Miracid Dosage/Direction for Use

Recommended Doses: Duodenal ulcer: For the short-term treatment of active duodenal ulcer, the usual adult dosage of omeprazole is 20 mg once daily. Therapy should be continued until healing occurs, usually within 2-4 weeks; some patients may benefit from an additional 4 weeks of therapy. Occasionally, dosages up to 40 mg daily may be necessary in patients who have been poorly responsive to therapy with H₂-receptor antagonists.
Duodenal ulcer associated with Helicobacter pylori: When omeprazole is used in combination with clarithromycin (dual therapy) for the treatment of Helicobacter pylori infection in patients with active duodenal ulcer, the usual adult dosage of omeprazole is 40 mg once daily (in the morning) for 14 days. In patients who have an active ulcer present at the time anti-H. pylori therapy is initiated, an additional 14 days of therapy with omeprazole 20 mg once daily is recommended for ulcer healing and symptom relief. When omeprazole is used in combination with clarithromycin and amoxicillin (triple therapy) for the treatment of H. pylori infection in patients with active duodenal ulcer, the usual adult dosage of omeprazole is 20 mg twice daily (morning and evening) for 10 days. In patients who have an active ulcer present at the time anti-H. pylori therapy is initiated, an additional 18 days of therapy with omeprazole 20 mg once daily is recommended for ulcer healing and symptom relief.
Gastric ulcer: For the short-term treatment of active benign gastric ulcer, the usual adult dosage of omeprazole is 40 mg once daily for 4-8 weeks.
Gastroesophageal reflux: For the short-term, symptomatic treatment of gastroesophageal reflux disease (GERD) without erosive esophageal lesions, the usual adult dosage of omeprazole is 20 mg once daily for 4 weeks.
For those with erosive esophagitis, the usual adult dosage of omeprazole is 20 mg once daily for 4-8 weeks. Occasionally, dosages up to 40 mg daily may be necessary in some patients. Therapy is continued until healing occurs, usually within 4-8 weeks; an additional 4 weeks therapy (up to 12 weeks for a single course) may contribute to healing and symptomatic improvement in some patients.
Pathologic GI hypersecretory conditions: For the treatment of pathologic GI hypersecretory conditions (e.g. Zollinger-Ellison syndrome), dosage of omeprazole should be individualized according to patient response and tolerance. The usual initial adult dosage is 60 mg once daily and therapy continued as long as clinically necessary. Daily dosages exceeding 80 mg should be administered in divided doses. A dosage up to 120 mg three times per day have been administered. Determination of gastric acid secretion during the hour prior to a dose may be useful in establishing optimum dosage.
Dosage in renal and hepatic impairment: Although pharmacokinetics may be altered in patients with renal impairment, dosage adjustment does not appear necessary in patients with such impairment. However, dosage adjustment should be considered in patients with hepatic impairment, particularly in such patients receiving long-term omeprazole therapy for maintenance or healing of erosive esophagitis. Some clinicians recommend that such patients with hepatic dysfunction receiving dosages exceeding 20 mg daily should be monitored closely for possible adverse effects.
Dosage in geriatric patients: Dosage adjustment solely on the basis of age generally is not required for geriatric patients especially when used short-term. However, since the bioavailability of omeprazole appears to be increased substantially in Asians, dosage adjustment should be considered in Asian patient especially when receiving long-term treatment for maintenance of healing of erosive esophagitis.
There is no evidence from omeprazole prescription safety database that Asians experience excess risk from omeprazole or that accumulation of omeprazole in the blood is harmful when used over a short period of time (e.g., 14 days of self-medication) in Asian patients.
Mode of Administration: Omeprazole should be taken before meal (most effective when given about 30 minutes prior to meals). Omeprazole usually is administered once daily in the morning. Patients should be advised that the capsules must be swallowed intact and not opened, chewed or crushed.