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Proton Pump Inhibitor

Omeprazole (Elderly)

Brand names: Losec, Prilosec

Used in: Gastrointestinal Bleeding

Omeprazole (in older people) is a proton pump inhibitor used for acid-related disorders such as reflux, peptic ulcer and gastroprotection; this page focuses on PPI use in the elderly.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It irreversibly inhibits the gastric H+/K+-ATPase (proton pump) in parietal cells, profoundly reducing gastric acid secretion.

Prescribing in practice

  • In older people review the ongoing need and deprescribe when possible, as long-term PPI use is associated with hypomagnesaemia, increased fracture risk, vitamin B12 deficiency, Clostridioides difficile and other enteric infections, and hyponatraemia.
  • It inhibits CYP enzymes and reduces the antiplatelet effect of clopidogrel; review interacting medicines.
  • PPIs can mask the symptoms of gastric cancer, so investigate alarm features before attributing them to benign reflux.

Monitoring

On prolonged therapy in older patients consider checking magnesium and, where relevant, vitamin B12, and periodically reassess whether continued treatment is needed.

Counselling the patient

  • Take before food, typically before breakfast, for best effect.
  • Tell a clinician about muscle cramps, tingling or persistent diarrhoea on long-term use.

Evidence & guidelines

MHRA advice notes the risk of hypomagnesaemia and fractures with prolonged PPI use, supporting periodic review and deprescribing in older adults.

Reference: NICE NG1; SIGN 142; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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