Adults

Typical dosage is 20-40 mg once daily, usually in the morning before food. Duration varies by condition (e.g., 4-8 weeks for ulcers).

Elderly

No general dosage adjustment required, but caution with severe hepatic impairment.

Renal_impairment

No dosage adjustment necessary for patients with impaired renal function.

Onset

Acid inhibitory effect starts within 1 hour, maximal effect within 2 hours.

Excretion

Approximately 80% is excreted in the urine as metabolites, and the remainder in the feces.

Half life

Plasma half-life is 0.5-1 hour, but acid suppression effect lasts much longer due to irreversible binding.

Absorption

Rapidly absorbed after oral administration; bioavailability is approximately 30-40% due to first-pass metabolism.

Metabolism

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

Diazepam

Prolonged elimination of diazepam.

Warfarin

Increased INR and bleeding risk. Monitor INR closely.

Tacrolimus

Increased tacrolimus plasma concentrations. Monitor tacrolimus levels.

Clopidogrel

Reduced antiplatelet effect of clopidogrel. Avoid concomitant use if possible.

Methotrexate

Increased methotrexate levels, potentially leading to toxicity.