Omeref

Important safety and use flags

• Do not use omeprazole as automatic cover for uncomplicated vomiting, gastritis, pancreatitis, hepatic disease, renal disease, corticosteroids or NSAIDs without an individual ulceration/bleeding rationale. Diagnose and treat the underlying cause.
• Do not use after a previous hypersensitivity reaction to omeprazole, another substituted benzimidazole or an excipient. Stop and treat urgently for facial swelling, bronchospasm, collapse or anaphylaxis.
• Alarm signs such as weight loss, recurrent vomiting, dysphagia, haematemesis, melaena or anaemia require investigation. Acid suppression can mask signs and delay diagnosis of neoplasia, foreign material or another bleeding lesion.
• Severe hepatic dysfunction can increase systemic exposure. Review liver disease, clinical response and adverse effects and use the lowest justified effective regimen.
• Review concurrent medicines: CYP2C19 effects can alter clopidogrel, diazepam, phenytoin, warfarin or tacrolimus exposure, while raised gastric pH can reduce absorption of itraconazole/ketoconazole, mycophenolate, iron and other pH-dependent drugs.
• Reassess prolonged treatment. Sustained acid suppression can cause hypergastrinaemia, altered gastrointestinal flora or infection risk and impaired magnesium/cobalamin/iron handling; monitor according to duration and patient risk.
• After more than 3-4 weeks of treatment, do not stop abruptly unless safety requires it. Taper a clinically unnecessary PPI to reduce rebound acid hypersecretion and recurrence of acid-related signs.
• OMEREF is an IV-only 40 mg vial with its own 10 mL solvent (4 mg/mL). Use only that exact preparation instruction, give slowly, inspect the solution, respect four-hour room-temperature stability and do not mix with unverified medicines or solvents.