Omeprazole onset of action

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Omeprazole Onset of Action: Key Findings

Immediate-Release Omeprazole and Rapid Onset

Immediate-release omeprazole combined with sodium bicarbonate (IR-OME) has a notably fast onset of action. In healthy adults, IR-OME began to significantly increase intragastric pH within 10 to 15 minutes after dosing, and this effect was sustained for at least two hours. This rapid onset was faster than that of delayed-release lansoprazole, and IR-OME also maintained a higher gastric pH for a longer period over 24 hours at steady state .

Onset in Pediatric and Critically Ill Patients

In critically ill pediatric patients, omeprazole suspension in a sodium bicarbonate vehicle showed a mean onset of action of about 62 minutes, but with a wide range (2 to 226 minutes). Younger children under 4 years old experienced more variability in onset time compared to older children, who typically saw effects within 2 to 40 minutes. With twice-daily dosing, gastric pH was maintained above 4.0 for most of the dosing interval, indicating effective acid suppression after onset .

Single-Dose Omeprazole and Acid Suppression

A single oral dose of omeprazole can inhibit gastric acid secretion, but the onset is not as rapid as some other treatments. The effect is dose-dependent, and higher doses lead to greater and longer-lasting acid suppression. After several days of daily dosing, the inhibitory effect stabilizes, with significant acid suppression observed after three days .

Comparison with Other Treatments for Rapid Relief

For immediate relief of acid exposure in the first hour after dosing, omeprazole is less effective than sodium alginate and ranitidine. Sodium alginate provided the fastest reduction in acid exposure, while ranitidine showed a superior effect starting from two hours post-dose. Omeprazole’s onset is slower in this context, making it less suitable for immediate symptom relief compared to these alternatives .

Suitability for On-Demand Therapy

When comparing omeprazole to other proton pump inhibitors for on-demand therapy, omeprazole’s onset of action is generally slower, making it less ideal for rapid symptom relief. However, it remains effective for sustained acid suppression when used regularly .

Conclusion

Omeprazole’s onset of action varies depending on the formulation and patient population. Immediate-release omeprazole with sodium bicarbonate can begin working within 10 to 15 minutes in adults, while suspension forms in children may take longer and show more variability. For immediate symptom relief, other treatments like sodium alginate or ranitidine may be more effective, but omeprazole is highly effective for sustained acid suppression with regular use 12345.

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Most relevant research papers on this topic

Omeprazole pharmacodynamics and gastric acid suppression in critically ill pediatric transplant patients

Omeprazole administered twice daily as a suspension effectively maintains gastric pH of >4.0 and achieves maximal pharmacodynamic effect in pediatric liver and/or intestinal transplant patients.

Non-RCT

2001·

21citations

·K. Olsen et al.

A randomized, crossover pharmacodynamic study of immediate‐release omeprazole/sodium bicarbonate and delayed‐release lansoprazole in healthy adult volunteers

Immediate-release omeprazole/sodium bicarbonate (IR-OME) is a safe and well-tolerated proton pump inhibitor that provides faster onset of action and better gastric acid suppression than delayed-release lansoprazole in healthy adults.

RCT

2016·

7citations

·V. Pratha et al.

Comparison of the effect on intragastric pH of a single dose of omeprazole or rabeprazole: Which is suitable for on‐demand therapy?

Omeprazole has a faster onset of action on gastric acid secretion compared to rabeprazole, making it suitable for on-demand heartburn treatment.

Non-RCT

2003·

15citations

·M. Inamori et al.

Effect of omeprazole--a gastric proton pump inhibitor--on pentagastrin stimulated acid secretion in man.

Omeprazole effectively inhibits gastric acid secretion, with a maximum suppression at 80 mg, and its effect lasts for up to three days.

Non-RCTHighly Cited

1983·

507citations

·T. Lind et al.

Rapid onset of effect of sodium alginate on gastro‐oesophageal reflux compared with ranitidine and omeprazole, and relationship between symptoms and reflux episodes

Sodium alginate effectively reduces gastro-oesophageal reflux and gastric acidity within the first hour, outperforming control, omeprazole, and ranitidine.

RCT

2006·

47citations

·P. Dettmar et al.

Endoscopic Analysis of Gastric Ulcer after One Week's Treatment with Omeprazole and Rabeprazole in Relation to CYP2C19 Genotype

Rabeprazole 10 mg shows faster onset of action and stronger inhibition of acid secretion than omeprazole 20 mg, with greater improvement ratios in homozygous extensive metabolizers and heterozygous extensive metabolizers than in homozygous poor metabolizers.

Non-RCT

2008·

18citations

·T. Ando et al.

Interface-Mediated Mechanism of Action-The Root of the Cytoprotective Effect of Immediate-Release Omeprazole.

Local release of omeprazole in the stomach allows it to act as a phospholipid-like drug, strengthening and protecting the gastric mucosa through electrostatic and hydrophobic interactions.

2021·

4citations

·Daniela Lopes-de-Campos et al.

Studies on the mechanism of action of omeprazole.

Omeprazole inhibits pig gastric (H+ + K + )-ATPase activity in a time-dependent manner, with its potency depending on the conditions used and pH.

In Vitro Study

1985·

66citations

·D. Keeling et al.

Omeprazole (20 mg) daily given in the morning or evening: a comparison of effects on gastric acidity, and plasma gastrin and omeprazole concentration

Morning administration of omeprazole is optimal, but patient response to 20 mg omeprazole is still variable.

RCTHighly Cited

1992·

73citations

·S. Chiverton et al.

Acid-Neutralizing Omeprazole Formulation for Rapid Release and Absorption

A sodium bicarbonate-based omeprazole formulation with sodium bicarbonate effectively neutralizes stomach acid, facilitating rapid release and absorption, making it an easily manufacturable alternative to enteric-coated omeprazole.

2025·

0citations

·Sreela Ramesh et al.

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