奧美拉唑
Omeprazole
5-methoxy-2-[[(4-methoxy-3,5-dimethyl-2-pyridinyl)methyl]sulfinyl]-1H-benzimidazole
別名: Gastrogard · Prilosec · Ulcergard · Zegerid · H-168/68 · omeprazolum
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
雪貂
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Short-term treatment of gastroenteritis | 0.7 mg/kg PO q24h | PO | q24h | Short-term | 🌎 NA |
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
豬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Ulcer management | 40 mg of PO daily for two days; fasted for 48 hours | PO | q24h | 2 days | 🌎 NA |
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
奧美拉唑 (Omeprazole) 是一種高效的質子幫浦抑制劑 (PPI)，在獸醫學中廣泛用於治療和預防胃十二指腸潰瘍與糜爛。
- 卓越的療效： 在提高胃內 pH 值和預防運動誘發的胃炎（如阿拉斯加雪橇犬的研究所示）方面，通常被認為優於 H2 受體拮抗劑（如法莫替丁）。
- 馬匹應用： 口服糊劑配方專門用於治療和預防馬匹胃潰瘍 (EGUS)，且效果顯著。
- 廣泛應用： 適用於多種動物（包括犬、貓、雪貂和豬），用於處理尿毒症性胃病、食道炎、幽門螺旋桿菌感染以及非類固醇消炎藥 (NSAID)/皮質類固醇引起的潰瘍。
臨床要點： 由於奧美拉唑需要酸性環境來活化，但在吸收前會被胃酸破壞，因此人類口服製劑均帶有腸溶衣。絕對不可壓碎或咀嚼，否則會破壞藥物的生物利用度。
作用機制
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.
安全性與警告
禁忌症
- Known hypersensitivity to omeprazole
不良反應
- GI distress (anorexia, colic, nausea, vomiting, flatulence, diarrhea)
- Hematologic abnormalities (rare)
- Urinary tract infections
- Proteinuria
- CNS disturbances
- Urticaria (rare in horses)
注意事項
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.
藥物相互作用
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
監測
- 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)
藥物動力學
半衰期
吸收
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.
分佈
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.
代謝
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.
排除
Metabolites are excreted principally in the urine, but also via the bile into feces.
過量
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.
可用產品
劑型
- 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)
獸醫用
- Omeprazole Oral Paste, 2.28 g per syringe; Gastrogard® (Merial), (Rx)
- Omeprazole Oral Paste, 2.28 g per syringe; Ulcergard® (Merial), (OTC)
人用標示
- 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®
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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.
飼主須知
- 給藥時間很關鍵： 請在空腹時給予此藥物，最好是在早上，飯前 30 到 60 分鐘。藥物需要活躍的質子幫浦才能發揮作用，而進食會刺激這些幫浦。
- 請勿壓碎或咀嚼： 如果使用人類的膠囊或錠劑，它們具有特殊的腸溶衣以抵抗胃酸。壓碎或咀嚼會使藥物在吸收前就被破壞。
- 如果必須打開膠囊餵食顆粒，請將顆粒與少量果汁（不可用水、牛奶或生理食鹽水）輕輕混合後立即餵食，切勿壓碎顆粒。
- 如果您的寵物出現持續嘔吐、腹瀉或食慾不振，請聯繫您的獸醫師。
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