Omtal D Dosage

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Dosage of Omtal D in details

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Omtal D Delayed-Release Capsules should be taken before eating. In the clinical trials, antacids were used concomitantly with Omtal D.

Patients should be informed that the Omtal D Delayed-Release Capsule should be swallowed whole.

For patients unable to swallow an intact capsule, alternative administration options are available.

Short-Term Treatment Of Active Duodenal Ulcer

The recommended adult oral dose of Omtal D is 20 mg once daily. Most patients heal within four weeks. Some patients may require an additional four weeks of therapy.

H. pylori Eradication For The Reduction Of The Risk Of Duodenal Ulcer Recurrence

Triple Therapy (Omtal D/clarithromycin/amoxicillin)

The recommended adult oral regimen is Omtal D 20 mg plus clarithromycin 500 mg plus amoxicillin 1000 mg each given twice daily for 10 days. In patients with an ulcer present at the time of initiation of therapy, an additional 18 days of Omtal D 20 mg once daily is recommended for ulcer healing and symptom relief.

Dual Therapy (Omtal D/clarithromycin)

The recommended adult oral regimen is Omtal D 40 mg once daily plus clarithromycin 500 mg three times daily for 14 days. In patients with an ulcer present at the time of initiation of therapy, an additional 14 days of Omtal D 20 mg once daily is recommended for ulcer healing and symptom relief.

Gastric Ulcer

The recommended adult oral dose is 40 mg once daily for 4-8 weeks.

Gastroesophageal Reflux Disease (GERD)

The recommended adult oral dose for the treatment of patients with symptomatic GERD and no esophageal lesions is 20 mg daily for up to 4 weeks. The recommended adult oral dose for the treatment of patients with erosive esophagitis and accompanying symptoms due to GERD is 20 mg daily for 4 to 8 weeks.

Maintenance Of Healing Of Erosive Esophagitis

The recommended adult oral dose is 20 mg daily. Controlled studies do not extend beyond 12 months.

Pathological Hypersecretory Conditions

The dosage of Omtal D in patients with pathological hypersecretory conditions varies with the individual patient. The recommended adult oral starting dose is 60 mg once daily. Doses should be adjusted to individual patient needs and should continue for as long as clinically indicated. Doses up to 120 mg three times daily have been administered. Daily dosages of greater than 80 mg should be administered in divided doses. Some patients with Zollinger-Ellison syndrome have been treated continuously with Omtal D for more than 5 years.

Pediatric Patients

For the treatment of GERD and maintenance of healing of erosive esophagitis, the recommended daily dose for pediatric patients 1 to 16 years of age is as follows:

Patient Weight Omtal D Daily Dose
5 < 10 kg 5 mg
10 < 20 kg 10 mg
≥ 20 kg 20 mg

On a per kg basis, the doses of Omtal D required to heal erosive esophagitis in pediatric patients are greater than those for adults.

Alternative administrative options can be used for pediatric patients unable to swallow an intact capsule.

Alternative Administration Options

Omtal D is available as a delayed-release capsule or as a delayed-release oral suspension.

For patients who have difficulty swallowing capsules, the contents of a Omtal D Delayed-Release Capsule can be added to applesauce.

One tablespoon of applesauce should be added to an empty bowl and the capsule should be opened. All of the pellets inside the capsule should be carefully emptied on the applesauce. The pellets should be mixed with the applesauce and then swallowed immediately with a glass of cool water to ensure complete swallowing of the pellets. The applesauce used should not be hot and should be soft enough to be swallowed without chewing. The pellets should not be chewed or crushed. The pellets/applesauce mixture should not be stored for future use.

Omtal D For Delayed-Release

Oral Suspension should be administered as follows:

For patients with a nasogastric or gastric tube in place:

How supplied

Dosage Forms And Strengths

Omtal D Delayed-Release Capsules, 10 mg, are opaque, hard gelatin, apricot and amethyst colored capsules, coded 606 on cap and Omtal D 10 on the body.

Omtal D Delayed-Release Capsules, 20 mg, are opaque, hard gelatin, amethyst colored capsules, coded 742 on cap and Omtal D 20 on the body.

Omtal D Delayed-Release Capsules, 40 mg, are opaque, hard gelatin, apricot and amethyst colored capsules, coded 743 on cap and Omtal D 40 on the body.

Omtal D For Delayed-Release

Oral Suspension, 2.5 mg or 10 mg, is supplied as a unit dose packet containing a fine yellow powder, consisting of white to brownish Omtal D granules and pale yellow inactive granules.

Storage And Handling

Omtal D Delayed-Release Capsules, 10 mg, are opaque, hard gelatin, apricot and amethyst colored capsules, coded 606 on cap and Omtal D 10 on the body. They are supplied as follows:

NDC 0186-0606-31 unit of use bottles of 30

Omtal D Delayed-Release Capsules, 20 mg, are opaque, hard gelatin, amethyst colored capsules, coded 742 on cap and Omtal D 20 on body. They are supplied as follows:

NDC 0186-0742-31 unit of use bottles of 30

NDC 0186-0742-82 bottles of 1000

Omtal D Delayed-Release Capsules, 40 mg, are opaque, hard gelatin, apricot and amethyst colored capsules, coded 743 on cap and Omtal D 40 on the body. They are supplied as follows:

NDC 0186-0743-31 unit of use bottles of 30

NDC 0186-0743-68 bottles of 100

Omtal D For Delayed-Release

Oral Suspension, 2.5 mg or 10 mg

, is supplied as a unit dose packet containing a fine yellow powder, consisting of white to brownish Omtal D granules and pale yellow inactive granules. Omtal D unit dose packets are supplied as follows:

NDC 0186-0625-01 unit dose packages of 30: 2.5 mg packets

NDC 0186-0610-01 unit dose packages of 30: 10 mg packets

Storage

Store Omtal D Delayed-Release Capsules in a tight container protected from light and moisture. Store between 15°C and 30°C (59°F and 86°F).

Store Omtal D For Delayed-Release

Oral Suspension at 25°C (77°F); excursions permitted to 15 – 30°C (59 – 86°F).

AstraZeneca Pharmaceuticals LP Wilmington, DE 19850. Revised December 2014

What other drugs will affect Omtal D?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Tell your doctor about all your current medicines. Many drugs can affect Omtal D + SyrSpend SF Alka, especially:

This list is not complete and many other drugs may affect Omtal D + SyrSpend SF Alka. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Drug Interactions (in more detail)

Omtal D interactions

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Effects of Omtal D on the Pharmacokinetics of Other Drugs: The following combination with Omtal D should be avoided: Ketoconazole and itraconazole.

Omtal D might influence the absorption of other drugs due to its effect on the gastric pH. The dissolution of ketoconazole tablets in the stomach is adversely affected if the pH of the gastric juice increases as a result of drug treatment (antacids, secretion-inhibiting agents, sucralfate). This leads to ineffective plasma concentrations of ketoconazole. During concomitant administration of Omtal D and itraconazole, the plasma concentration and area under the curve (AUC) of itraconazole are reduced by approximately 65%, probably as a result of poorer absorption, which is dependent on pH.

Omtal D inhibits the enzyme CYP2C19 and therefore, increased plasma levels of other drugs (diazepam, warfarin, phenytoin) metabolized via this enzyme might be expected. Monitoring is recommended during initiation or withdrawal of Omtal D in patients being treated with phenytoin, warfarin or other vitamin K antagonist.

During concomitant administration of clarithromycin or erythromycin and Omtal D, the plasma concentrations of Omtal D were increased. The plasma concentrations of Omtal D are not influenced during concomitant administration with amoxicillin or metronidazole.

Concomitant administration of Omtal D (40 mg once daily) and atazanavir 300 mg/ritonavir 100 mg to healthy volunteers resulted in a marked reduction in total atazanavir exposure (approximately 75% reduction of AUC, Cmax and Cmin). An increase in the atazanavir dose to 400 mg did not compensate for the effect that Omtal D had on atazanavir exposure. Proton pump inhibitors including Omtal D should therefore not be administered concomitantly with atazanavir.

Concomitant administration of Omtal D and tacrolimus may increase the serum levels of tacrolimus. Monitoring of the plasma tacrolimus concentration is recommended when treatment with Omtal D is being initiated or discontinued. Omtal D (40 mg daily) increased the Cmax and AUC of voriconazole (CYP2C19 substrate) by 15% and 41%, respectively.

Effects of Other Drugs on the Pharmacokinetics of Omtal D: Drugs inhibiting the enzymes CYP2C19 or CYP3A (HIV protease inhibitors, ketoconazole, itraconazole) might increase the plasma concentrations of Omtal D. Voriconazole increases the AUC of Omtal D by 280%. In cases of concomitant treatment, an adjustment of the Omtal D dose should be considered for patients with considerable impaired hepatic function and in cases of long-term treatment.

Case reports, published population pharmacokinetic studies and retrospective analyses suggest that concomitant administration of PPIs and methotrexate (primarily at high doses) may elevate and prolong serum levels of methotrexate and/or its metabolite hydroxymethotrexate. However, no formal drug interaction studies of methotrexate with PPIs have been conducted.

No interactions between Omtal D and antacids, theophylline, caffeine, quinidine, lidocaine, propranolol, metoprolol or ethanol have been detected.


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References

  1. DailyMed. "OMEPRAZOLE MAGNESIUM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. MeSH. "Anti-Ulcer Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
  3. European Chemicals Agency - ECHA. "(S)- sodium 5-methoxy-2-{[(4-methoxy-3,5-dimethylpyridin-2-yl)methyl]sulfinyl}benzimidazol-1-ide: The information provided here is aggregated from the "Notified classification and labelling" from ECHA's C&L Inventory. ". https://echa.europa.eu/information-o... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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