Proton pump inhibitors (PPIs) – omeprazole

Last updated on September 26, 2024

Generic name

omeprazole

 Strength

20 mg
Form tablet/capsule

Criteria

Approval period

1. For gastroesophageal reflux disease (GERD), reflux esophagitis, duodenal ulcer or gastric ulcer

Indefinite

OR  

2. For Barrett's esophagus, Zollinger-Ellison syndrome, connective tissue disease, e.g., lupus, scleroderma, CREST

Indefinite

OR  

3. For eradication of Helicobacter pylori as part of triple therapy

Maximum 14 days

PLUS  

Failure of reasonable trials of, or intolerance to, rabeprazole AND pantoprazole magnesium
 
 

Practitioner exemptions

  • No practitioner exemptions.

Special notes

  • CREST is an acronym for the five main features of the limited form of scleroderma: calcinosis, Raynaud’s disease, esophageal dysmotility, sclerodactyly, and telangiectasia.
  • Reasonable trials of rabeprazole and pantoprazole magnesium will be considered a trial at usual adult doses for at least 4 weeks for each of the two reference PPIs.

Special Authority requests