Can a 15-Year-Old Take Omeprazole?
Yes, a 15-year-old can safely take omeprazole for appropriate indications, as it is FDA-approved for children aged 2-16 years for treatment of symptomatic GERD and erosive esophagitis. 1
FDA-Approved Indications for Adolescents
Omeprazole is specifically approved for patients aged 2-16 years (which includes 15-year-olds) for the following conditions 1:
- Symptomatic GERD: Treatment of heartburn and other GERD symptoms for up to 4 weeks 1
- Erosive esophagitis: Short-term treatment (4-8 weeks) of acid-related damage to the esophageal lining 1
- Maintenance therapy: Maintaining healing of erosive esophagitis, though controlled studies do not extend beyond 12 months 1
Recommended Dosing for a 15-Year-Old
For a typical 15-year-old who weighs ≥20 kg (which is virtually all adolescents), the recommended dose is 2:
- 20 mg once daily for symptomatic GERD
- 20 mg once daily for erosive esophagitis
The medication should be taken approximately 30 minutes before a meal for optimal effect 3. If the adolescent cannot swallow the capsule whole, the pellets can be mixed with applesauce 2.
When Omeprazole Should NOT Be Used
Critical caveat: Omeprazole should NOT be used empirically in adolescents with chronic cough alone without gastrointestinal symptoms 4. Multiple high-quality guidelines from 2017-2019 strongly recommend against treating GERD in children with chronic cough who lack typical GER symptoms such as recurrent regurgitation, heartburn, or epigastric pain 4. This represents a common pitfall where clinicians inappropriately prescribe PPIs for isolated respiratory symptoms.
Safety Considerations
Omeprazole is generally well-tolerated in pediatric patients, but prescribers should be aware of 2, 1:
- Common side effects: Headaches, diarrhea, constipation, and nausea
- Serious but rare risks: Tubulointerstitial nephritis (kidney problems), severe diarrhea from Clostridium difficile, increased fracture risk with long-term use, and certain types of lupus 1
- Long-term concerns: Use exceeding 2.5 years may cause enterochromaffin cell hyperplasia in up to 50% of children 2
- Monitoring: For long-term therapy, monitor for potential side effects and consider periodic reassessment of need 2
Clinical Effectiveness
Omeprazole has demonstrated superior efficacy compared to H2-receptor antagonists for pediatric GERD 2, 3. In children with severe or refractory GERD, doses may need to be escalated from the starting dose of 0.7 mg/kg/day up to 1.4-2.8 mg/kg/day in divided doses 2, 5. Clinical trials support its efficacy for severe esophagitis and esophagitis refractory to H2-receptor antagonists 3, 6.
Drug Interactions
The adolescent should not take omeprazole if they are 1:
- Taking rilpivirine (used for HIV treatment)
- Allergic to omeprazole or other proton pump inhibitors
Inform the prescriber if the patient takes clarithromycin, amoxicillin, clopidogrel, methotrexate, St. John's Wort, or rifampin, as these may interact with omeprazole 1.