Gastritis: Atrophic gastritis has been noted occasionally in gastric corpus biopsies from patients treated long-term with omeprazole and esomeprazole.
Hepatic effects: In patients with various degrees/types of hepatic disease, the area under the curve (AUC) was prolonged (lansoprazole, esomeprazole, rabeprazole, pantoprazole), half-life was prolonged (lansoprazole, omeprazole, rabeprazole, pantoprazole), increased bioavailability was observed (omeprazole), decreased clearance with rabeprazole and increased maximum pantoprazole concentrations.
Gastric malignancy: Symptomatic response to therapy with proton pump inhibitors does not preclude gastric malignancy.
Use in Pregnancy: Category C (omeprazole); Category B (lansoprazole, rabeprazole, pantoprazole, esomeprazole).
Use in Lactation: Omeprazole has been measured in the breast milk. Because of the potential for serious adverse reactions in breast-feeding infants, decide whether to discontinue breast-feeding or to discontinue the drug, taking into account the importance of the drug to the mother.
Use in Children: The safety and efficacy of omeprazole have not been established for pediatric patients younger than 2 years of age.
Use in Elderly: The elimination rate of omeprazole was somewhat decreased in the elderly and the bioavailability increased.