Omeprazole in Zollinger-Ellison syndrome

Corleto V, Annibale B, D Ambra G, Saggioro A, Ferrua B, Cassetta MR, Della Fave G (1993) Efficacy of long-term therapy with low doses of omeprazole in the control of gastric acid secretion in Zollinger-Ellison syndrome patients. Aliment Pharmacol Therl 167-173... 

Clissold, S. P., Campoli-Richaeds, D. M., Omeprazole. A preliminary review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in peptic ulcer disease and Zollinger-Ellison syndrome, Drugs 1986, 32, 15-47. 

In patients with Zollinger-Ellison syndrome, omeprazole causes significant weight gain, perhaps because of shifts in hormonal balance (SEDA-17, 419 897,898). 

Patients who are unsuited to receive oral therapy, omeprazole sodium may be given on a short-term basis by intravenous infusion, in a usual dose equivalent to 40 mg of the base over a period of 20-30 min in 100 ml of sodium chloride 0.9% or glucose 5%. It may also be given by slow intravenous injection. Higher intravenous doses have been given to patients with Zollinger-Ellison syndrome [1]. 

H2-receptor antagonists are quite effective in some peptic acid disorders (duodenal ulcers, gastric ulcers), whereas their effectiveness in others is less apparent (Zollinger-Ellison syndrome, gastrooesophageal reflux disease) [22]. For such conditions, prolonged and potent reduction of acid secretion caused by H /K -ATPase inhibitors is necessary and results in superiority of omeprazole over H2-receptor antagonists [25, 26]. 

Omeprazole effectively inhibits gastric secretion by inhibiting the gastric H+, K+-ATPase. " This enzyme is responsible for gastric acid production and is located in the secretory membranes of parietal cells. Thus, omeprazole is proposed as an anti-ulcerative drug, specially in the treatment of Zollinger-Ellison syndrome. " ... 

The interaction between voriconazole and omeprazole is established but no adjustment to the dose of voriconazole is required. The clinical importance of the marked rise in serum omeprazole levels caused by voriconazole is not established, but the manufacturers recommend that the omeprazole dose be halved, although the US manufacturers restrict this to patients taking omeprazole 40 mg or more. The increase in levels of esomeprazole by voriconazole does not routinely require a dose adjustment of esomeprazole However, patients taking esomeprazole in doses of more than 240 mg daily (e.g. for Zollinger-Ellison syndrome) may require a dose adjustment. ... 

Vinayek R, Frucht H, London JF, et al. Intravenous omeprazole in patients with Zollinger-Ellison syndrome undergoing surgery. Gastroenterology 1990 99( 1) 10-16. 

Delchier JC, Soule JC, Mignon M, Goldfain D, Cortot A, Travers B, Isal JP, Bader JP (1986) Effectiveness of omeprazole in seven patients with Zollinger-Ellison syndrome resistant to histamine H2-receptor antagonists. Dig Dis Sci 31 693-699... 

Bardram L, Stadil F (1986) Omeprazole in the Zollinger-Ellison syndrome. Scand J Gastroenterol 21 374-378... 

Lloyd-Davies KA, Rutgersson K, Solved L (1988) Omeprazole in the treatment of Zollinger-Ellison syndrome a 4-year international study. Aliment Pharmacol Ther 2 13-32... 

Vinayek R, Amantea MA, Maton PN, Frucht H, Gardner JD, Jensen RT (1991) Pharmacokinetics of oral and intravenous omeprazole in patients with the Zollinger-Ellison syndrome. Gastroenterology 101 138-147... 

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