What is the dosage of Omeprazole (Intravenous) for a 6-year-old patient weighing 17 kilograms?

Omeprazole IV Dosing for a 6-Year-Old, 17 kg Patient

For a 6-year-old child weighing 17 kg, administer omeprazole 10 mg IV once daily, as this patient falls into the 10 to <20 kg weight category per FDA-approved pediatric dosing guidelines. 1

Weight-Based Dosing Algorithm

The dosing for pediatric omeprazole follows a straightforward weight-based approach:

• Children weighing 10 to <20 kg: 10 mg once daily 1
• Children weighing ≥20 kg: 20 mg once daily 1

Since your patient weighs 17 kg, the appropriate dose is 10 mg IV once daily. 1

Administration Considerations

• Timing: Administer 30-60 minutes before meals for optimal acid suppression, though this is less critical with IV formulation 2
• Duration: Initial treatment should continue for 4-8 weeks before assessing response and considering dose adjustment 2
• Monitoring: Assess clinical improvement within 14 days of initiating therapy 3

When to Consider Dose Escalation

If symptoms persist after 4-8 weeks of standard dosing, consider increasing to 20 mg IV once daily (approximately 1.2 mg/kg/day for this patient). 2 However, most pediatric patients respond adequately to weight-based standard dosing. 1

For severe or refractory GERD specifically, doses up to 1.4-2.8 mg/kg/day in divided doses may be required, though this is uncommon in the 6-year-old age group compared to infants. 1, 3

Common Pitfalls to Avoid

• Do not extrapolate adult dosing: Pediatric patients require weight-based dosing due to different pharmacokinetics, particularly altered volumes of distribution and elimination half-lives 4
• Avoid premature dose escalation: Allow adequate time (4-8 weeks) for therapeutic response before increasing the dose, as some patients require up to 8-12 weeks to show improvement 2
• Monitor for side effects: Common adverse effects include headaches, diarrhea, constipation, and nausea, occurring in up to 14% of children 3

Long-Term Considerations

If long-term therapy beyond 12 months is required, periodically reassess the need for continued treatment and use the lowest effective dose. 2 Long-term use (>2.5 years) has been associated with enterochromaffin cell hyperplasia in up to 50% of children, though clinical significance remains unclear. 1, 3