Omeprazole Dosing for a 12-Year-Old Weighing 36kg
For a 12-year-old child weighing 36kg, the recommended omeprazole dose is 20 mg once daily, as this patient weighs greater than 20 kg. 1
FDA-Approved Dosing by Weight
The FDA label provides clear weight-based dosing for pediatric patients aged 2-16 years 1:
- Children weighing 10 to less than 20 kg: 10 mg once daily
- Children weighing 20 kg and greater: 20 mg once daily
Since your patient weighs 36 kg, they fall into the ≥20 kg category and should receive 20 mg once daily 1.
Treatment Duration by Indication
The duration varies based on the specific condition being treated 1:
- Symptomatic GERD: Up to 4 weeks 1
- Erosive esophagitis (EE) treatment: 4 to 8 weeks initially 1
- Maintenance of healing of EE: Once daily dosing; controlled studies do not extend beyond 12 months 1
If the patient does not respond to 8 weeks of treatment for erosive esophagitis, an additional 4 weeks may be given 1. If EE or GERD symptoms recur, additional 4-8 week courses can be considered 1.
Administration Instructions
Omeprazole should be taken before meals 1. The capsules must be swallowed whole and should not be chewed 1.
For patients unable to swallow intact capsules, the capsule can be opened and the pellets mixed with one tablespoon of applesauce (not hot, soft enough to swallow without chewing), then swallowed immediately with cool water 1. The pellets must not be chewed or crushed 1.
Supporting Evidence from Clinical Studies
Clinical guidelines support effective dosing ranges in pediatric populations 2:
- Studies demonstrate an effective dosage range of 0.7 to 3.3 mg/kg daily based on symptom improvement and pH monitoring 2
- For a 36 kg child, 20 mg daily equals approximately 0.56 mg/kg, which falls within the lower therapeutic range
- Lansoprazole studies showed 0.7 to 3.0 mg/kg daily improved GERD symptoms and healed erosive esophagitis in 1-12 year old children 2
Safety Considerations
Common adverse effects include headaches, diarrhea, constipation, and nausea in up to 14% of older children 2. Monthly monitoring is not routinely required for short-term use, but be aware that acid suppression may increase risk of community-acquired pneumonia and gastroenteritis 2.
Important caveat: Antacids may be used concomitantly with omeprazole 1. If a dose is missed, administer as soon as possible, but if the next scheduled dose is due, skip the missed dose and resume the regular schedule—never double dose 1.