오메프라졸
Omeprazole
5-methoxy-2-[[(4-methoxy-3,5-dimethyl-2-pyridinyl)methyl]sulfinyl]-1H-benzimidazole
다른 이름: Gastrogard · Prilosec · Ulcergard · Zegerid · H-168/68 · omeprazolum
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| GI ulcer management/prevention | 0.5-1 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Adjunctive treatment of uremic gastropathy | 0.5-1 mg/kg PO q24h | PO | q24h | — | 🌎 NA |
| Prevent exercise-induced gastritis in racing Alaskan sled dogs | approx. 0.85 mg/kg (one 20 mg tablet) once daily approximately 30 minutes before being fed | PO | q24h | — | 🌎 NA |
| Adjunctive treatment of esophagitis or gastric ulcers | 0.5-1 mg/kg PO q24h | PO | q24h | — | 🌎 NA |
| Gastrinomas or severe esophagitis | 0.7-1.5 mg/kg PO q24h, but if severe esophagitis or gastrinomas may use up to 2 mg/kg PO q12h | PO | q12h-q24h | — | 🌎 NA |
| General GI therapeutics | 0.7 mg/kg PO q24h (20 mg/dog) | PO | q24h | — | 🌎 NA |
| Esophagitis | 0.7 mg/kg PO twice daily | PO | q12h | — | 🌎 NA |
| Adjunctive treatment of uremic vomiting | 0.7 mg/kg PO q12h | PO | q12h | — | 🌎 NA |
| Helicobacter infection/gastritis | Omeprazole 0.7 mg/kg PO once daily (or an H2 blocker), amoxicillin 15 mg/kg PO twice daily, metronidazole 10 mg/kg PO twice daily, and Pepto Bismol ¼-2 tablets PO twice daily | PO | q24h | 2 weeks | 🌎 NA |
- Adjunctive treatment of uremic gastropathy: Dosage may need to be modified in moderate or severe renal failure.
- Prevent exercise-induced gastritis in racing Alaskan sled dogs: Dosing began approximately 48 hours before exercise.
- Helicobacter infection/gastritis: Other suggestions include omeprazole with either azithromycin 10-20 mg/kg PO once daily or clarithromycin 7.5 mg/kg PO twice daily.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Adjunctive treatment of esophagitis or gastric ulcers | 0.5-1 mg/kg PO q24h | PO | q24h | — | 🌎 NA |
| GI ulcer management/prevention | 0.7-1.5 mg/kg PO q12-24h | PO | q12h-q24h | — | 🌎 NA |
| Adjunctive treatment of uremic gastropathy | 0.7 mg/kg PO q24h | PO | q24h | — | 🌎 NA |
- Adjunctive treatment of uremic gastropathy: Dosage may need to be modified in moderate or severe renal failure.
페렛
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Short-term treatment of gastroenteritis | 0.7 mg/kg PO q24h | PO | q24h | Short-term | 🌎 NA |
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Treatment of gastric ulcers | 4 mg/kg PO once daily for 4 weeks; to prevent recurrence treat for at least another 4 weeks at 2 mg/kg PO once daily | PO | q24h | 8 weeks total | 🌎 NA |
| Foals: Preventative dose | 1 mg/kg PO q24h | PO | q24h | — | 🌎 NA |
| Foals: Treatment dose | 4 mg/kg PO q24h | PO | q24h | — | 🌎 NA |
| Treatment or prophylaxis of gastric ulcers in foals | 4 mg/kg PO once daily for treatment, 1-2 mg/kg PO once daily for prophylaxis | PO | q24h | — | 🌎 NA |
| Foals: Gastric ulcers | 4 mg/kg PO q24h | PO | q24h | — | 🌎 NA |
- Treatment of gastric ulcers: ARCI UCGFS Class 5 Drug
- Foals: Preventative dose: There has been a recent shift to not administering prophylactic antiulcer medication routinely to sick foals.
- Foals: Treatment dose: Will reduce gastric pH in a few hours.
- Foals: Gastric ulcers: Commonly foals will be started on ranitidine (1.5 mg/kg IV q8h; 6.6 mg/kg PO q8h) and omeprazole together.
돼지
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| Ulcer management | 40 mg of PO daily for two days; fasted for 48 hours | PO | q24h | 2 days | 🌎 NA |
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
오메프라졸은 수의학에서 위십이지장 궤양 및 미란의 치료와 예방에 널리 사용되는 매우 효과적인 프로톤 펌프 억제제(PPI)입니다.
- 우수한 효능: 알래스카 썰매견의 운동 유발성 위염 예방 연구에서 입증되었듯, 위내 pH를 높이는 데 있어 H2 수용체 길항제(예: 파모티딘)보다 우수한 것으로 간주됩니다.
- 말에서의 사용: 경구용 페이스트 제제는 말의 위궤양(EGUS) 치료 및 예방용으로 승인되었으며 매우 효과적입니다.
- 광범위한 적용: 개, 고양이, 페럿, 돼지 등 다양한 종에서 요독성 위병증, 식도염, 헬리코박터 감염, NSAID/코르티코스테로이드 유발성 궤양 등을 관리하는 데 사용됩니다.
임상 팁: 오메프라졸은 활성화를 위해 산성 환경이 필요하지만 흡수 전 위산에 의해 분해될 수 있으므로 인체용 경구 제제는 장용 코팅이 되어 있습니다. 약물의 생체 이용률을 파괴할 수 있으므로 절대 부수거나 씹어서 먹여서는 안 됩니다.
작용 기전
Omeprazole is a prodrug that acts as a substituted benzimidazole gastric acid pump inhibitor.
- Absorption & Distribution: After absorption, it diffuses from the blood into the highly acidic secretory canaliculi of the gastric parietal cells.
- Activation: In this acidic environment (pH < 3), it is protonated and rearranged into its active form, a sulphenamide derivative.
- Irreversible Binding: The active sulphenamide binds irreversibly via disulfide bonds to the H⁺/K⁺ ATPase enzyme (the proton pump) at the secretory surface.
- Acid Suppression: This blocks the final common pathway of gastric acid secretion, inhibiting the transport of hydrogen ions into the stomach lumen during both basal and stimulated conditions.
Pharmacological Note: Because the binding is irreversible, acid secretion only resumes when new H⁺/K⁺ ATPase enzymes are synthesized. This explains why its duration of action (24-72 hours) far outlasts its short plasma half-life (~1 hour). Omeprazole also inhibits the hepatic cytochrome P-450 mixed-function oxidase system, which can lead to drug interactions.
안전성·주의사항
금기사항
- Known hypersensitivity to omeprazole
부작용
- GI distress (anorexia, colic, nausea, vomiting, flatulence, diarrhea)
- Hematologic abnormalities (rare)
- Urinary tract infections
- Proteinuria
- CNS disturbances
- Urticaria (rare in horses)
주의
Use with caution in patients with severe hepatic or renal disease, as the drug's half-life may be prolonged and dosage adjustment may be necessary. Safety during pregnancy is not fully established (FDA Category C); high doses in lab animals showed embryo-lethality. Nursing is discouraged due to potential adverse effects in infants and tumorigenicity seen in rat studies. Chronic very high doses in rats caused enterochromaffin-like cell hyperplasia and gastric carcinoid tumors, though the clinical significance for standard veterinary use (e.g., 4 weeks in dogs, 90 days in horses) is believed to be low.
약물 상호작용
Omeprazole may potentially alter benzodiazepine metabolism and prolong CNS effects
Increased levels of omeprazole, clarithromycin and 14-hydroxyclarithromycin are possible
Omeprazole may decrease oral absorption
Omeprazole may reduce cyclosporine metabolism
Omeprazole increases gastric pH, which may decrease the absorption of these drugs that require an acidic environment
Omeprazole may increase anticoagulant effect
모니터링
- Clinical efficacy (resolution of clinical signs of ulcers/esophagitis)
- Adverse effects (GI distress)
- Liver enzymes (may increase)
- Serum gastrin levels (will increase early in therapy)
약동학
반감기
흡수
Rapidly absorbed from the gut. The human commercial product is in an enteric-coated granule form as the drug is rapidly degraded by stomach acid. The equine paste is not enteric coated. In humans, peak serum levels occur within 0.5-3.5 hours and onset of action within 1 hour.
분포
Distributed widely, but primarily concentrates in gastric parietal cells. In humans, approximately 95% is bound to albumin and alpha1-acid glycoprotein. It is unknown whether omeprazole enters maternal milk.
대사
Extensively metabolized in the liver via the cytochrome P-450 mixed function oxidase system to at least six different metabolites. Significant hepatic dysfunction will reduce the first pass effect of the drug.
배설
Metabolites are excreted principally in the urine, but also via the bile into feces.
과다투여
The LD50 in rats after oral administration is reportedly >4 grams/kg. Humans have tolerated oral dosages of 360 mg/day without significant toxicity.
Should a massive overdose occur, treat symptomatically and supportively. Due to its wide safety margin, acute toxicity from accidental ingestion is generally mild.
제품
제형
- Oral paste
- Delayed-release capsules (enteric-coated)
- Delayed-release tablets (enteric-coated)
- Powder for oral suspension (with sodium bicarbonate)
- Immediate-release capsules (with sodium bicarbonate)
동물용의약품
- Omeprazole Oral Paste, 2.28 g per syringe; Gastrogard® (Merial), (Rx)
- Omeprazole Oral Paste, 2.28 g per syringe; Ulcergard® (Merial), (OTC)
인용의약품
- Omeprazole Oral Delayed-Release Capsules: 10 mg, 20 mg & 40 mg; Prilosec®
- Omeprazole Oral Delayed-Release Tablets: 20 mg; Prilosec® OTC
- Omeprazole/Sodium Bicarbonate Oral Capsules (Immediate Release): 20 mg or 40 mg omeprazole with 1,100 mg sodium bicarbonate; Zegerid®
- Omeprazole/Sodium Bicarbonate Powder for Oral Suspension: 20 mg or 40 mg omeprazole with 1,680 mg sodium bicarbonate; Zegerid®
규제 현황
규제 데이터 없음: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Omeprazole oral paste should be stored below 86°F (30°C). Transient exposure to temperatures up to 104°F is permitted. Omeprazole tablets/capsules should be stored at room temperature in light-resistant, tight containers. Omeprazole pellets found in the capsules are fragile and should not be crushed.
보호자 정보
- 투약 시간이 중요합니다: 이 약은 공복, 가급적 아침 식사 30~60분 전에 투여하십시오. 약물이 작용하려면 활성화된 프로톤 펌프가 필요한데, 이는 식사에 의해 자극됩니다.
- 부수거나 씹지 마십시오: 인체용 캡슐이나 정제를 사용하는 경우, 위산에 견딜 수 있도록 특수 코팅이 되어 있습니다. 부수거나 씹으면 약물이 흡수되기 전에 파괴됩니다.
- 캡슐을 열어 알갱이를 먹여야 하는 경우, 알갱이를 부수지 말고 소량의 과일 주스(물, 우유, 식염수 불가)와 부드럽게 섞어 즉시 먹이십시오.
- 반려동물에게 지속적인 구토, 설사 또는 식욕 부진이 나타나면 수의사에게 연락하십시오.
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