Adults

For most conditions (e.g., GERD, ulcers), 20-40 mg once daily, usually 30-60 minutes before a meal. Duration depends on the specific condition and response.

Elderly

No specific dose adjustment is generally required, but caution should be exercised in elderly patients with severe hepatic impairment.

Renal_impairment

No dose adjustment is needed for patients with mild to moderate renal impairment. Data are limited for severe impairment.

Onset

Significant acid suppression occurs within 1-2 hours, with maximal effect observed within 5 days of repeated daily dosing.

Excretion

Approximately 80% of the metabolites are excreted in the urine and the remaining 20% in the feces.

Half life

Approximately 1.5 hours.

Absorption

Rapidly absorbed after oral administration. Bioavailability is approximately 50-60% after a single dose and increases to about 68% with repeated daily dosing.

Metabolism

Extensively metabolized in the liver via the cytochrome P450 system (primarily CYP2C19 and CYP3A4).

Warfarin

Increased INR and prothrombin time, monitor for bleeding.

Clopidogrel

Reduced antiplatelet effect, concurrent use generally not recommended.

Methotrexate

Increased methotrexate levels, especially with high doses, monitor for toxicity.

Nelfinavir, Atazanavir

Reduced plasma levels of antiretrovirals, avoid co-administration.

Diazepam, Citalopram, Phenytoin

Decreased metabolism, potentially increasing levels of these drugs.