Peptic ulcer: 20 or 40 mg/day in severe cases for 4 wk (duodenal ulcer) or 8 wk (gastric ulcer). Maintenance: 10-20 mg/day.
NSAID-associated ulceration 20 mg/day.
GERD 20 mg once daily for 4 wk, may continue for another 4-8 wk if needed.
Refractory oesophagitis: 40 mg/day. Maintenance: 20 mg/day (after healing of oesophagitis); 10 mg/day (acid reflux).
Erosive oesophagitis 20 mg daily for 4-8 wk. Maintenance: 20 mg/day.
Acid-related dyspepsia 10 or 20 mg/day 2-4 wk.
Zollinger-Ellison syndrome. Initial: 60 mg once daily. Dose Range: 20-120 mg/day. All doses to be given once in the morning but doses >80 mg in 2 divided doses. Prophylaxis of acid aspiration during general anaesthesia: 40 mg in the evening and another 40 mg 2-6 hr pre-op.
H.pylori infection: 20 mg bid or 40 mg once daily w/ clarithromycin and either amoxicillin or metronidazole.
Gastric and duodenal ulcers; NSAID-associated ulceration; GERD: 40 mg once daily infused over 20-30 min or slow inj over 5 min until PO can be resumed.
Zollinger-Ellison syndrome. Initial: 60 mg/day, adjust if needed. Daily doses >60 mg/day should be given in 2 divided doses.
Adverse drug reactions
: increased risk of Clostridium difficile-associated diarrhoea (CDAD) and osteoporosis-related fractures. Headache, rash, pruritus, dizziness, fatigue, cough, back or abdominal pain, arthralgia and myalgia, urticaria, dry mouth, bronchospasm, somnolence, insomnia, reversible confusional states, depression, increased liver enzyme, hepatitis, jaundice, hepatic encephalopathy.
Adapted from CIMS Drug Information System. Internet. Accessed on January 10, 2016.