From the Research
Intravenous omeprazole can be used in neonates for acid suppression, but its use should be limited to the shortest period necessary due to potential risks, and the most recent evidence suggests a dose of 0.5-1 mg/kg/day given once daily or divided twice daily, as seen in the study by 1.
Key Considerations
- The use of intravenous omeprazole in neonates is generally reserved for cases where oral administration is not possible, such as severe gastrointestinal bleeding or gastroesophageal reflux disease.
- The medication should be reconstituted with normal saline or 5% dextrose and infused over 10-30 minutes.
- Monitoring should include assessment of symptoms, electrolyte levels (particularly magnesium), and watching for potential adverse effects such as infections.
- Prolonged use of omeprazole in neonates has been associated with increased risks of necrotizing enterocolitis, pneumonia, and other infections, as noted in various studies, including 1.
Dosage and Administration
- The dose of intravenous omeprazole for neonates is typically 0.5-1 mg/kg/day given once daily or divided twice daily, as suggested by the most recent evidence 1.
- For severe conditions like upper GI bleeding, higher doses of 1-2 mg/kg/day may be used, but this should be done with caution and close monitoring.
Safety and Efficacy
- The safety and efficacy of intravenous omeprazole in neonates have been evaluated in several studies, including 1, which found that empirical use of omeprazole continuous intravenous infusion in children with GI bleeding was not favorable in terms of shortening PICU LOS and duration of GI bleeding, but provided evidence supporting the safety and tolerability of omeprazole continuous infusion.
- Other studies, such as 2, 3, 4, and 5, have compared the efficacy of omeprazole with other treatments, such as ranitidine, in the management of upper GI bleeding, with mixed results.