolites have very little or no antisecretory activity.