Omeprazole Dosing for a 14-Year-Old
For a 14-year-old patient, omeprazole should be dosed at 20 mg once daily for symptomatic GERD or erosive esophagitis, taken before meals. 1
FDA-Approved Weight-Based Dosing
The FDA label provides clear guidance for pediatric patients aged 2-16 years: 1
- For patients weighing ≥20 kg (which includes most 14-year-olds): 20 mg once daily 1
- For patients weighing 10 to <20 kg: 10 mg once daily 1
Treatment Duration by Indication
Symptomatic GERD
Erosive Esophagitis (EE)
- Duration: 4 to 8 weeks initially 1
- If no response after 8 weeks, an additional 4 weeks may be given 1
- For recurrent EE or GERD symptoms, additional 4-8 week courses can be considered 1
Maintenance of Healing of EE
Special Considerations for Higher Doses
While the standard FDA-approved dose is 20 mg once daily, certain conditions may warrant higher dosing: 2
- For eosinophilic esophagitis: Doses up to 1 mg/kg twice daily (maximum 40 mg twice daily) may be appropriate, with treatment duration of 8-12 weeks before assessing response 3
- For refractory cases: The American Academy of Pediatrics notes that effective dosing ranges from 0.7 to 3.3 mg/kg daily based on clinical improvement 2
Administration Instructions
- Take before meals 1
- Swallow capsules whole; do not chew 1
- For patients unable to swallow: Open capsule and mix pellets with one tablespoon of applesauce (not hot), swallow immediately without chewing pellets, followed by cool water 1
- Antacids may be used concomitantly 1
Important Clinical Caveats
- Do not reduce established doses in primary care, especially for conditions like eosinophilic esophagitis where weight-based dosing has been carefully determined 3
- Missed doses: Take as soon as possible, but skip if next dose is due; never double up 1
- Rabeprazole is FDA-approved for ages 12 and older at 20 mg daily, providing an alternative PPI option for this age group 2