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| Interactions: | Molecule : Alprazolam
Adverse Effect: alprazolam toxicity (CNS depression, ataxia, lethargy)
Clinical Management: With concurrent administration, monitor patients for CNS depression.Consider switching to lorazepam, oxazepam, temazepam.
Molecule : Ampicillin
Adverse Effect: Reduced ampicillin bioavailability
Clinical Management: Monitor the patient for ampicillin efficacy if omeprazole is being using concurrently.
Molecule : Carbamazepine
Adverse Effect: An increased risk of carbamazepine toxicity
Clinical Management: Monitor patients receiving concurrent carbamazepine and omeprazole therapy for signs of carbamazepine toxicity (ataxia, nystagmus, diplopia, headache, vomiting, apnea, seizures, coma). Also monitor carbamazepine serum levels. Doses of carbamazepine may need to be reduced.
Molecule : Clarithromycin
Adverse Effect: Increased bioavailability of both agents
Molecule : Diazepam
Adverse Effect: Enhanced and prolonged diazepam effects
Clinical Management: Monitor for signs of excessive Diazepam effects (eg, sedation, dizziness, ataxia, weakness, decreased cognition or motor performance). If symptoms are present, reduce diazepam dose or consider switching to a Diazepam eliminated by glucuronidation (eg, lorazepam, oxazepam, temazepam).
Molecule : Digoxin
Adverse Effect: Digoxin toxicity (vomiting, cardiac arrhythmias)
Clinical Management: Monitor patient for signs of digoxin toxicity and adjust digoxin dose if necessary.
Molecule : Disulfiram
Adverse Effect: disulfiram toxicity (confusion, disorientation, psychotic changes)
Clinical Management: Closely monitor patient response with special attention to mental status changes when coadministering disulfiram and omeprazole. Dose reductions in either or both agents may be needed.
Molecule : Itraconazole
Adverse Effect: loss of itraconazole efficacy
Clinical Management: Itraconazole should be administered with a cola beverage in patients receiving Omeprazole.
Molecule : Ketoconazole
Adverse Effect: loss of ketoconazole efficacy
Clinical Management: Concurrent administration of ketoconazole and Omeprazole should be undertaken with caution. If concurrent use cannot be avoided, aggressively monitor these patients for continued antifungal efficacy.
Molecule : Methotrexate
Adverse Effect: an increased risk of methotrexate toxicity
Clinical Management: Closely monitor patients receiving omeprazole and methotrexate concurrently. Omeprazole may have to be temporarily discontinued.
Molecule : Midazolam
Adverse Effect: Midazolam toxicity (CNS depression, ataxia, lethargy)
Clinical Management: With concurrent administration, monitor patients for CNS depression (sedation, lethargy, speech difficulties), and adjust doses accordingly.Switch to lorazepam, oxazepam, temazepam.
Molecule : Olanzapine
Adverse Effect: Concomitant administration results in increased clearance of Olanzapine due to the induction of CYP1A2 or glucuronyl transferase enzyme
# Clinical Management: Monitor for the therapeutic effects and adjust the dose accordingly.
Molecule : Phenytoin
Adverse Effect: An increased risk of phenytoin toxicity (ataxia, hyperreflexia, nystagmus, tremor)
Clinical Management: Monitor patients for phenytoin toxicity with concomitant omeprazole use; serum phenytoin levels might also be considered, particularly with doses of omeprazole greater than 20 milligrams daily. Adjust phenytoin dosage as needed.
Molecule : Rifampicin
Adverse Effect: Concomitant administration results in increased clearance of Olanzapine due to the induction of CYP1A2 or glucuronyl transferase enzyme
# Clinical Management: Monitor for the therapeutic effects and adjust the dose accordingly.
Molecule : Ticlopidine
Adverse Effect: increased omeprazole bioavailability
Molecule : Warfarin
Adverse Effect: An increased risk of bleeding
Clinical Management: In patients receiving oral anticoagulant therapy with warfarin, the prothrombin time ratio or international normalized ratio (INR) should be closely monitored with the addition and withdrawal of treatment with omeprazole, and should be reassessed periodically during concurrent therapy. Adjustments of the warfarin dose may be necessary in order to maintain the desired level of anticoagulation. |
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