Omeprazole use in pediatric patients
Pro Research Analysisby 
Searched over 200M research papers
Omeprazole Use in Pediatric Patients: Indications and Effectiveness
Omeprazole, a proton pump inhibitor (PPI), is widely used to treat acid-related disorders in children, including gastroesophageal reflux disease (GERD), erosive esophagitis, peptic ulcers, and Helicobacter pylori (HP) infection. Although not always officially approved for pediatric use in all countries, omeprazole has been shown to be effective in both acute and chronic management of these conditions, especially in children who do not respond to other treatments like histamine-2 receptor antagonists or prokinetic agents 124568.
Dosage and Administration in Children
Studies indicate that children often require higher doses of omeprazole per kilogram of body weight compared to adults. The most commonly effective starting dose is around 0.7–1 mg/kg per day, with some cases requiring up to 3.5 mg/kg per day for healing severe esophagitis or refractory acid-related diseases 245810. For specific situations, such as after liver or intestinal transplantation, dosing every 6–12 hours may be necessary to maintain adequate acid suppression . Both granule and suspension forms of omeprazole are suitable for pediatric use, with no significant differences in blood levels between the two formulations .
Efficacy in Treating Pediatric Acid-Related Disorders
Omeprazole has demonstrated high effectiveness in healing erosive esophagitis and reducing symptoms of GERD in children, including those with severe or refractory disease and those who have failed other medical or surgical treatments 2458. In multicenter studies, healing rates for chronic, severe esophagitis were very high, with most children experiencing significant symptom relief . Omeprazole is also effective for short-term treatment of refractory duodenal and gastric ulcers in children .
Safety and Tolerability in Pediatric Patients
Omeprazole is generally well tolerated in children, with a low incidence of adverse effects reported in both short-term and long-term use 2458. Mildly elevated liver enzymes and increased fasting gastrin levels have been observed, but no severe adverse effects have been reported. The long-term significance of elevated gastrin levels in children remains unclear and requires further study . In critically ill children, continuous intravenous infusion of omeprazole was found to be safe and well tolerated, though it did not shorten the length of hospital stay or duration of bleeding compared to other therapies .
Regulatory and Practical Considerations
While omeprazole is well studied and widely used in pediatric populations, its official approval for use in children varies by country. In some regions, such as Russia, omeprazole is only approved for specific indications in children, and off-label use requires careful consideration of clinical guidelines and regulatory documents .
Pharmacokinetics in Children
Children, especially those aged 1–6 years, metabolize omeprazole more rapidly than adults, which explains the need for higher per-kilogram dosing in this age group . Pharmacokinetic studies show that both granule and suspension forms provide similar blood levels, making either formulation appropriate for pediatric patients .
Conclusion
Omeprazole is a highly effective and generally safe option for treating acid-related disorders in pediatric patients, particularly for those with severe or refractory disease. Dosing must be carefully adjusted based on age and severity, and while short-term safety is well established, ongoing monitoring and further research are needed to fully understand long-term effects. Regulatory approval and guidelines should be consulted to ensure appropriate use in each region 12345678+2 MORE.
Sources and full results
Most relevant research papers on this topic