BNFC Omeprazole Dosing for 43 kg, 8-Year-Old Girl
For an 8-year-old girl weighing 43 kg, the appropriate omeprazole dose is 20 mg once daily for standard indications such as symptomatic GERD or erosive esophagitis. 1
Weight-Based Dosing Algorithm
The FDA-approved dosing for pediatric patients aged 2-16 years follows a weight-based approach 1:
- Patients weighing 10 to less than 20 kg: 10 mg once daily
- Patients weighing 20 kg and greater: 20 mg once daily
Since this patient weighs 43 kg, she falls into the ≥20 kg category and should receive 20 mg once daily 1.
Indication-Specific Considerations
For Symptomatic GERD
For Erosive Esophagitis (EE)
- Dose: 20 mg once daily 1
- Duration: 4 to 8 weeks initially 1
- If inadequate response after 8 weeks, an additional 4 weeks may be given 1
- For recurrent symptoms, additional 4-8 week courses may be considered 1
For Maintenance of Healing of EE
Higher Dose Considerations for Eosinophilic Esophagitis
If treating eosinophilic esophagitis (off-label use), higher dosing may be appropriate 2:
- Dose: 1 mg/kg twice daily (up to maximum 40 mg twice daily) 2
- For this 43 kg patient, this would be approximately 40 mg twice daily
- Duration: 8-12 weeks before assessing histological response 2
- This higher dosing regimen (omeprazole 20 mg twice daily or equivalent) has shown superior response rates (50.8%) compared to standard doses (35.8%) 2
Administration Instructions
- Swallow capsules whole before meals; do not chew 1
- For patients unable to swallow intact capsules, open and mix pellets with one tablespoon of applesauce, then swallow immediately without chewing 1
- Antacids may be used concomitantly 1
Important Caveats
- The dose-finding study in children under 2 years showed that while most respond to 0.7 mg/kg/day, some required up to 2.8 mg/kg/day 3
- However, for children 2-16 years, the FDA-approved weight-based dosing (not mg/kg dosing) should be followed 1
- Do not reduce doses in primary care once established, especially for conditions like EoE 2