Nonencapsulated, intact omeprazole granules effectively suppress intragastric acidity when administered via a gastrostomy.
Because of its acid-labile nature, omeprazole is usually administered as encapsulated enteric-coated granules. The gelatin capsule and acid-resistant coating are essential for effective drug absorption and optimal bioavailability.


OBJECTIVE
This study tested the effectiveness of nonencapsulated, intact omeprazole granules in suppressing intragastric acidity when administered through a gastrostomy.


METHODS
Fourteen male patients with established gastrostomies underwent a baseline 24-h intragastric pH monitoring study while off any acid-suppressing medication. Via the gastrostomy, they then received 7 days of dosing with 20 mg omeprazole as intact granules in orange juice. Twenty-four-hour intragastric pH monitoring was repeated on the seventh day.


RESULTS
Mean intragastric pH during the baseline study was 1.8 (+/- SD 0.7). This pH increased to 4.9 +/- 0.8 with omeprazole granules (p < 0.0001). Median intragastric pH rose from 1.3 to 5.3 (p < 0.0001). During the baseline study, intragastric pH was above 3 for 21.2 +/- 14.1%, above 4 for 14.9 +/- 11.0%, and above 5 for 9.5 +/- 8.4% of the 24-h recording period. Corresponding values after 7 days of omeprazole were 80 +/- 15.1%, 72.5 +/- 16.3%, and 59.1 +/- 16.6% (p < 0.0001 for each comparison with pretreatment values).


CONCLUSIONS
Omeprazole effectively suppresses intragastric acidity when given through a gastrostomy tube as nonencapsulated, intact granules.
Sharma
V K
VK
Department of Internal Medicine, and W. J. B. Dorn Veterans' Affairs Medical Center, University of South Carolina School of Medicine, Columbia 29203-6808, USA.
Heinzelmann
E J
EJ
Steinberg
E N
EN
Vasudeva
R
R
Howden
C W
CW
D000368:Aged; D000897:Anti-Ulcer Agents / Q000008:administration & dosage*; D005744:Gastric Acid / Q000378:metabolism*; D005774:Gastrostomy; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage*; D013270:Stomach / Q000187:drug effects* / Q000503:physiopathology*
D000897:Anti-Ulcer Agents; D009853:Omeprazole